Development of a Nursing Care Model for Preventing Abdominal Distention among Patients with Open Appendectomy

Abstract

Open abdominal surgery among acute appendicitis patient with anesthesia during surgery incurs intestinal
movement stopped or decreased and abdominal distension occurs after the operation. The development
of the clinical nursing practice model will help patients recover faster. Objective: 1) to develop the nursing
care model to preventing abdominal distention among patients with open appendectomy. 2) To evaluate
the nursing care model to preventing abdominal distention among patients with open appendectomy.
Methods: This Research and development consist of four stages: 1) Situation analysis 2) Development of
nursing programs 3) Experiment nursing program and 4) Evaluation. The evaluation was conducted in: 1) Patients receiving open appendicitis surgery from February to July 2020 purposive sampling was used to
recruit 6 0 patients and divided them into two groups: 3 0 patients in control and treatment groups. 2) 9
professional nurses. Every questionnaire was validated by experts and the reliability test of research
instruments was used in this study including: 1) Patient demographic data 2) the nursing documentations
monitoring form 3) 28-day recovery monitoring form and length of stay. Record descriptive statistics were
used for data analysis.
Results: 1) The nursing care model to preventing abdominal distention among patients with open
appendectomy consisted of: nursing program for the prevention of abdominal distention in patients after
open appendectomy and nursing care standard guide for preventing abdominal distention after open
appendectomy and 2) the effect of a nursing model for open appendectomy patients to trial. The patient
outcomes found that (1) The abdominal distension severity in the experimental group before was moderate
76.70 percent and 100 percent did not show (2) Postoperative bowel movements consist of: The duration
of a feeling of hunger was found before using the guidelines mean 2.29 and after using the guidelines mean
1.06. The duration of the first bowel movement was found to decrease after the use guidelines from 6.00-
4. 70 hours. Burping time after the use of nursing guidelines decreased from 6.00 hours to 5. 10 hours.
Defecation time after the use nursing guidelines application showed that the mean duration decreased from
48.00 hours to 30.00 hours decreased.
(3) Length of stay from 3.6 days to 2.20 days. Personnel results found that 1) Staff satisfaction was very high
with mean of 4.78 and 2) 100 percent of staff adherence use nursing guidelines followed.
Conclusion: The nursing care model to preventing abdominal distention among patients with open
appendectomy is good outcomes for patients. It can prevent abdominal distention, which is a major
disturbance in postoperative patients, nursing staff are satisfaction with the nursing model and have standard
of care.