<![CDATA[Background: Increased intracranial pressure (IICP) is a life-threatening complication of traumatic brain injury (TBI). Previous studies in Thailand have not evaluated the effectiveness of a structured clinical nursing practice guideline (CNPG) in improving nurses’ knowledge, skills, and confidence, highlighting the urgent need for a rigorously developed and evaluated CNPG.Purpose: This study evaluated the effectiveness of a CNPG in improving nurses’ knowledge, skills, and confidence in managing IICP among patients with TBI, and explored nurses’ perceptions of its feasibility, optimality, and benefits.Methods: A sequential explanatory mixed methods design was employed. A quantitative pretest–posttest design was conducted from February to September 2024. The intervention involved implementing an IICP CNPG among 45 registered nurses in two neurological wards at a tertiary hospital in eastern Thailand. Data were collected using four validated instruments: the Nurses’ Knowledge on IICP Questionnaire, Clinical Skills Observation Checklist, Self-Confidence Scale for IICP Care, and Nurses’ Perception of CNPG Questionnaire. In the qualitative phase, 20 nurses participated in two focus group discussions, which were analyzed using conventional content analysis.Results: Nurses showed statistically significant improvements in knowledge, clinical skills, and self-confidence following CNPG implementation (all p < .001). Perceptions of the CNPG in terms of feasibility, optimality, and benefits all significantly exceeded the standard benchmark (all p < .001). Eight qualitative themes were identified, highlighting the roles of evidence-based knowledge, repeated training, structured protocols, interprofessional collaboration, and refresher training in improving consistency, confidence, and quality of IICP care.Conclusion: The CNPG was feasible, effective, and well-accepted among nurses, leading to significant improvements in knowledge, clinical skills, and self-confidence in IICP management. Future research should examine its long-term impact and effectiveness across diverse clinical settings. ]]>
