The Journal of Chulabhorn Royal Academy

The Role of Emergency Nurses in Contemporary Health Crisis Management in the BANI World

Duangkamon Prasopsantawee — Wed, 20 May 2026 00:00:00 +0700

The BANI framework (Brittle-Anxious-Nonlinear-Incomprehensible) has been proposed to describe the characteristics of the contemporary world, which is increasingly fragile, uncertain, complex, and difficult to predict. In recent years, healthcare systems worldwide have faced growing uncertainty due to emerging infectious disease outbreaks, natural disasters, and environmental challenges that significantly affect population health. Within this context, emergency departments play a critical role in responding to health crises. Emergency nurses, as frontline healthcare professionals responsible for triage, rapid assessment, and the provision of timely and effective emergency care, are essential in managing urgent and critical health situations.

This article aims to analyze the roles and essential competencies of emergency nurses in managing contemporary health crises within the context of the BANI era and to propose approaches for strengthening emergency nursing capacity to address evolving healthcare challenges. An analytical literature review was conducted using academic sources published between 2019 and 2024. The analysis was guided by the conceptual perspectives of systemic management, situational leadership, and innovative nursing. The findings indicate that four key competencies are essential for emergency nurses in responding to health crises in the BANI context: (1) critical clinical decision-making, (2) risk and disaster management, (3) health technology utilization, and (4) interprofessional collaboration. These competencies play an important role in enhancing crisis response capacity and strengthening health system resilience in increasingly complex and unpredictable healthcare environments.

The Role of Cardiac Telemetry Unit Nurses in the Surveillance of Cardiac Arrhythmias in Hospital Settings

Chaiwat Wanchuay, Urasri Imsomboon, Sopita Areerob — Wed, 20 May 2026 00:00:00 +0700

Cardiac telemetry is a technology used for continuous monitoring of cardiac rhythms to detect abnormalities such as cardiac arrhythmias in a timely manner. This monitoring system is commonly implemented in large or university hospitals where cardiology specialists are available and nurses possess expertise in electrocardiogram (ECG) interpretation. The system also requires substantial financial investment in patient monitoring devices. In many institutions, nurses are assigned primary responsibility for continuously monitoring, analyzing, and interpreting ECG rhythms for 24 hours a day. Their role is essential in detecting potentially life-threatening abnormalities, enabling prompt medical management, reducing complications, and lowering mortality rates. Nurses responsible for cardiac telemetry monitoring must possess both basic and advanced competencies in ECG interpretation, as well as the ability to assess cardiac emergencies. Effective communication and coordination with interdisciplinary healthcare teams are also essential to ensure timely clinical responses. In addition, telemetry nurses provide guidance to ward nurses in managing arrhythmic events and educate patients and their families to enhance understanding and reduce anxiety during monitoring. Although the use of cardiac telemetry has increased in hospital settings, nursing roles in ECG surveillance vary across organizational contexts. Moreover, systematic synthesis of knowledge that clearly defines nursing roles, competencies, and scopes of practice in cardiac telemetry monitoring remains limited. Therefore, this article aims to present and synthesize current knowledge regarding cardiac telemetry systems and the roles of nurses in monitoring cardiac arrhythmias. The findings may support appropriate clinical application, enhance monitoring efficiency, and improve nursing outcomes for patients undergoing cardiac monitoring.

Application of Social Epidemiology: Towards Fundamental Community Health Management

Gusumad Tunchai, Wanasara Chaoniyom, Punthip Ramasuta — Wed, 20 May 2026 00:00:00 +0700

Introduction:Health management in the 21st century has become increasingly complex, as health determinants are no longer limited to biomedical factors but are also influenced by social, economic, cultural, and political structures. Objective: This study was to present a conceptual framework and practical approaches for applying social epidemiology to community health management through a review of academic literature in public health and social sciences. Scope of Study: Integrating key epidemiological and social theories, including Social Capital Theory and Structural Violence, to explain the biological, behavioral, and psychosocial mechanisms linking health determinants in communities. Method: Synthesizing knowledge from empirical research, policy reports, and relevant case studies. Results: Social epidemiology can explain health problems and inequalities through social determinants of health, which affect health according to the eco-social theory. This study develops a framework for grassroots community health management to support the design of health measures and policies aimed at systematically reducing inequality. Conclusion: The developed framework reflects the importance of community health management based on social determinants of community participation, and the enhancement of health literacy, which contributes to reducing health inequalities and developing Thailand's healthcare system.

