Effect of Educational Guidelines on Nurses’ Performance Regarding Caring of Patients on Extracorporeal Membrane Oxygenation and Patient Outcomes

Abstract

Background Extracorporeal membrane oxygenation (ECMO) has become an important form of organ support for patients with severe circulatory or respiratory failure, as a bridge to recovery or more definitive treatment options. Therefore, this demands a more efficient performance by the nursing staff, to achieve optimum results. Aim: The study aims to assess the effect of educational guidelines on nurses' performance regarding caring for patients on extracorporeal membrane oxygenation and patient outcomes. Design: A quasi-experimental (one group pretest/posttest) design was utilized in this study. Sample: A convenience sample of all available nurses (50 nurses) and a convenience sample of 40 patients to assess patient outcomes. Setting: The study was conducted at a critical care unit affiliated to Sohag University Hospitals, Egypt. Tools: From the previous method setting, three tools were used to perform the study, 1- a Nurse Knowledge Assessment Questionnaire and 2- Nurse' Observational Checklist were utilized 3- patients outcomes questionnaire. Results: the result showed that that 54% of the studied nurses were between the ages of > 26- <35 years with a mean age of 31.82±7.6. About gender, 62% were males, 72% were single, and 86% had a bachelor's degree in nursing. And 96% of the studied nurses had a satisfactory level of knowledge and 98% of nurses had an adequate level of practice regarding ECMO post-implementing of intervention guidelines. Regarding to patient outcomes 37.5% of the studied patients have Acute respiratory failure as a medical diagnosis. About Types of ECMO Modalities, 77% were put on VV mode, and 75% were put on central ECMO cannulation also15.76±4.33 was the mean number of days on ICU and7.43±3.16 was the mean number of days on ECMO and 10.98±5.74 was the mean number of days on mechanical ventilator. Regarding ECHMO complications 15% of them had renal and pulmonary complications. Conclusion: Based on the results of the present study, it can be concluded that the implementation of educational guidelines had a statistically significant positive effect on total knowledge and practice satisfactory levels in the pre-, and immediate post-tests. There was a highly statistically significant difference regarding nurses' total level of knowledge and practice regarding ECMO complications rate, which supported the research hypothesis. Recommendations: Conduct training programs for the nurses caring for patients on ECMO machines. Providing nurses caring for patients on the ECMO machine with a designed instructional Arabic booklet and pamphlet regarding how to deal with the ECHMO machine.