The Development of an Assessment System on Clinical Deterioration Monitoring Using Phachomklao Modified Early Warning Sign Scores (PCK MEWS Scores) among Intracerebral Hemorrhage Patients
Keywords:Assessment System, Clinical Deterioration Monitoring, Early Warning Signs, Intracerebral Hemorrhage
This research and development study aimed to develop an assessment system on clinical deterioration monitoring using Phrachomklao (PCK) Modified Early Warning Scores (MEWS) among intracerebral hemorrhage patients. There were four phases in this research procedure. Phase 1 was to analyze situations and problems by reviewing medical records and conducting semi-structured focus group interviews. Participants in this process consisted of 12 workers, including physicians, head nurses and registered nurses. Phase 2 was to develop the assessment system based on the evidence-based practice. Phase 3 was to conduct a quasi-experimental research to trial the assessment system among 37 intracranial hemorrhage patients per groups. Phase 4 was to evaluate the outcomes after applying the assessment system. This phase was evaluated by 44 registered nurses. Research instruments in a qualitative process were a semi-structured interview and a focus group discussion. Research instruments in a quantitative process were the satisfaction assessment form and the feasibility assessment form for using the system. Content analysis was used to analyze qualitative data. Frequencies and means were used to analyze quantitative data.
The results showed that the assessment system on clinical deterioration monitoring based on the PCK MEWS included: 1) collaborative planning; 2) clearly define roles and responsibilities; 3) effective communication; and 4) controlling, regulating, and monitoring the practice. After applying the assessment system on clinical deterioration monitoring, it was found that the percentage of unplanned transfers to the intensive care unit dropped from 27.28% in the control group and 9.09 % in the experimental group. The opinion of registered nurses on the feasibility of using the assessment system was at a high level (= 4.43). The satisfaction of registered nurses after using this system was also at a high level (= 4.73). This research results suggested that nurses or other health care providers can be applied this assessment on the clinical deterioration monitoring in patients with other diseases in order to improve a quality of patient care.
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