The Development of Clinical Nursing Practice Guideline for Patients with Diabetic Ketoacidosis in Critical Phase
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Abstract
This research and development study aimed to develop clinical nursing practice guidelines (CNPG) for patients with diabetic ketoacidosis in the critical phase and to evaluate the results of applying the developed CNPG. The study was conducted in a medical ward, Rajavithi Hospital, during January 2019-October 2020, which consisted of 4 phases, as follows: 1) situation analysis, 2) CNPG development, 3) implementation of CNPG, and 4) the CNPG outcome evaluation. The development process was conducted based on the Deming cycle and the concept of CNPG development of the National Health and Medical Research Council; Australia. A purposive sampling method was used to select samples, which were 1) 40 registered nurses, and 2) 70 DKA patients composed of 35 allocated to a control group and 35 to an experimental group. The data were analyzed using frequency, percentage, mean, standard deviation and paired t-test statistics. The study found that CNPG for patients with diabetic ketoacidosis was divided into 4 phases: 1) critical phase, 2) post-critical phase, 3) discharge planning phase, and 4) return for follow-up examination phase. The CNPG was then evaluated. It was found that 1) the duration of time of the patients were out of ketone retention decreased from 28.23 hours to 16.18 hours, 2) none was re-admitted to the hospital within 28 days, 3) glycemic control increased from 11.4% to 35.1%, 4) the mean behavioral score of glycemic control of the experimental group after using CNPG was significantly higher than before using the CNPG for each item and overall at the 0.05 level, and 5) the majority of registered nurses (86.25%) reported a high score on the application of the CNPG. However; nursing practice based on this CNPG should be continuously monitor using PDCA process to cover all categories and all issues.
Article Details
บทความและรายงานวิจัยในวารสารพยาบาลกระทรวงสาธารณสุข เป็นความคิดเห็นของ ผู้เขียน มิใช่ของคณะผู้จัดทำ และมิใช่ความรับผิดชอบของสมาคมศิษย์เก่าพยาบาลกระทรวงสาธารณสุข ซึ่งสามารถนำไปอ้างอิงได้
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