Quality Improvement of Discharge Planning for Patients with Acute Myocardial Infarction in Cardiac Care Unit, Nakornping Hospital, Chiang Mai Province
Keywords:
Quality Improvement, Discharge Planning, Acute Myocardial InfarctionAbstract
Patient Discharge planning is an important process to prepare patients from acute to transitional stages in order to enhance patients’ self-care and self-management when discharged from the hospital. This study aimed to improve the quality of discharge planning for patients with acute myocardial infarction in the Cardiac Care Unit, Nakornping Hospital, Chiang Mai Province by using the FOCUS-PDCA process improvement method. Population included 14 registered nurses working in the Cardiac Care Unit, Nakornping Hospital. The instruments used in the study were the check list of discharge planning practices of professional nurses, developed by the researcher, Thitinut Akkadechanunt and Somjai Sirakamon based upon the literature review. The content validity index was 0.98 and the reliability was 1.00. The focus group interview guidelines regarding problems, barriers and recommendations for discharge planning was approved by three experts. Data was analyzed by descriptive statistics and content analysis.
The study results revealed that:
- The mean score of discharge planning practices for patients with acute myocardial infarction after using the FOCUS-PDCA process improvement method in the first, second and sixth week were
86.31, 92.98 and 96.32 respectively.
- The problems and barriers to patient discharge planning were 1) Nursing staff: high workload, lack of monitoring and encouraging for discharge planning. 2) Patients: language barrier during communication and the understanding of the disease and practices after receiving teaching and advice and 3) Discharge planning process: many steps in the discharge planning process which takes time to record all the information. The recommendations for patient discharge planning were: 1) Head nurses should always monitor, encourage and promote nurses in planning for patients discharge regularly and 2) Nurses should coordinate discharge planning among stakeholders both in the hospital and the community.
These results of the study will be useful for nurse administrators to develop strategies in discharge planning and continuously monitor the discharge planning for patients with acute myocardial infarction among nurses in the Cardiac Care Unit at Nakornping Hospital.
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