Development of Clinical Practice Guidelines for the Care of patients with Bloodstream Infections at Nongphok Hospital, Roi Et Province

Abstract

This action research aimed to develop a clinical practice guideline for the care of patients with sepsis at Nong Phok Hospital, Roi Et Province. The process involved participation from relevant agencies and was conducted over a period of 20 weeks. It was divided into three phases: studying the context and analyzing the situation, developing the practice guideline, and testing and evaluating the results. The target groups consisted of those participating in the development of the clinical practice guideline for the care of patients with sepsis, totaling 9 persons: 1 physician from Nong Phok Hospital, 5 professional nurses, and 3 public health academic officers. The group that implemented the guideline consisted of 41 professional nurses from Nong Phok Hospital, Roi Et Province. The tools used were interview forms, observation, medical record forms, and questionnaires. The quality of the tools was verified by content validity, reliability, and credibility. Data were analyzed using content analysis and paired t-test at a significance level of 0.05.

The results showed that the development of the practice guideline significantly increased the knowledge of professional nurses (p<0.001), with the average knowledge score increasing by 5.10 points, and satisfaction with the guideline increasing by 17.29 points after implementation. In addition, the patient care outcomes found that the lactate follow-up rate increased from 42.7 percent to 96.4 percent, the mortality rate decreased to 0 percent, and the unplanned referral rate decreased from 55.9 percent to 28.6 percent when compared with the data before the development of the guideline. The new practice guideline helped to solve the problems found in the previous care system, including delayed detection of sepsis, unstructured symptom assessment, lack of standard physician reporting, and incomplete documentation. This led to more efficient screening, treatment, and patient follow-up. It is concluded that the development of the clinical practice guideline for the care of patients with sepsis at Nong Phok Hospital increased efficiency in screening, treatment, and patient follow-up, reduced mortality rate, and significantly improved staff satisfaction. The guideline should be expanded to other community hospitals together with continuous training to improve the quality of patient care sustainably.