Development of clinical nursing practice guideline to critically ill trauma patients with risk of acute kidney injury from rhabdomyolysis in ICU Trauma Buddhachinaraj Phitsanulok Hospital

Abstract

This research and development study aimed to develop and study the effects of developing nursing practice guidelines for critically ill trauma patients at risk of acute kidney injury from rhabdomyolysis. The study was conducted in four phases: 1) situational analysis, 2) development of nursing practice guidelines, 3) implementation of nursing practice guidelines, and 4) evaluation of the use of nursing practice guidelines. The sample consisted of two groups: 1) 17 registered nurses, and 2) 60 patients, divided into a pre-implementation and post-implementation group (30 patients each). The research implementation tool was the developed nursing practice guidelines. Data collection tools included: 1) a patient data collection form, 2) a questionnaire assessing opinions towards the nursing practice guidelines, and 3) a nursing practice record form. Data were analyzed using frequency, percentage, mean, standard deviation, Chi-square test, and Relative risk (RR).

The research results revealed that the developed nursing practice guidelines consisted of patient assessment, nursing diagnosis, planning, implementation, and evaluation according to the phases of rhabdomyolysis. After using the guidelines, the incidence rate of acute kidney injury decreased statistically significantly (p < 0.05) with an RR of 0.333 (95% CI: 0.100–1.112), indicating that the guidelines could reduce the risk of acute kidney injury by 66.7% compared to before the development.

The recommendation for implementing the research findings is that these developed nursing practice guidelines should be applied in critical care settings to help increase the efficiency of patient care and result in better clinical outcomes.