The Development of Nursing Practice for Prevention Nausea and Vomiting from Undergoing Anesthesia in Adult Patient Udonthani Hospital

Abstract

              This study employed a research and development design with the objective to develop and evaluate the outcomes of a comprehensive practice guideline. The study was divided into three phases: Phase 1 involved examining the incidence of postoperative nausea and vomiting (PONV) from medical records over a 3-year retrospective period: Phase 2 focused on developing a nursing practice guideline: and Phase 3 evaluated the outcomes of implementing this guideline.

               The research instruments included a nursing practice guideline for monitoring and preventing PONV in adults receiving general anesthesia at Udon Thani Hospital, and research data collection forms. These instruments were validated by five anesthesiologists and nurse anesthetists. The sample consisted of patients who received anesthesia at Udon Thani Hospital from June to December 2023. Participants included both patients and professional nurses. The patient sample, calculated to be 128 individuals, was divided into an experimental group (n = 64) and a control group (n = 64). The control group received standard care, while the experimental group was managed according to the newly developed nursing practice guideline for monitoring and preventing PONV in adults at Udon Thani Hospital. Systematic random sampling was used to select participants for the study, with the control group completed first. The professional nurse sample consisted of 50 voluntary participants who implemented the practice guideline. Data analysis included descriptive statistics (frequency, percentage, mean, and standard deviation) for patient demographics. The incidence of PONV and length of hospital stay were compared between groups using Chi-Square and t-test. Data concerning professional nurses who implemented the guideline, and their satisfaction were analyzed using frequency, percentage, mean, and standard deviation.

               The research findings showed no significant differences in baseline characteristics between the experimental and control groups. Post-anesthesia outcomes revealed a statistically significant difference (p < 0.05) in the incidence of PONV between groups. Patient satisfaction with the service was at the highest level (mean = 4.47, S.D. = 0.14), with a statistically significant difference at p < 0.05. The satisfaction of the 50 nurse anesthetists who used the practice guideline was also at the highest level (mean = 4.59, S.D. = 0.52). Professional nurses' overall satisfaction with the guideline was at the highest level (mean = 4.59, S.D. = 0.52).