Effectiveness of the nursing practice guideline in preventing pneumonia in older patients with Hip fractures at Phaholpayuhasena Hospital, Kanchanaburi Province

Abstract

Objectives: To study the effectiveness of a nursing practice guideline in preventing pneumonia in elderly patients with hip fractures and to compare the knowledge of nurses before and after implementing the guideline.

Methods: This quasi-experimental, two-group study was conducted from July to December 2024. The sample consisted of 60 elderly patients with hip fractures admitted to the Orthopedic Ward at Phaholpolpayuhasena Hospital, divided into two phases: pre-implementation (n=30) and post-implementation (n=30) of the guideline. Additionally, 12 nurses participated. The research instrument was the nursing practice guideline for preventing pneumonia in elderly patients with hip fractures. Data were collected using questionnaires and analyzed using descriptive statistics and Fisher's exact test.

Results: Following the implementation of the nursing practice guideline, the incidence of pneumonia decreased from 2 cases to 0 cases (6.7% and 0.0% respectively; p=0.492). Most nursing practices within the guideline were consistently performed, with the exception of turning every 2 hours and effective hand washing, which were inconsistently performed at 13.3%. After training on the guideline, the mean knowledge scores of the participating nurses regarding pneumonia in elderly patients with hip fractures significantly increased (12.08 ± 1.50 and 13.67 ± 0.49; p=0.002).

Conclusion: The implementation of this nursing practice guideline effectively prevented and reduced pneumonia in elderly patients with hip fractures and enhanced nurses' knowledge. This guideline is suitable for use by nurses in patient care at the hospital.