Practice Guideline Development for Referral Patients with Acute Stroke at Primary Level Hospital

Arissara SUKWATJANEE

Abstract


This action research aimed to develop a practice guideline for referral patients with acute stroke at a primary level hospital. Seventy two participants were healthcare providers working at an emergency room of the hospital. The participants were divided into 2 teams of developing and trying out the guideline by using the conduct and utilization of research in nursing model (CURN) as a conceptual framework. Descriptive statistics were used to assess the participants’ demographic characteristics including feasibility and possibility of using the guideline among the participants. Problems and obstacles of using the guideline were analyzed via content analysis. After 12 months of developing and trying out the guideline with acute stroke patients at an emergency room, the result revealed that time spent for referral of the patients was approximately 45 min reaching the standard of the American Heart Association. The recommendation was that this effective practical guideline could benefit referral patients with acute stroke at a primary level hospital.

Keywords


Practice guideline, refer, acute stroke, primary level hospital

Full Text:

PDF

References


EM Barker. Neuroscience Nursing: A Spectrum of Care. 3rd eds. Mosby Elsevier, St. Louis, Mo, 2008, p. 521-63.

Ministry of Public Health, Available at: http://www.moph.go.th, accessed March 2018.

WJ Powers, AA Rabinstein, T Ackerson, OM Adeoye, NC Bambakidis and K Becker. 2018 guidelines for the early management of patients with acute ischemic stroke: A guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2018; 49, e46110.

LP Kammersgaard, HS Jorgensen, JA Rungby, J Reith, H, Nakayama and UJ Weber. Admission body temperature predicts long-term mortality after stroke: The copenhagen stroke study. Stroke 2002; 33, 1759-62.

MW Parsons, A Barber, PM Desmond, TA Baird, DG Darby and G Bymes. Acute hyperglycemia adversely affects stroke outcome: A magnetic resonance imaging and spectroscopy study. Ann. Neurol. 2002; 52, 20-8.

W Hacke, G Donnan, C Fieschi, M Kaste, JP Broderick and T Brott. Association of outcome with early stroke treatment: Pooled analysis of ATLANTIS, ECASS, and NINDS rt-PA stroke trials. Lancet 2004; 363, 768-74.

C Lu-Emerson, D Likosky, A Amin and D Tirschwell. Management of ischemic stroke: Part I emergency room management. J. Hosp. Med. 2010; 5, 33-40.

Sena Hospital. Patient file 2012-2016 (in Thai). Sena Hospital, Ayutthaya Province, 2012.

S Theamkao. Development of stroke network in north-east part (in Thai). J. Thai Stroke Soc. 2015; 14, 3-13.

C Koosuwan, W Hankunakun and S Sirikun. Development of continuing care in stroke patients at Nopparut Radchatanee (in Thai). In: Proceedings of the Human Source and Service with Human Heart. 2009.

American Heart Association. Guidelines for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation 2015, 132, S315-67.

National Collaborating Centre for Chronic Conditions (UK). Stroke: National Clinical Guideline for Diagnosis and Initial Management of Acute Stroke and Transient Ischemic Attack (TIA). Available at: https://www.ncbi.nlm.nih.gov/pubmed/21698846, accessed March 2018.

DR Summers, A Leonard, D Wentworth, JL Saver, J Simpson and JA Spilker. Comprehensive overview of nursing and interdisciplinary care of the acute ischemic stroke patient: A scientific statement from the American Heart Association. Stroke 2009; 40, 2911-44.

EC Jauch, JL Saver, HP Adams, A Bruno, JJ Connors and BM Demaerschalk. Guidelines for the early management of patients with acute ischemic stroke. Stroke. 2013; 44, 870-947.

JA Horsley, J Crane, MK Crabtree and DJ Woos. Using research to Improve Nursing Practice: A Guide (CURN Project). Grune & Stratton, Orlando FL, 1983, p. 33-5.

Prasat Neurological Institute. Guideline of Caring Stroke Patients for General Nurses (in Thai). Neuroscience Institute, Medical Center, Ministry of Public Health, Bangkok, 2011, p. 26-9.

P Ponprasert. Development of Nursing Guideline for Discharge Planning in Patients Retained Central Vein Catheter (in Thai). MNS Thesis, Prince of Songkla University, Songkla, Thailand, 2009.

R Grol. Beliefs and evidence in changing clinical practice. BMJ 2006; 332, 151.

C Thongchai and P Nuntachaipun. Opinion survey related to use a practice guideline (in Thai). In: Proceedings of the Evidence Based Practice. Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand, 2004.

J Considine and B McGillivry. An evidence-based practice approach to improve nursing care of acute stroke in an Australian emergency department. J. Clin. Nurs. 2010; 19, 138-44.


Refbacks

  • There are currently no refbacks.




http://wjst.wu.ac.th/public/site/images/admin/image012_400

Online ISSN: 2228-835X

http://wjst.wu.ac.th

Last updated: 12 August 2019