การพัฒนาแนวปฏิบัติการพยาบาลผู้ป่วยขณะคาท่อระบายทรวงอก โดยใช้หลักฐานเชิงประจักษ์ ในหอผู้ป่วยอายุรกรรม

Abstract

          Intercostal chest drains (ICD) is an important procedure to drain blood, air, water orpus from the pleural space. During 2013-2015, there was an increasing number of this procedure at ward of Internal Medicine. The reviews at Sanpasitthiprasong Hospital on procedures had shown that 1) no clear guideline for nursing practice, 2) the risk incidences found during patients were on ICD, 3) different of nursing practice among patient with ICD. The
aim of this study was to develop a nursing practice guideline for the patients with thoracic drainage at ward of Internal Medicine (male 4th floor) at Sanpasitthiprasong Hospital using the concept of the Soukup. The evidence basis for the development consisted of nine clinical researches and related literatures due to their quality, application and working context. Comments and suggestions from the researches were analyzed and synthesized as a draft of nursing practice guideline for patients with ICD, consisting of 2 main activities, which included 18 issues of nursing practice for effective chest drainage and 8 issues of pulmonary rehabilitation and prevention of complications. Then the guideline was evaluated by 5 experts upon the criteria of AGREE II with scores of 85-90 percent. The practices applied to 10 patients at ward of internal medicine resulted in a decreased number of complications and good pulmonary rehabilitation. Moreover, almost all the nurses agreed that the guideline can be practiced as routine nursing care.