The Development of Nursing Care Model for Patients with Abdominal Aortic Aneurysm Undergoing Endovascular Aneurysm Repair
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Abstract
BACKGROUND: Endovascular aneurysm repair (EVAR) for patients with abdominal aortic aneurysm (AAA) requires a specialized surgical team. Apparently, the existing nursing care model is only a guideline for the care of patients undergoing general surgery. Consequently, the researchers developed the EVAR nursing care model. Implementing evidence-based practice that is accurate, up to date, and suitable for the context of surgery in Thailand is necessary. The EVAR care model can help reduce the mortality and morbidity rate, thereby enhancing quality of life for patients with AAA.
OBJECTIVES: This action research aimed to develop the nursing care model for patients undergoing EVAR, and study the effects of the EVAR care model on nursing outcomes.
METHODS: This study was divided into 2 phases including Phase 1: Development of the EVAR nursing care model using IOWA model, and Phase 2: Use of the EVAR care model. The samples comprised of health personnel involved in EVAR surgery. Fifty AAA patients undergoing EVAR matched pair by age and gender and then were divided equally into 2 groups (comparison & experimental groups). The research instruments consisted of a group discussion form, a behavior observation form for surgical personnel, the EVAR care model, a patient data recording form, a satisfaction assessment form surgical failure (SF) record as measured by its complications, duration of surgery (DS) and cost of surgery (CS) record, and post-operative length of stay record (P-LOS). Data were analyzed using descriptive statistics, Chi-square, and independent t-test.
RESULTS: The findings showed that the EVAR care model yielded overall quality at 76.4 %. Therefore, it met the standard for model quality (greater than 60%). 86.7% of the operating staff expressed satisfaction with the model’s application at the highest level. In addition, there were no statistically significant differences in SF, DS, or P-LOS for both groups. There was statistically significant different in CS between both groups (t = 2.28, p < 0.05).
CONCLUSIONS: The EVAR care model is an innovation for care focusing on healthcare outcomes. Broad implementation of the EVAR care model and monitoring of its effectiveness to promote quality of care are recommended. A longitudinal study focused on potential complications is also recommended.
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References
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