Development and Evaluation of Clinical Nursing Practice Guideline for Promoting Recovery in Elderly Patients After Abdominal Surgery

Abstract

Objective: Develop and evaluate the effectiveness of a nursing practice guideline for enhancing recovery after abdominal surgery in elderly patients. Methods: Applied the quality of care model of the National Medical and Health Research Council Australia (2000) and the review of evidence related to enhancing recovery after abdominal surgery to guide this study that consisted of 2 stages: 1) developing the clinical nursing practice guideline (CNPG), and 2) evaluating the guideline. Stage 1: developing the clinical nursing practice guideline revealed that: the newly developed nursing practice guideline has 3 components: 1) pre-operative care; 2) immediate postoperative care - 24 hours after surgery; and 3) postoperative care days 1-7. There were three categories of recovery indicators: 1) clinical outcomes; 2) psychosocial outcome; and 3) the functional ability. The content validity index of the guideline verified by three experts was 0.96. Stage 2: The evaluation was conducted in 14 nurses and 25 male older patients. Results: The findings of this study revealed that: 1) Fifty-seven point one percent of nurses who used the CNPG rated the overall feasibility of the CNPG at a high level (Mode 3) 2) One hundred percent of nurses who used the CNPG rated their satisfied at a high level, 3) Level of recovery after abdominal surgery among elderly patients in three aspects was better than before using the CNPG, and 4)Seventy-six percent of elderly patients after abdominal surgery were satisfied with the care following the CNPG at a high level (M = 2.93, SD = 0.27). Conclusion: This CNPG should be continually applied in similar settings. Future research should be conducted to measure long-term clinical outcomes, such as postoperative complications and cost outcome.