The Outcome of Nursing for Monitoring the Deteriorating Symptoms of Patients in the Observation Room at Uttaradit Hospital

Abstract

Objective: To examine the effects of nursing interventions for monitoring deterioration in patients admitted to the observation room at Uttaradit Hospital.
Methods: A quasi-experimental study using a two-group posttest design was conducted with prospective data collection. A purposive sampling method was applied to select 240 patients, divided into two groups: Control group: Patients monitored for deterioration between September and November 2023 (n=120) and Experimental group: Patients monitored for deterioration between December 2023 and February 2024 (n=120). Research instruments included 1) A general patient information questionnaire 2)
A deterioration monitoring assessment using the Modified Early Warning Score (MEWS), validated through IOC and Cronbach’s alpha reliability testing. Data were analyzed using frequency, percentage, mean, standard deviation, and t-test.
Results: Most patients were female (56.67%) and aged over 60 years (45%). The most common comorbidity was diabetes mellitus (18.33%), followed by hyperlipidemia (14.17%). The most frequent presenting symptom was abdominal pain (20%). Comparison of nursing outcomes
using MEWS showed that the experimental group achieved safe care outcomes, with patients discharged home (Mean = 3.19, SD = 0.70), at a significantly higher level than the control group (p<0.01). The average observation time was 1–2 hours (Mean=3.35, SD=1.08), which differed significantly from the control group (p<0.001).
Conclusion: Nursing interventions for monitoring deterioration using MEWS were significantly more effective than standard care (p<0.001). This approach prevented patient deterioration, enhanced safety, reduced the risk of critical events, and clearly supported the quality of nursing care in observation rooms.