Development of a comprehensive nursing service system for elderly leprosy patients with chronic diseases in Rajpracha Samasai Institute.
Keywords:
Comprehensive nursing service system, elderly leprosy patients with chronic diseases, the average number of hospital stay, readmission, fall, pressure injuryAbstract
This research aimed to develop a comprehensive nursing service system for elderly leprosy patients with chronic diseases at Rajpracha Samasai Institute by using 4 phases of action research: phase 1: comprehending the problem of the current nursing service system, phase 2: developing the comprehensive system, phase 3: testing the draft of the system, phase 4: evaluating the result of the system. The target populations comprised of a total of 76 people, were the director, nurses responsible for caring for leprosy patients, a multidisciplinary team working with leprosy patients, community leaders, and 124 elderly leprosy patients from Rajpracha Samasai Institute, and the team from Bang Ya Phraek Health Promoting Hospital, at Samut Prakan. The instruments were in-depth interview, focus group discussion, practical observation form, satisfaction assessment form, the copy of nursing outcome form. The research was conducted from December 2019 to May 2022. The quantitative data were analyzed by descriptive statistics, and qualitative data by content analysis.
The results revealed that 1) the comprehensive nursing service system for elderly leprosy patients with chronic disease and the practice providers could be divided into two systems: the comprehensive nursing system for elderly leprosy patients with chronic disease who were dependent and independent without a caregiver. These 2 systems consisted of subsystems of out-patient, in-patient, and community nurse practitioners and there was a link between working systems from the multidisciplinary team, and community. 2) nurse practitioners and multidisciplinary team could follow the developing system with a high satisfaction and acceptance rate of the comprehensive system in every subject (M = 3.94, SD=0.83 , M = 3.98, SD = 0.82) 3) the elderly leprosy patients were highly satisfied and accepted every subject in comprehensive system (M = 4.20, SD =0.63, M = 4.27, SD = 0.60). 4) the nursing outcome evaluation found that the number of hospital stays in elderly leprosy patients with chronic disease was decreased by 16.87%. The readmission rate was decreased by 100%, fall by 61.54% and pressure injury rate by 61.54%. The results implied that there is the limitation in the system due to patients discharge like shared bathroom which is not appropriate for the elderly. The relevant institutions, the municipalities, should provide adequate care and assistance. Hence there is an extensive need for Further research and the evaluation of the system.
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