The Development of Anesthetic Nursing Practice Guidelines for Hepatectomy in Sunpasitthiprasong Hospital : Enhanced Recovery After Surgery,ERAS
Keywords:
nursing practice guidelines, anesthesia, liver surgery, Enhanced Recovery After SurgeryAbstract
This research and development study aimed to examine the current nursing practices for patients undergoing liver surgery under general anesthesia and to develop and evaluate a set of nursing practice guidelines to promote postoperative recovery. The study integrated Soukup’s evidence-based development framework, the Enhanced Recovery After Surgery (ERAS) concept, and King’s Goal Attainment Theory. The study was conducted in two phases: Phase I involved analysis of the situation and development of the guidelines; Phase II evaluated the effectiveness of the implemented nursing guidelines. The participants included 34 liver surgery patients (17 in the intervention group and 17 in the control group) and 78 professional nurses. Research instruments consisted of: (1) the developed nursing practice guideline and (2) outcome evaluation tools, including a perceived feasibility questionnaire, a nurse satisfaction scale, pain assessment, bowel function assessment, and early mobilization records. Data were analyzed using descriptive statistics (frequencies, percentages, means, and standard deviations) and inferential statistics (Chi-square tests and Independent t-tests).
Results demonstrated that the intervention group reported significantly lower pain levels (t=-4.715, p<.001), better bowel function (t=3.711, p<.004), and earlier postoperative mobilization (t= 3.082, p<.001) than the control group. Moreover, 97.44% of nurses perceived the guideline as highly feasible for implementation, and 93.59% expressed high satisfaction. This indicates that the developed nursing guidelines can be adopted as a standardized protocol for liver surgery care to enhance care quality, reduce care variability, and improve health system efficiency.
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