EFFECT OF APPLYING GUIDELINES ON NURSES` PERFORMANCE REGARDING FLUID AND ELECTROLYTE IMBALANCE IN

Ahmed Hassan, Heba Mohamed

doi:10.21608/pssjn.2021.181002

EFFECT OF APPLYING GUIDELINES ON NURSES` PERFORMANCE REGARDING FLUID AND ELECTROLYTE IMBALANCE IN

Document Type : Original Article

Author

heba Mohamed Ahmed Hassan

M.Sc., Faculty of Nursing, Port Said University

10.21608/pssjn.2021.181002

Abstract

Background: The accurate monitoring of fluid balance activities is a vital part of patients‟ baseline information, which guides nursing interventions to achieve physiological stability. Inaccurate monitoring of fluid balance especially in critically ill patients can deteriorate patients‟ conditions. Aim: Evaluate the effect of applying guidelines on nurses' performance regarding fluid and electrolyte imbalances in intensive care units. Subjects and method: Design: A quasi- experimental research design was utilized. Setting: Intensive care unit in Damietta General Hospital. Subjects: A convenience sample of 72 nurses working in above mentioned setting. Tools: Two tools were used to collect the needed data; nurses' knowledge Questionnaire and nurses' observation checklist. Results: The majority of nurses had satisfactory knowledge immediately and after guidelines applications comparing to before. Regarding fluid loss, also more than two thirds of nurses had satisfactory knowledge immediately after guidelines applications and follow up comparing to before guidelines application .There were statistically significant relation regarding scores of nurses' practice regarding fluid & electrolyte imbalances monitor and management pre, immediately after and follow up after guidelines applications in area of fluid and electrolyte monitor score, fluid and electrolyte management score and total practice .Conclusion: improve nurses ' knowledge and practice after application of guidelines regarding fluid and electrolyte imbalance . Recommendations: Continues education for nurses are required to have the knowledge and competence to care for patients, which includes understanding the indications for and importance of fluid balance charts and fluid &electrolyte imbalance management.

Keywords

References

Alberts, B. (2014). Essential cell biology (4ed.), New York, Garland.

AGREE (2012). Advancing the science of practice guidelines. Available at: http://www. agreetrust.org/. Accessed September 30, 2012.

American Association of Colleges of Nursing (2014). 2013-2014 Enrollment and graduations in baccalaureate and graduate programs in nursing. Washington, DC: Author.

American Medical Association (AMA), (2010). Current procedural terminology: CPT 2010. (Professional edition). Chicago: Author American Nurses Association (ANA). (1980). ANA social policy statement. Washington, DC: Author.

Boyd, J., Forbes, J., Nakada, T., Walley, K., & Russell, J. (2011). Fluid resuscitation in septic shock: A positive fluid balance and elevated central venous pressure are associated with increased mortality. Critical Care Med; 39 (2), 259-65.

British Society of Gastroenterology practice guidelines (2012). Available at: http:// www.bsg.org.uk/clinical/general/ guidelines.html. Accessed September 30, 2012.

Bunn, F., & Trivedi, D. (2012). Colloid solutions for fluid resuscitation. Cochrane database of systematic reviews, (6).‏

Diacon, A., & Bell, J. (2014). Investigating the recording and accuracy of fluid balance monitoring in critically ill patients. S Afr J Crit Care, 30 (2), 55- 7.

Eckman, M. & Lobus, O. (2010). Fluid and electrolyte an incredibility easy pocket guide (2nd ed.). New York: Lippincott Williams & Wilkins.

Hamed, S.M. (2009). Nurses performance during cardio-pulmonary resuscitation in Intensive Care Unit and Cardiac Care Unit at Benha University hospital, unpublished Master thesis, Faculty of Nursing, Benha University.

Asfour, H. I. (2016). Fluid balance monitoring accuracy in intensive care units. IOSR Journal of Nursing a Nd Health Science (IOSR-JNHS), 5(4), 53-62.‏

Identification of the influence of organizational variables on hospital staff nurses’ job performance, unpublished PhD thesis. University of Iowa City, Iowa, USA.

Ignatavicius, D. & Workman, M. (2010). Medical-Surgical Nursing: Patient-Centered Collaborative care. 6th ed., St. Louis, MO: Elsevier; Pp. 170-198.

Imel, E. A., & Econs, M. J. (2012). Approach to the hypophosphatemic patient. The Journal of Clinical Endocrinology & Metabolism, 97(3), 696-706.‏

Lee, J. W. (2010). Fluid and electrolyte disturbances in critically ill patients. Electrolytes & Blood Pressure: E & BP, 8(2), 72.‏

Johnson, K. (2010). Determinants and assessment of fluid and electrolyte balance. In: Connor M, ed. High-Acuity Nursing. 5th ed., Upper Saddle River, NJ: Prentice Hall; Pp. 606-620.

National patient safety goals.. (2010). Retrieved from http://www.jointcommission.org/ patientsafety/nationalpatientsafetygoals. accessed at 24/6/2016. Aceessed in 13 January, 2010.

Lee, J. (2010). Fluid and electrolyte disturbances in critically ill Patients. Electrolyte Blood Press, 8(2),72–81. Available at: http://www.ncbi.nlm.nih.gov/ pmc/articles/PMC3043756/?report=classi.Acessed on: 14-2-2015.

McCance, K., & Huether, SE. (2010). Pathophysiology: the biologic basis for disease in adults and children (6 th ed.). St Louis, Mosby.

Mogileeswari, P., & Ruth, M. (2016). Knowledge and practice regarding fluid and electrolyte replacement therapy for patient with burns. International Journal of Multidisciplinary Research and Development, 3 (4), 217-20.

Pancorbo-Hidalgo, P.L., Garcia-Fernandez, F.P., Lopez-Medina, I. M., & Lopez-Ortega, J. (2007). Pressure ulcer care in Spain: Nurses’ knowledge and clinical practice. Journal of Advanced Nursing, 58, 327-338.

Pegram, A., Bloomfield, J. (2015). Nutrition and fluid management. Nursing Standard, 29 (31).

McGloin, S. (2015). The ins and outs of fluid balance in the acutely ill patient. British Journal of Nursing, 24(1), 14-18.‏

Shahin, M.A, Mohamed,W.Y & Sayed, M. (2012). Nurses’ knowledge and practices regarding enteral nutrition at the critical care department of Al- Manial University hospital in Egypt: Impact of a designed instructional program. Journal of American Science, 8 (11).

Shepherd, A. (2011). Measuring and managing fluid balance. Nursing Times, 107(28), 12-6.

Thomas, B., Boris, M., Hendy, A., Sophie, A., Jérôme, N., Peter, J. & Stéphane, D, (2015). Assessing fluid balance in critically ill pediatric patients. Eur J Pediatr, 174,133–137 DOI 10.1007/s00431-014-2372-9.

Vincent, M., Mahendiran, T. (2015). Improvement of fluid balance monitoring through education and rationalization. BMJ Quality Improvement Reports, u209885.w4087 doi: 10.1136/bmjquality. u209885.w4087. http://qir.bmj.com/ retrieved on May 14, 2016.

Njung’e, W. W., Mbithi, B. W., & Okova, R. (2017). Completion of Intravenous Fluids Administration Regimen by Nurses Working in Adult Medical and Surgical Wards at a County Referral Hospital, Kenya.