ประสิทธิผลของการใช้แนวปฏิบัติการพยาบาลสำหรับการจัดการ ความปวดในผู้สูงอายุหลังผ่าตัดเปลี่ยนข้อเข่าเทียม โรงพยาบาล เชียงรายประชานุเคราะห์

Abstract

AaaaaaaAppropriate pain management through the use of clinical nursing practice guidelines is beneficial in relieving pain among the elderly after total knee arthroplasty. The purpose of this operational study was to evaluate the effectiveness of clinical nursing practice guidelines implementation for pain management among elderly patients after total knee arthroplasty, Chiangrai Prachanukorh Hospital. Guidelines from the Registered Nurses Association of Ontario (RNAO, 2012) was used as the framework of the study. The sample consisted of 30 elderly patients undergoing total knee arthroplasty and 15 professional nurses. The patients were divided into two groups, 15 in each: the clinical nursing practice guidelines group and the hospital standard of nursing care group. The study was conducted from August to September 2014. The instrument used in this study was the clinical nursing practice guidelines for pain reduction in total knee arthroplasty patients developed by Supaporn Hipunpuchchong (2006). The instruments for data collection consisted of a demographic data recording form for elderly patients and nurses, a numeric pain rating scale, and a satisfaction questionnaire to measure patient and nurse satisfaction with clinical nursing practice guidelines implementation. Data were analyzed using descriptive statistics and Fisher’ s exact test. Study findings revealed that: 1. Patient post-operative pain was lower in the clinical nursing practice guidelines group as compared to the hospital standard of nursing care group at hours 24, 48 and 72. This difference was statistically significant at p <.01 2. Ninety-three point thirty-three percent of patients in the clinical nursing practice guidelines group were satisfied with clinical practice guidelines implementation. 3. Ninety-three point thirty-three percent of nurses who used the clinical nursing practice guidelineswere satisfied with their implementation The results of this study confirm the effectiveness of the evidence based nursing practice guidelines implementation for pain management among elderly after total knee arthroplasty. Therefore, these guidelines should be used to improve quality of care for elderly patients after total knee arthroplasty.