Development of a Case-Based Nursing Model for Patients with Multiple Trauma in the Accident and Emergency Nursing Unit, Ratchaburi Hospital

Abstract

The purpose of this research and development study was to develop and evaluate the effectiveness of a nursing model for patients with multiple trauma at Ratchaburi Hospital. The study comprised three phases: situation analysis, model development, and effectiveness evaluation, focusing on three key aspects: 1) nurses' knowledge and practice, 2) clinical outcomes of patients, and 3) feasibility of implementation. The sample included 40 professional nurses and patients with multiple trauma, divided into control and experimental groups, with 32 participants per group. The research instruments consisted of group discussion records, nursing knowledge assessments, guideline compliance assessment forms, and clinical outcome records. Data were analyzed using descriptive statistics, the Chi-square test, and the t-test.

The developed multisystem trauma nursing model included a nursing manual, competency development programs, and decision-making guidelines. In terms of effectiveness evaluation, significant improvements were found in nurses' performance (p < 0.001), access to emergency medical services (p = 0.02), and the accuracy of initial assessments of emergency patients' conditions (p = 0.03). Additionally, a significant reduction in patient deterioration during transfer was observed (p = 0.02).

In conclusion, the developed nursing model effectively enhances the accuracy of patient assessment. This model should be integrated into the care of high-risk emergency trauma patients or those with multiple injuries in tertiary care hospitals to improve the quality of care and enhance patient safety.