Outcomes of the Development of an Initial Assessment and Nursing Management Guideline for Older Persons with Sepsis in Emergency Department
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Abstract
Objective: The purpose of this study was to develop and evaluate clinical nursing practice guideline (CNPG) of an initial assessment and nursing management for older persons with sepsis in emergency department (ED), Hat-Yai hospital. Methods: Participants were 38 emergency nurses and 120 older persons with sepsis admitted in ED. The content validity of this CNPG examined by 3 experts was 1.00, and reliability of nurses’ records for initial assessment and nursing management for older persons with sepsis, using the percentage of agreement was 1.00. Data were analyzed using descriptive statistics. Results: The results showed that contents of this developed CNPG composed of 5 elements; (1) assessment, (2) identify nursing diagnosis, (3) nursing care, (4) evaluation of nursing care, and (5) evaluation of clinical outcomes. The clinical outcomes showed that 5.83% of older persons had a decrease in the search out severity (SOS) score; 77.67% of older persons received antibiotics within 1 hour; 59.17% of older persons had the length of stay in the ED less than 2 hours; and 85.71% of older persons admitted to an intensive care unit. The feasibility of implementing this CNPG perceived by emergency nurses was at a high level in total and each item (M=4.34, SD=.70 in total). Conclusion: According to the outcomes of this study, the CNPG could be implemented in the ED to help emergency nurses in applying a standard of care for older persons with sepsis, which will result in an optimal care delivered to older persons, and also improve nursing outcomes and clinical outcomes.
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