The Development of Nursing Model for Urgent Patients (Triage Level 3) in Accident and Emergency Room, Buri Ram Hospital

Abstract

Background: Urgent Patients are injured or have a very acute or severe illness. They need to assess urgent management and treatment. The incidence of deteriorating patient during treatment in fiscal year 2018-2020, and cause was ineffective and inconsistent assessment. Which aggravate the injury or illness Complications resulting in death at a later stage.
Objective: To develop a nursing model for urgent patients. And to compare the results of the development of nursing models for Urgent Patients.
Study design: This research is research and development. Setting at the Accident & Emergency Room, Buriram Hospital. Between November 2020 to February 2021
Methods: The research and development study was conduct 4 studies. Phase 1: Preparation and Analysis of the situation, Study the information, observing the performance, inquiring and interviewing practitioners and service recipient. Medical record review, and review the incident report. Phase 2: Establish and develop a nursing model. To study and collect data, academic paper, research paper, etc. To make knowledge as best practice by developing nursing model. Phase 3: Bringing the nursing model into practice. Phase 4: Summary and evaluation of nursing model: Evaluate the use of the nursing model and the feasibility of implementation. The sample group was divided into 3 groups: 1) 41 urgent patients; 2) 39 professional nurses and emergency medical practitioners; 3) 10 people of multidisciplinary team. The research instruments consisted of 2 parts: (1) The tools to perform the action are: Guidelines for Nursing groups of Urgent Patients and manuals, Primary nursing assignment and supervision, and nursing records. (2) The tools used for data collection: The satisfaction test form for using the nursing model, Evaluation form for the ability to apply nursing practice guidelines. The validity of the content was approved by five experts. The validity of the questionnaire was analyzed. Cronbach's alpha coefficients was 0.7 and 0.9 The data were analyzed by using percentage, mean, standard deviation, Paired t-test and Chi-square test.
Results: The Development Nursing models for Urgent Patients are: 1) Prepare a project to develop staff potential, by assessment of knowledge and skills in practice and theory. According to the learning concept "Friends help friends". 2) Guideline for Urgent Patients, and Early warning signs for high-risk diseases. 3) Assignment and supervision, by using the primary nursing assignment. There is supervision and coaching techniques by the team leader. 4) The Focus Charting Nursing Documentation. Found that: The incidence of deterioration during treatment and ER visit within 48 hours of discharge was significantly different than before the model was statistically significant (p <0.05). The satisfaction increase was significantly different in all aspects (p <0.05). Overall satisfaction was high at 89.7%, and ability to apply overall nursing practice, 98.5%. This development nursing model for Urgent Patients is useful and practical. Give good results Which reflects a better quality of care
Conclusion: The Development Nursing models for Emergency injury patients (Urgent) do let the practitioners have guidelines for deciding to take care of accident patients. Causing patients to have less risk protected Or causing the patient to have more survival opportunities.
Key words: The Development of Nursing Model, Urgent patients, Emergency room