Integrating International Standards for Disinfection and Sterilization to Enhance Patient Safety in Thai Healthcare Facilities

Wed, 20 May 2026 00:00:00 +0700

Disinfection and sterilization are essential components of infection prevention and control in healthcare facilities and are directly associated with patient safety, quality of care, and the reduction of healthcare-associated infection risks. This article aims to review and synthesize international standards for disinfection and sterilization and to analyze their application in the context of healthcare facilities in Thailand. The review is based on key conceptual frameworks, including the Spaulding classification, guidelines issued by the Centers for Disease Control and Prevention (CDC), the Food and Drug Administration (FDA), the World Health Organization (WHO), and the Association for the Advancement of Medical Instrumentation (AAMI) standards ST79 and ST91. The article covers the principles of risk classification for medical devices, the selection of appropriate disinfection and sterilization methods based on device intended use, and factors that affect process effectiveness, including pre-cleaning, disinfectant concentration, contact time, temperature, material compatibility, quality assurance, traceability, and occupational safety. It also discusses practical challenges in reprocessing complex medical devices, such as flexible endoscopes and respiratory equipment. The synthesis indicates that the effectiveness of disinfection and sterilization processes depends not only on compliance with international standards but also on the integration of manufacturers’ instructions, device design characteristics, personnel competency, quality assurance systems, and the availability of institutional resources. These considerations are particularly important in Thailand, where healthcare facilities vary substantially in infrastructure and service capacity across different levels of care. In conclusion, the systematic application of international standards for disinfection and sterilization, adapted to the context of Thai healthcare facilities, can strengthen process quality, enhance patient and personnel safety, and reinforce infection prevention and control systems in the long term.

Comparison of Blood Coagulation Tests in Fresh Frozen Plasma Thawed at 37 and 45 Degrees Celsius

Wed, 20 May 2026 00:00:00 +0700

Fresh frozen plasma (FFP) is an important blood component used in the treatment of bleeding, particularly in emergency situations where rapid administration is required. The thawing temperature and the post-thaw storage duration affect the quality of coagulation factors. This study aimed to compare prothrombin time (PT) and activated partial thromboplastin time (aPTT) in FFP thawed at 37°C and 45°C. A total of 150 plasma segments from 100 FFP units were divided into two experimental sets. The first set, PT and aPTT were measured immediately after thawing at 37°C and 45°C for 5 minutes and after 24 hours of storage. The second set, FFP was thawed at 45°C for 20 minutes, with PT measured immediately and after 24 hours of storage, and aPTT measured immediately and after 6, 12, and 24 hours of storage. The results showed that the temperature and duration of thawing did not significantly affect PT and aPTT when compared at the same time points. However, storage after thawing for 24 hours resulted in a significant increase in both PT and aPTT (p < 0.0001). PT increased by 5.5–6.2%, and aPTT increased by 14.2–21.7%, depending on the thawing temperature and duration of thawing. These findings indicate that post-thaw storage impacts plasma quality, particularly aPTT, which is highly sensitive to storage duration. Therefore, FFP should be used immediately after thawing. Further studies are recommended to evaluate the stability of specific coagulation factors before applying the thawing method at 45°C in clinical practice.

Factors Associated with Preoperative Anxiety Among Cataract Surgery Patients in Secondary Level Hospital

Baibun Chueacharng; Wimonrut Boonsatean, Nam-oy Pakdevong — Wed, 20 May 2026 00:00:00 +0700

Cataracts can be effectively treated through surgery; however, patients often experience preoperative anxiety, which may affect their cooperation during the procedure and lead to postponement or cancellation of the surgery. This descriptive correlational study aimed to investigate preoperative anxiety levels and examine their associations with socioeconomic status, information needs, healthcare providers support, and health literacy. The sample comprised 177 participants selected through purposive sampling. Data were collected using questionnaires with reliability coefficients ranging from .71 to .92 and were analyzed using descriptive statistics and Spearman's rank correlation.

The findings revealed that participants experienced a moderate level of preoperative anxiety (M = 47.18, SD = 9.67). Statistically significant low positive correlations (p < .01) were identified between preoperative anxiety and emotional information needs (r_s = .203) and fundamental health literacy (r_s= .228). The findings highlight the necessity of assessing patients’ anxiety levels prior to cataract surgery and providing information tailored to patients’ health literacy levels, particularly regarding pain perception and temporary visual impairment, in order to reduce preoperative anxiety.

Frequencies of clinically important antigens in Rh and MNS blood group systems among donors in Samut Prakan Hospital

Wed, 20 May 2026 00:00:00 +0700

Currently, hospitals in Thailand have shown increasing interest in detecting clinically significant red blood cell antigens in donor blood samples, specifically within the Rh and MNS systems. As patients frequently develop alloantibodies against these blood group systems, ensuring transfusion safety requires the selection of antigen-negative blood units that correspond to the patient’s antibodies. Consequently, pre-transfusion phenotyping of donor blood is highly beneficial for facilitating safe and rapid blood procurement.

This research investigated the frequency of Rh and MNS blood group antigens among 315 blood donors at Samut Prakan Hospital utilizing the standard tube technique. The results revealed the following Rh antigen frequencies: D (99.68%), C (95.56%), c (36.83%), E (28.57%), and e (98.73%). Regarding the MNS system, the antigen frequencies were: M (93.65%), N (48.57%), and Mia (12.7%). The most prevalent Rh phenotype was DCCee (60.95%), followed by DCcEe (22.54%). For the MNS system, the most common phenotype was M+N- (51.43%).

