Development of a Thirst Relief Bundle for Patients Undergoing Abdominal Surgery
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Abstract
Propose: To develop a clinical nursing practice guideline, the Thirst Relief Bundle, to reduce thirst and dry mouth for patients undergoing abdominal surgery in the surgical intensive care unit.
Design: A clinical nursing practice guideline development.
Methods: The model of the Center for Advanced Nursing Practice (Soukup) was used as a conceptual framework to develop the Thirst Relief Bundle. There were 4 phases, including 1) evidence triggered, 2) evidence supported, 3) evidence observed, and 4) evidence-based phases. This study was focused on Phases 1 through 3. Based on a literature review using the PICO framework and the evaluation of evidence quality using the Joanna Briggs Institute Levels of Evidence; 10 studies were included. The AGREE II assessment and the content validity evaluation of this guideline were verified by five experts. Then, the guideline was implemented for a trial with two patients in a surgical intensive care unit.
Main findings: The findings of the analyses and syntheses of all the literature were divided into three main elements: 1) risk factors related to thirst and dry mouth; 2) thirst and dry mouth assessment; and 3) nursing management for reducing thirst and dry mouth. The overall quality evaluation of the Thirst Relief Bundle was 90%, and the content validity index was .96. Afterward, the adjustment was conducted. The results of the trial showed that the guideline was able to reduce thirst in post-abdominal surgery patients. However, there was no difference in dry mouth symptoms before and after nursing management.
Conclusion and recommendations: The Thirst Relief Bundle developed from evidence-based support can be applied in practice to reduce thirst in post-abdominal surgery patients. However, nurses should be trained to enhance their knowledge and skills for implementing this guideline in their clinical contexts following the Soukup conceptual framework.
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