Development of Nursing practice Guidelines for Rehabilitation Stroke Patients for Subdistrict Health Promoting Hospital, Muang Ubon Ratchathani Province.

Abstract

     The action research project focused on creating nursing practice guidelines for caring for stroke patients during the ongoing home care phase, specifically for sub-district health promotion hospitals in Mueang Ubon Ratchathani District. The target group for developing these guidelines included 25 participants, with 7 experts involved in evaluating the model. The implementation phase involved two sample groups: 1) 20 professional nurses from sub-district health promotion hospitals, and 2) 20 stroke patients receiving continuous care at home. The research tools included group discussion records, assessment forms for the appropriateness of nursing practice guidelines, knowledge and skill evaluation forms for caring for stroke patients in the continuous home care phase, ADL (Activities of Daily Living) assessment forms, and self-management behavior measures for stroke patients. These instruments had reliability coefficients of 0.82, 0.86, 0.88, and 0.82, respectively. Data analysis was conducted using descriptive statistics, paired sample t-tests, and content analysis.
     The study results indicated the following: 1. The nursing practice guidelines for caring for stroke patients during the continuous home care phase comprised 10 steps: 1) Assessment and initial patient care, 2) Neurological examination, 3) Laboratory/special examination, 4) Reporting to doctors, 5) Providing information to patients and their families, 6) Collaborative care, 7) Resource utilization,  Integration of telemedicine systems, and 9) Monitoring and follow-up. The application of these guidelines significantly improved outcomes compared to pre-implementation (p-value<0.01). 2. The nursing practice guidelines were rated as highly appropriate and feasible, with a mean score of 4.64 (S.D.=0.28). 3. Following the implementation. 3.1) There was a significant increase in the mean scores of nurses’ knowledge and skills for caring for stroke patients at home (p<.001). 3.2) Stroke patients in the continuous care phase showed significant improvement in daily living activities and self-management behaviors (p<.001).