In conclusion, this study found that D, e, and C were the most common Rh antigens, while M was the most predominant MNS antigen in donor blood samples at Samut Prakan Hospital. These findings are consistent with other studies conducted in Thailand. The obtained data serves as a guideline for establishing a blood donor antigen database at Samut Prakan Hospital.

Effects of Music Therapy on a Gastrointestinal and Fatigue Symptom Cluster in Breast Cancer Patients Undergoing Chemotherapy

Jesadaporn Wongkapin, Kanitha Hanprasitkam, Rachanee Namjuntra — Wed, 20 May 2026 00:00:00 +0700

Breast cancer patients receiving chemotherapy often experience a gastrointestinal and fatigue symptom cluster. This symptom cluster had the greatest impact on their quality of life. Music therapy is a safe and low-cost approach for symptom management. This quasi-experimental two-group comparative study aimed to examine the effects of music therapy on the severity and distress of the gastrointestinal and fatigue symptom cluster among breast cancer patients receiving chemotherapy. Fifty participants were randomly assigned to a control group (n = 25) receiving standard nursing care and an experimental group (n = 25) receiving standard care combined with music therapy for 30 minutes per day for 21 consecutive days after chemotherapy. Research instruments included a demographic questionnaire and a symptom severity and distress assessment form (Cronbach’s alpha = 0.92). Data were collected at baseline (D0), days 1–7 (D1–D7), day 14 (D14), and day 21 (D21). Data were analyzed using two-way repeated measures ANOVA. The results showed no significant differences between groups at baseline. After the intervention, the experimental group had significantly lower severity and distress scores than the control group (p < .001), and the pattern of change in distress differed significantly between groups over time (p < .05). In conclusion, the findings indicate that music therapy can be integrated as a nursing approach to enhance the management of a gastrointestinal and fatigue symptom cluster in breast cancer patients undergoing chemotherapy.

Performance Comparison of AUTOBIO BC60 and BD BACTEC™ FX Blood Culture Systems for Detecting Microorganisms in Spiked Blood Samples

Wed, 20 May 2026 00:00:00 +0700

Introduction: Sepsis represents a critical medical condition, therefore the prompt and precise identification of the causative pathogen is essential for effective therapeutic intervention. Objective: The aim of this study was to evaluate the performance of two automated blood culture systems, AUTOBIO BC60 and thereference blood culture system BD BACTEC™ FX, both utilizing CO2 sensor technology for the monitoring of microbial growth. Methods: This study employed a comparative analysis by inoculating blood culture bottles with both reference strains and clinical isolates obtained from patients at Samutprakan Hospital. The parameters evaluated were Time to Positive (TTP) and the Recovery Rate (RR). All microbial identi-fications were further validated using MALDI-TOF MS technology Results: The comprehensive statistical analysis revealed no significant differences in TTP and RR between the two systems (p-value > 0.05). However,
subgroup analysis revealed that the BD BACTEC™ FX system had a significantly shorter TTP for gram-
positive and gram-negative bacteria compared to the AUTOBIO BC60 (p < 0.05). However, the AUTOBIO BC60 system showed a distinct advantage in detecting Cryptococcus neoformans (C. neoformans) faster than the reference system. Conversely, it exhibited limitations in supporting the growth of alkaliphilic microorganisms Conclusion: The BD BACTEC™ FX system reveals the rapid detection of major gram-positive and gram-
nega-tive bacterial pathogens, while the AUTOBIO BC60 offers an advantage specifically for C. neoformans but is limitations regarding alkaliphiles. Therefore, careful risk assessment concerning specific microbial groups should be considered.

Factors Predicting Quality of Life of the Elderly in Elderly Schools

Wed, 20 May 2026 00:00:00 +0700

This cross-sectional analytical study aimed to examine the level of quality of life (QOL) and identify factors predicting QOL among older adults attending Elderly Schools in Chonburi Province, Thailand. A total of 230 older adults registered during the 2024 fiscal year were selected using cluster random sampling. Data were collected through structured interview questionnaires comprising six components: personal characteristics, self-esteem (Rosenberg Self-Esteem Scale), active aging (Active Ageing Scale for Thai People: AAS-Thai), family relationships (Family Attachment and Changeability Index: FAC-18), social support (Multidimensional Scale of Perceived Social Support: MSPSS), and quality of life (Older People’s Quality of Life Questionnaire: OPQOL-brief). Data were analyzed using descriptive statistics, Chi-square tests, correlation analysis, and multiple linear regression. Multiple linear regression analysis indicated that active aging (B = 0.138, p < 0.001), social support (B = 0.078, p = 0.006), and family relationships (B = 0.066, p = 0.010) were significant predictors of QOL, jointly explaining 29.2% of the variance (R² = 0.292, p < 0.001). These findings indicate that active aging, family relationships, and social support are key factors associated with QOL among older adults attending Elderly Schools and may support the development of community-based health promotion strategies in aging populations