Development of Clinical Practice Nursing Guidelines for Weaning of Mechanical Ventilation among Critically Ill Patients with Traumatic Brain Injury, Neurosurgery and Brain Intensive Care Unit, Nakhon Pathom Hospital

Abstract

This action research aimed to develop clinical nursing practice guidelines for weaning mechanical ventilation among critically ill patients with traumatic brain injury in the Neurosurgery and Brain Intensive Care Unit at Nakhon Pathom Hospital. The guidelines followed the seven-step conceptual framework for developing guidelines outlined by the National Health and Medical Research Council [NMRC], 1999. This framework included 1) defining the problem to be solved, 2) establishing a development team, 3) defining objectives, scope, and outcomes, 4) searching and evaluating empirical evidence, 5) drafting the clinical nursing practice guidelines, 6) expert review, and 7) conducting trials of the guidelines. The results were revealed as follows. 1) The clinical practice nursing guidelines for weaning of mechanical ventilation among critically ill patients with traumatic brain injury in the Neurosurgery and Brain Intensive Care Unit at Nakhon Pathom Hospital comprised two categories: evaluating readiness for weaning of mechanical ventilation and evaluating symptoms during the weaning process. The guidelines underwent content validation index by three experts with scores of 1.0, 1.0, and 1.0, respectively. 2) The feasibility of implementing, it was determined that the guidelines proposed for the Neurosurgery and Brain Intensive Care Unit at Nakhon Pathom Hospital are highly feasible, with a 100% approval rating from 10 participants. This included the clarity of the recommendations, suitability for the agency, cost savings, problem-solving capabilities, and positive impact on service recipients. Additionally, the guidelines were found to be moderately convenient and easy to use by 80% of the respondents.Overall, the satisfaction level with the implementation of these guidelines was very high, with an average score of 4.30 (SD 0.78). Recommendation: should be studied by measuring relevant outcomes Keywords: development of clinical practice nursing guidelines, weaning of mechanical