การพัฒนาและประเมินผลแนวปฏิบัติในการประเมินสุขภาพผู้สูงอายุในแผนกผู้ป่วยนอก

Abstract

This study aimed to develop and evaluate the utilization of a clinical practice guideline for assessing geriatric health in an outpatient department. The participants comprised 2 groups: 10 registered nurses and 30 elder patients in an outpatient department. Two processes were conducted: 1) developing the clinical practice guideline, examining its content validity using a panel of 5 experts (CVI = 0.91) and determining its inter-rater reliability (percentage of raters' agreement = 95), and 2) implementing and evaluating the guideline by the participants. The users' opinions on feasibility and ease of use of the guideline and satisfaction with adopting the guideline including its efficacy on making diagnosis for each elder's health problems were collected. Barriers and obstacles including suggestions on its utilization were analyzed using content analysis. The newly developed clinical practice guideline comprised 2 implementing steps: 1) holistic health screening and 2) holistic health assessment. The feasibility/ease of use of the guideline, and satisfaction with adopting the guideline were confirmed by all users. Only 2 new graduates with less nursing experience reported difficulty in social and spiritual assessment. The efficacy of using the guideline in making diagnosis revealed that most elder participants (n=26) were diagnosed in all health dimensions (physical, psychological, social, and spiritual). Therefore, the clinical practice guideline can be used for geriatric health assessment in an outpatient department. However, a manual for making diagnosis on the elderly health should be provided in the guideline operation package. The further development of an information management system using digital technology is highly recommended for advancing the implementation of the clinical practice guideline.