The development of clinical nursing practice guideline (CNPG) for patients undergoing coronary artery bypass graft surgery

Background: The current clinical nursing practice guideline (CNPG) for coronary artery bypass graft (CABG) patients lacks comprehensive coverage across all phases of care, leading to postoperative complications and increased readmissions. Therefore, the development of a new CNPG is essential to ensure continuity and quality of care. Methods: This research and development study was conducted from August 2024 to January 2025 and involved two sample groups: (1) 32 patients undergoing CABG surgery, compared with a retrospective chart review of patients with similar characteristics treated within six months prior to CNPG implementation, and (2) 52 nurses providing care for CABG patients. Research instruments included: (1) a nursing questionnaire, (2) a demographic questionnaire, (3) a newly developed CNPG covering all phases of care from preoperative to discharge, (4) a nurse satisfaction survey on CNPG use, and (5) a CABG care knowledge assessment for nurses. Data were analyzed using descriptive statistics, independent t-test, and Chi-square test. Results: All patients underwent CABG surgery as scheduled, with no postponements due to unpreparedness. There were no significant differences in baseline characteristics between the control and intervention groups. The intervention group demonstrated significant reductions in intubation time, ICU stay, hospitalization duration, and post-discharge complications (p < .05), with durations decreasing from 7.28 ± 2.75 to 6.66 ± 2.15 days, 8.88 ± 1.90 to 8.63 ± 2.15 days, and 1.56 ± 0.72 to 1.16 ± 0.45 days, respectively. Nurse’s knowledge of CABG care significantly improved after CNPG implementation (p < .01). Overall, nurses reported the highest level of satisfaction with the CNPG (Mean = 4.73 ± 0.27). Conclusions: This developed CNPG for patients undergoing CABG can be effectively implemented by nurses covering preoperative, intraoperative, postoperative, and discharge periods.