The Development of nursing care model for the multiple trauma patients in emergency department.

Abstract

This research and development study aimed to: 1) examine the current situation of nursing care for multiple trauma patients in the emergency department; 2) develop an evidence-based nursing care model; and 3) evaluate its outcomes in terms of nurses’ competency, nurses’ satisfaction, guideline adherence, and patient outcomes. The research was conducted from January to August 2025.It involved multiple trauma patients, registered nurses, and multidisciplinary teams, followed by four phases: 1) situational analysis and need assessment for development, 2) model development, 3) pilot testing, and                 4) effectiveness evaluation. The sample was 30 multiple trauma patients and 55 registered nurses. Data were collected using medical record reviews, in-depth interviews, focus group interviews, observational record forms, nurses’ stratification surveys, nurses’ competency assessment forms, nurses’ adherence assessment forms, and nursing outcomes record forms.  Paired T-Test was used to analyse nurses’ competency pre- and post-developing the model. Chi-square was used to compare nursing outcomes pre- and post-developing the model. The results were a nursing care model for the multiple trauma patients in emergency department, including nursing practice guidelines, competency development programs, and innovations (KKaRe Trauma, Primary Survey Card, and SIT KKH), which supported assessment and review of nursing care.The implementations significantly improved nurses’ competency (p<0.05), achieved a high rate for guideline adherence (95.7%), and enhanced patient outcomes: triage accuracy, timely intubation in ten minutes, prompt management of tension pneumothorax, pain control, and urgent surgery within 60 minutes (p<0.05). Nurses’ satisfaction was high at 93.52%. In conclusion, the model effectively enhanced nurses’ competencies and elevated the standard of care Furthermore, it improved outcomes for multiple trauma patients in emergency care.