Development of clinical nursing practice guideline based on evidence-based practice for prevention of surgical site infection (CNPG SSI) in a patient undergoing mitral valve replacement procedure at Sunpasitthiprasong Hospital
Keywords:clinical nursing practice guideline, evidence-based practice, mitral valve replacement, preventing surgical site infection
This research and development design was aimed to develop the clinical nursing practice guideline (CNPG) based on evidence-based practice (EBP)for the prevention of surgical site infection (SSI) in a patient undergoing a mitral valve replacement procedure at Sunpasitthiprasong hospital and to study results of using CNPG. Research method composed of 2 phases; The first phase was to develop CNPG base on the conceptual for translating EBP into clinical practice guidelines suggested by Joanna Briggs Institute (JBI). The second phase was to evaluated the implementation of CNPG SSI. The purposive sample were 26 perioperative nurses and nine patients undergoing mitral valve replacement procedures. The research instruments were: 1) CNPG SSI quality agreement of experts using The AGREE II and the nursing practice record form, 2) surgical patient record form and 3) prevention assessment SSI form. The quantitative data were analyzed using descriptive statistic.
The results indicated that: 1) The first phase of the CNPG SSI development were: (1) preoperative phase including patient information and knowledge, (2) intraoperative phase including techniques for preventing infection surgical site, preparing instrument and equipment, inspection of artificial heart valves, stimulates the heartbeat with warm normal saline solution and keep warm, and (3) postoperative phases and transfer patients to ICU including monitoring blood circulation, respiratory rate and keep warm. 2) The second phase of outcomes of CNPG SSI evaluation were: (1) no sign of sternal wound infection in nine patients after 72 hours (2) CNPG SSI evaluated by nurses was 96.29% practical in all steps.
This study suggests that the CNPG SSI could be applied appropriately in the hospital and should be improved for updated CNPG currently.
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