Journal of Nursing Science Christian University of Thailand

Effects of Development of Clinical Practice Guidelines for Weaning of Mechanical Ventilation among Patients with Brain Injury, Nakhon Pathom Hospital

2025-01-29T11:52:17+07:00

Purpose: This study aimed to develop and evaluate the effectiveness of clinical practice guidelines (CPGs) for weaning patients with brain injuries from mechanical ventilation at Nakhon Pathom Hospital.

Design: Research and development

Method: This study utilized the CPGs development framework from the National Health and Medical Research Council of Australia in conjunction with the systems theory. Participants consisted of 22 registered nurses, who implemented the guidelines, and 60 brain-injured patients on mechanical ventilation with 30 in the pre-implementation group and 30 in the post-implementation group. Data were collected using a feasibility assessment form and a practice guideline adherence recording form. Data analysis was conducted using descriptive and inferential statistics.

Main findings: The CPGs included four categories :1) the assessment of readiness for weaning from mechanical ventilation, 2) nursing during weaning and after extubation, 3) assessment of readiness for extubation, and 4) documentation. The guidelines were found to be highly feasible for implementation. The post-implementation group demonstrated significantly shorter weaning times and extubation durations compared to the pre-implementation group (p < .001). The incidence of re-intubation within 48 hours was significantly lower in the post-implementation group (p < .05), while there was no significant difference in the incidence of ventilator-associated pneumonia (p > .05).

Conclusion and recommendations: The use of the CPGs led to favorable outcomes. It is recommended that the guidelines be utilized and promoted continuously as a policy within nursing departments at the organizational level.

Effects of an Electronic Learning Program on Ostomy Nursing Skills and Retention of Knowledge Among New Graduate Nurses at Ratchaburi Hospital

2024-09-23T13:45:08+07:00

Objective: This study aimed to compare the knowledge and ostomy nursing skills of new graduate nurses before and after receiving a skill development program using electronic media. Additionally, it sought to assess the retention of learning about ostomy care among new graduate nurses.

Research Design: This quasi-experimental study used a one-group pretest-posttest design.

Methods: The sample consisted of 34 new graduate nurses working at Ratchaburi Hospital from 2021 to 2023. The skill development program utilized electronic media in the form of videos covering six topics related to ostomy care. Research instruments included a 20-item knowledge test on ostomy care and a 15-item nursing skills assessment. Data were analyzed using percentages, means, standard deviations, and Paired t-tests to examine changes in knowledge and skills.

Results: The results showed that the knowledge and nursing skills of new graduate nurses significantly increased after the program (p-value < 0.001). Furthermore, the knowledge at weeks 7 remained

Conclusion and Recommendations: The electronic media-based skill development program effectively enhanced the knowledge and nursing skills of new graduate nurses in ostomy care and contributed to sustained learning retention. It is recommended that online learning programs, such as video-based training, be continuously used to reduce the gap in hands-on experience in ostomy care and to boost nurses' confidence in their clinical practice.

Cultural Dietary Habits of Indigenous People in the North of Thailand

2025-02-27T15:10:07+07:00

Purpose: to explore the cultural dietary habits on patterns of food selection, preparation, and consumption of indigenous people who were middle-aged adults living in the north of Thailand.

Design: A qualitative research design

Method: Data were collected by in-depth interviews and focused group discussion using semi-structured interview questions during November to December 2024. There were 20 key informants from five selected indigenous people included Karen, Hmong, Tai Lue, Shan (Tai-Yai) and Tai-Yong. Data were analyzed by content analysis using summative approach.

Main findings: The cultural food consumption behaviors of the five indigenous tribes included seven themes consisted of the definition of good food, commonly eaten food, cooking methods and main ingredients, adjusting diet when working outside the house, the food for a new generation, and food taboos, and desserts.

Conclusion and recommendations: It could be summarized that there were some similarities and differences in cultural dietary habits of those five indigenous people. The results also reflected the influences of social and economic changes to the acculturation on dietary habits of the indigenous people which would affect their health status especially the younger generation in the future. It was suggested that the traditional food of the indigenous people should be preserved and health education about how to choose proper modern foods according to urban lifestyle should also provide.

Development of a Model for Admitting Patients According to Appointments to The Hospital in the Outpatient Surgery Department Using Lean Concepts

2024-07-28T23:30:51+07:00

Purpose: To 1) Develop a system for admitting patients by appointment to the hospital in the surgical department and 2) Evaluate the waiting time for admitting patients to the hospital and patients’ satisfaction of service.
Design: Action Research
Method: Surgery patients who came to make an appointment to stay in the at the surgery department at Samut Sakhon Hospital, total number of 43 people. Tools used in the research consisted of mainly quantitative tools used to collect data, such as 1) Service satisfaction questionnaires 2) Service duration record forms. The timer starts when the patient arrives at the outpatient service. Qualitative tools used to improve and develop the hospital admissions system are lean system tools, which consisted of 1) Drawing a value stream diagram (Flow process diagram) and 2) Creating operational standards of practice. Data were analyzed using descriptive statistics.
Main findings: The majority of the sample was male, accounting for 65.1% of the patients and with most of them being more than 60 years old, accounting for 51.2% of the patients. Patients who were appointed for a general surgery took up 76.74% of the patients. 32.6% had high blood pressure, 60.5% had graduated from primary school, 34.9% worked freelance. After the usage of the Lean system, we found that the time spent at each service point had lessen, using only 25 minutes on average with the overall satisfaction score being 4.44 with a standard deviation of 0.46.
Conclusion and recommendations: All units in the outpatient department are encouraged to use Lean concept in developing service system to increase service efficiency and the satisfaction of both recipients and service providers.
Keywords: Waiting time, Outpatient services, Lean concept

Effects of Facial Pressure Sore Prevention Program for Spine Surgery in Prone Position

2025-01-21T21:55:13+07:00

Purpose: Aimed to study the effects of a facial pressure sore prevention program in patients who received general anesthesia for spine surgery in prone position.

Design: Randomized controlled trial

Method: The sample consisted of 168 patients who underwent spinal surgery at Vajira Hospital, Faculty of Medicine Vajira Hospital, Navamindradhiraj University. A convenience sampling method was employed, with participants randomly assigned into experimental and control groups, each comprising 84 individuals. Data analysis was conducted using the chi-square test at a statistical significance level of 05.

Main findings: 1) The group of participants who received the facial pressure ulcer prevention program experienced a significantly lower incidence of facial pressure ulcers compared to the control group.

2) The participants who received the facial pressure ulcer prevention program had a lower stage of facial pressure ulcers than those in the control group.

Conclusion and recommendations: The results of the study will be used as guidelines for providing care to patients undergoing spinal surgery who receive general anesthesia in the prone position to prevent pressure sores on the face during surgery.