Development of Nursing Practice Guideline for Monitoring Adverse Events among Outpatients waiting for Treatment at Thongsaenkhan Hospital

Abstract

Objective: To study the situation of adverse events occurring while waiting for treatment in the Outpatient Department of Thongsaenkhan Hospital. Develop a nursing practice guideline for monitoring adverse events while waiting for treatment in the Outpatient Department.
Methods: The research and development (R&D) study was conducted over a over a four-month period, from May to August 2025. The study participants included 11 registered nurses working in the outpatient department of Thongsaenkhan Hospital, Uttaradit Province, who were selected through purposive and voluntary sampling. In addition, patients who voluntarily agreed to participate were recruited at the waiting area of the outpatient department of Thongsaenkhan Hospital, Uttaradit Province. The sample size was determined using Krejcie and Morgan’s table, resulting in a total of 287 participants. Data were collected through a questionnaire and analyzed using content analysis, frequency, percentage, mean, standard deviation, the Wilcoxon signed-rank test, and the One-sample t-test.
Results: After the implementation, the study revealed that the participants’ mean satisfaction with nursing practice guidelines for monitoring adverse symptoms while waiting for treatment was ≥85%, with statistical significance at p<0.001. Most participants reported a high level of satisfaction with the outpatient nursing services at Thongsaenkhan Hospital, Uttaradit Province, accounting for 91.40%. The comparison of mean waiting times, measured from card submission at the examination room to the time of returning home, showed that prior to the development, the average waiting time was 81 minutes (1 hour and 21 minutes), whereas after the development, the waiting time decreased to 53 minutes. Regarding the service providers, registered nurses demonstrated a high level of knowledge concerning the monitoring of adverse symptoms while waiting for treatment, accounting for 99.09%, with a mean score of 19.82, which was significantly higher than before the development (p<0.001). The response time to changes in symptoms before and after implementing the nursing practice guideline for monitoring adverse symptoms decreased from an average of 19.63 minutes to 12.21 minutes, representing a 37.80% reduction. This finding indicates an improvement in the efficiency of patient care.
Conclusion: The results of this study on the development of nursing practice guidelines for monitoring adverse symptoms while waiting for treatment in the outpatient department of Thongsaenkhan Hospital demonstrated improved efficiency in patient care. The guidelines enabled healthcare personnel to respond more promptly to patients’ adverse symptoms.