Development of a Clinical Nursing Practice Guideline for Prevention of Acute Delirium in Elderly Undergoing Gastrointestinal Surgery
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Date
2010-04-01
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Thailand Nursing and Midwifery Council
Abstract
This clinical nursing practice guideline (CNPG) for preventing acute delirium in elderly after gastrointestinal surgery was established by using evidence-based practice (EBP) model of Soukup (2000). Strategies for developing CNPG according to this model were Evidence triggered phase, Evidence supported phase, Evidence observed phase and Evidence-based phase. This study was only conducted to phase 3 of EBP model. Evaluation of research quality, scientific merit and feasibility of research results implementation was performed. From 14 evidence based, there were 2 CNPGs, 2 randomized controlled trials, 1 quasi experimental study, 7 cohort studies, and 2 retrospective studies. The summary of findings from those evidence-based studies was used to establish CNPG including assessment of risk factors for acute postoperative delirium, nursing intervention related to risk level assessment, and control of risk factors including promoting perception among elderly patients who has cognitive impairment, prevention and monitor contagious diseases, balancing water substance and electrolyte, accidental prevention, and controlling of postoperative pain. The validation of this CNPG was verified by 3 experts, were 1 gastrointestinal surgical doctor, 1 expert nurse instructor in caring for elderly patients after gastrointestinal surgery, and 1 expert surgical nurse in caring for elderly. The recommendations for nursing practice were mentioned. The CNPG should include a pilot study in order to evaluate the process and outcomes of this CNPG. The application into practice should be related to the organizational culture for maintaining continuous quality improvement. Evaluation for short and long terms outcomes from this CNPG implementation should be performed using outcome research.
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Thai Journal of Nursing Council; Vol.23 No.2 April-June 2008; 26-37