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Abstract\ \ Keywords\ \ : Clinical nursing practice guidelines, Breast cancer surgery, Evidencebasedstrategies: The objective of this article was to present the development of clinicalnursing practice guidelines (CNPGs) for patients undergoing breast cancer surgeryby using evidence-based strategies. Thirty-three staff nurses of seven surgical wardsat Ramathibodi Hospital were asked to read, use, and evaluate the CNPGs. Findingsrevealed that two-thirds of the staff nurses reported that the language use, contents,applicability, and usefulness of the CNPGs are good. In addition, the CNPGs werehelpful to strengthen nurses๛ confidence in nursing practice. However, the CNPGshad some limitations and made it not feasible for some cases. Because the CNPGshave been newly developed, it needs more time for nurses to understand themthoroughly.
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Abstract: Length of hospital stay has been used as an indicator of the quality of care in the acute care setting. Prolonged length of stay may result in patients’ complications, a low rate of patient bed utilization, and high health care cost. The purpose of this descriptive study was to examine selected factors (i.e., age, gender, number of chronic diseases, body weight, hemoglobin level, albumin level, total protein, functional ability, and family support) related to length of hospital stay of older patients in Ramathibodi Hospital. The sample consisted of 324 patients aged 60 years and older, who were admitted in medical and surgical-orthopedics wards during October to December 2004. Data collection procedures were conducted after the approval of the Ethics Committee of Ramathibodi Hospital. Findings showed that most of the sample (63.9%) were female; their age ranged from 60 to 97 years with a mean age of 72.26 years (SD = 7.07). The length of hospital stay ranged from 1 to 62 days with a mean of 10.98 days (SD = 9.74), a median of 8 days, and a mode of 6 days. Because most study variables were not normally distributed, Spearman’s rho (rs) was used to explore the relationships among variables. The results revealed that the albumin and total protein level at admission, functional abilities at admission and at discharge were significantly, negatively correlated with the length of hospital stay, indicating that the higher level of such variables, the shorter length of hospital stay of older patients. However, age, gender, the number of underlying disease, body weight at admission, the hemoglobin level, functional abilities before admission, and family support were not significantly correlated with the length of hospital stay. The results suggest that nutritional status and functional ability be improved to shorten the length of hospital stay of older patients.
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Abstract: The purpose of the study was to prevent functional decline during hospitalization and improve functional ability of post-operative older patients, and prepare caregivers for taking care of their older patients at home. Subjects were recruited fromthree surgical units at the university hospital. The total sample (N= 89) consisted of the control group (n = 45) and the experimental group (n = 44). The control group was treated with the usual care provided in the surgical units while the experimentalgroup was treated with the usual care and caregiversû participation in taking care of the older patients. The mean age of older patients in the control group was 67.5 years; however that of older patients in the experimental group was 68.4 years. Most caregivers were the older patientsû daughters or sons. The results showed that in the analysis of the student-t test, the mean score of the caregiversû preparedness in theexperimental group was significantly higher than that in the control group (p \< .05). In addition, the mean score of the older patients and their caregiversû satisfaction in the experimental group were significantly higher than that in the control group (p \< .05). However, there was no difference in older patientsû functional status between these two groups. The findings support the effectiveness of the intervention program for older patients and their caregiversû satisfaction and caregiversû preparedness forcontinuity of care at home.