수용개작방법을 활용한 전신마취 수술 후 폐합병증 예방 간호실무지침 개발
Development of the Nursing Practice Guidelines for Preventing Postoperative Pulmonary Complications using the Guideline Adaptation Process
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목적: 전신마취 수술 후 폐합병증은 수술 후 환자 상태의 악화와 불필요한 의료비용을 발생시킬 수 있는 임상문제로 예방이 중요하다. 본 연구는 전신마취 수술 후 폐합병증 예방을 위한 근거기반의 간호실무지침을 개발하고자 하였다. 방법: 병원간호사회에서 제시한 간호분야 실무지침 수용개작방법 24단계에 따라 이루어졌다. 결과: 개발된 전신마취 수술 후 폐합병증 예방을 위한 지침은 4개의 영역과 30개의 권고안으로 구성되어 있다. 권고안은 영역별로 수술 전 환자 상태 사정 7개, 전신마취 수술 후 폐합병증 예방을 위한 간호중재 17개, 교육 4개, 모니터링 및 기록 2개로 구분된다. 각 권고안의 근거수준은 I수준 2개(6.7%), II수준 18개(60.0%), III수준 10개(33.3%)로 구성되어 있고, 권고등급은 A등급 2개(6.7%), B등급 18개(60.0%), C등급 10개(33.3%)로 구성되어 있다. 결론: 본 연구에서 개발된 전신마취 수술 후 폐합병증 예방 간호실무지침을 통해 간호실무의 질 및 환자만족을 향상시킬 수 있을 것이다. 간호실무지침의 질적 향상을 위해 지속적인 보완과 개정을 제언한다.
Abstract
Purpose: This study aimed to develop an evidence-based nursing practice guideline for preventing postoperative pulmonary complications (PPCs). Methods: The guideline adaptation process was conducted through the 24 steps based on the guideline adaptation manual of Korean Hospital Nurses Association. Results: The newly developed guideline to prevent PPCs consisted of four domains and 30 recommendations. The number of recommendations in each domain was 7 for assessment of PPCs, 17 for nursing interventions to prevent PPCs after general anesthesia, 4 for education (intended for patients and medical staff), and 2 for monitoring and recording. Conclusion: The developed guidelines will contribute in standardization of nursing practice and PPCs prevention and management. We recommend the dissemination and utilization of these guidelines nationwide to improve the quality of postoperative pulmonary complication prevention.
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