Development and Implementation of a Clinical Nursing Practice Guideline for Prevention and Management of Increased Intracranial Pressure in Hemorrhagic Stroke Patients
Background Hemorrhagic stroke is a serious condition that leads to high morbidity and mortality rates, particularly within the first 30 days following the stroke. One serious complication is increased intracranial pressure (IICP), which worsens neurological symptoms and can result in death or disabi...
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2024-12-01
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| Series: | SAGE Open Nursing |
| Online Access: | https://doi.org/10.1177/23779608241303025 |
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| author | Kannika Sirisaen Suchira Chaiviboontham Surachest Phornsuwannapha |
| author_facet | Kannika Sirisaen Suchira Chaiviboontham Surachest Phornsuwannapha |
| author_sort | Kannika Sirisaen |
| collection | DOAJ |
| description | Background Hemorrhagic stroke is a serious condition that leads to high morbidity and mortality rates, particularly within the first 30 days following the stroke. One serious complication is increased intracranial pressure (IICP), which worsens neurological symptoms and can result in death or disability. Purposes To develop and implement a clinical nursing practice guideline (CNPG) for prevention and management of IICP in hemorrhagic stroke patients. Methods This study had two phases: (1) Evidence trigger and support, identifying clinical problems and gathering empirical evidence, and (2) Evidence-observed, where a CNPG was developed and implemented. The CNPG was based on the Nursing Role Effectiveness Model and Soukup's Nursing Practice Development Model, covering preoperative and postoperative care and key nursing activities such as assessment, prevention, and management. The study assessed the CNPG's impact on nurses’ knowledge, practices, and implementation feasibility. Nineteen registered nurses from the Surgical Intensive Care Unit were included and analyzed using descriptive statistics, interquartile range, and the Wilcoxon signed-rank test. Results The findings showed a significant improvement in nurses’ mean knowledge scores after implementing the nursing guideline for preventing IICP in hemorrhagic stroke patients ( p < 0.000). The overall mean knowledge score was high (X̄ = 23.11, SD = 2.54, Mdn = 23, IQR = 5). Additionally, the total mean nursing practice score (X̄ = 122.53, SD = 17.80) and overall mean perceived implementation feasibility score were both high (X̄ = 4.68, SD = .35). Conclusions The findings suggest that integrating nursing practice guidelines and providing training to enhance nurses’ knowledge significantly contribute to positive outcomes in both structure and process. Regarding structure, nurses demonstrated increased knowledge and proficiency in nursing practices. Regarding process outcomes, evidence-based guidelines were effectively utilized, paving the way for practical application in future nursing practice. |
| format | Article |
| id | doaj-art-8e505b7b4cf1404b8a8c2c4bafdd7ab2 |
| institution | Kabale University |
| issn | 2377-9608 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | SAGE Open Nursing |
| spelling | doaj-art-8e505b7b4cf1404b8a8c2c4bafdd7ab22024-12-05T10:03:20ZengSAGE PublishingSAGE Open Nursing2377-96082024-12-011010.1177/23779608241303025Development and Implementation of a Clinical Nursing Practice Guideline for Prevention and Management of Increased Intracranial Pressure in Hemorrhagic Stroke PatientsKannika Sirisaen0Suchira Chaiviboontham1Surachest Phornsuwannapha2 Thai Board of Advanced Practice in Adult and Gerontological Nursing, Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University. Professional Nurse, Bangkok Christian Hospital, Bangkok, Thailand Ramathibodi School of Nursing, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand Department of Surgery, , Bangkok, ThailandBackground Hemorrhagic stroke is a serious condition that leads to high morbidity and mortality rates, particularly within the first 30 days following the stroke. One serious complication is increased intracranial pressure (IICP), which worsens neurological symptoms and can result in death or disability. Purposes To develop and implement a clinical nursing practice guideline (CNPG) for prevention and management of IICP in hemorrhagic stroke patients. Methods This study had two phases: (1) Evidence trigger and support, identifying clinical problems and gathering empirical evidence, and (2) Evidence-observed, where a CNPG was developed and implemented. The CNPG was based on the Nursing Role Effectiveness Model and Soukup's Nursing Practice Development Model, covering preoperative and postoperative care and key nursing activities such as assessment, prevention, and management. The study assessed the CNPG's impact on nurses’ knowledge, practices, and implementation feasibility. Nineteen registered nurses from the Surgical Intensive Care Unit were included and analyzed using descriptive statistics, interquartile range, and the Wilcoxon signed-rank test. Results The findings showed a significant improvement in nurses’ mean knowledge scores after implementing the nursing guideline for preventing IICP in hemorrhagic stroke patients ( p < 0.000). The overall mean knowledge score was high (X̄ = 23.11, SD = 2.54, Mdn = 23, IQR = 5). Additionally, the total mean nursing practice score (X̄ = 122.53, SD = 17.80) and overall mean perceived implementation feasibility score were both high (X̄ = 4.68, SD = .35). Conclusions The findings suggest that integrating nursing practice guidelines and providing training to enhance nurses’ knowledge significantly contribute to positive outcomes in both structure and process. Regarding structure, nurses demonstrated increased knowledge and proficiency in nursing practices. Regarding process outcomes, evidence-based guidelines were effectively utilized, paving the way for practical application in future nursing practice.https://doi.org/10.1177/23779608241303025 |
| spellingShingle | Kannika Sirisaen Suchira Chaiviboontham Surachest Phornsuwannapha Development and Implementation of a Clinical Nursing Practice Guideline for Prevention and Management of Increased Intracranial Pressure in Hemorrhagic Stroke Patients SAGE Open Nursing |
| title | Development and Implementation of a Clinical Nursing Practice Guideline for Prevention and Management of Increased Intracranial Pressure in Hemorrhagic Stroke Patients |
| title_full | Development and Implementation of a Clinical Nursing Practice Guideline for Prevention and Management of Increased Intracranial Pressure in Hemorrhagic Stroke Patients |
| title_fullStr | Development and Implementation of a Clinical Nursing Practice Guideline for Prevention and Management of Increased Intracranial Pressure in Hemorrhagic Stroke Patients |
| title_full_unstemmed | Development and Implementation of a Clinical Nursing Practice Guideline for Prevention and Management of Increased Intracranial Pressure in Hemorrhagic Stroke Patients |
| title_short | Development and Implementation of a Clinical Nursing Practice Guideline for Prevention and Management of Increased Intracranial Pressure in Hemorrhagic Stroke Patients |
| title_sort | development and implementation of a clinical nursing practice guideline for prevention and management of increased intracranial pressure in hemorrhagic stroke patients |
| url | https://doi.org/10.1177/23779608241303025 |
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