Development of Nursing Practice Guidelines for At-Risk Outpatients with Community-Acquired Pneumonia at Phichit Hospital
Keywords:
Nursing practice guideline, High-risk patients, Community-acquired pneumonia, Outpatients, Health literacyAbstract
Objectives: This research aimed to develop and evaluate a nursing practice guideline for patients at risk of community-acquired pneumonia (CAP) in the outpatient department of Phichit Hospital
Methods: This research and development study was conducted in two cycles. Cycle 1 involved problem analysis and guideline development based on a literature review and input from nurses and experts. In Cycle 2, the refined guideline was implemented with a sample of 10 outpatient nurses and 34 patients at risk of CAP (diagnosed with influenza or COVID-19). Research instruments included screening/history-taking forms, pre-discharge assessment forms, symptom follow-up records, Six-Domain Health Literacy Enhancement Program, health literacy and satisfaction assessment tool, and clinical outcome records. Data were analyzed using descriptive statistics and paired t-test.
Results: A nursing practice guideline covering 7 key components, aligned with outpatient service standards, was developed. Patients demonstrated a statistically significant increase in health literacy scores across all domains (t(33)=25.35, p-value<.001). The overall mean score improved from 51.07 (SD=4.50) to 72.62 (SD=2.80), representing a 42.21% improvement. No clinical complications (e.g., acute respiratory failure, septic shock, or household transmission) were observed. Both patient and nurse satisfaction levels were high to very high (mean scores of 4.38 and 4.35, respectively).
Conclusion: The developed nursing practice guideline proved effective in enhancing health literacy, preventing complications, and improving the quality of nursing care for outpatients at risk of CAP. The integration of digital follow-up via the LINE application supported continuous home-based care.
Keywords: Nursing practice guideline, High-risk patients, Community-acquired pneumonia, Outpatients, Health literacy
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