Thai Journal of Cardio-Thoracic Nursing 2020-04-04T09:24:15+07:00 Assist. Prof. Dr. Duangkamol Wattradul Open Journal Systems <p>เป็นวารสารที่จัดทำโดยสมาคมพยาบาลโรคหัวใจและทรวงอก ซึ่งเป็นสมาคมพยาบาลที่มีสมาชิกที่มีความเชี่ยวชาญในสาขาการดูแลผู้ป่วยโรคหัวใจและทรวงอกร่วมกันจัดทำวารสารเพื่อเป็นศูนย์กลางแลกเปลี่ยนความรู้ ประสบการณ์ และเผยแพร่วิทยาการใหม่ๆ เช่น งานวิจัย นวัตกรรม ในสาขาการดูแลรักษาและการพยาบาลโรคหัวใจและทรวงอก โรคเรื้อรัง รวมทั้งศาสตร์อื่นๆ ที่เกี่ยวข้อง ในสมาชิกสมาคมพยาบาลโรคหัวใจและทรวงอกและผู้ที่สนใจ ปีละ 2 เล่ม มกราคม -มิถุนายน และ กรกฎาคม - ธันวาคม</p> Massage From Editor 2020-03-13T20:49:43+07:00 Duangkamol Wattradul 2020-03-07T00:00:00+07:00 Copyright (c) Nursing care for patients undergoing transradial cardiac catheterization: case study 2020-03-13T18:26:19+07:00 Jamchan Prateepmanowong Surasit Chouyboon Nahareuthai Nareumanphokin <p>&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;Cardiac catheterization is a standard procedure for the diagnosis and treatment of coronary artery disease. The use of artery access sites for catheterization includes the brachial, radial, and femoral arteries. Many studies have found that cardiac catheterization through the radial artery is more effective than through other access sites. The transradial approach has several benefits including cost savings due to shorter hospital stays, greater patient comfort, the absence of limitations for ambulation, and decreased vascular access site complications. In addition, the mortality and ischemic complication of transradial approach is reduced in comparison to the transfemoral approach. Thus, radial approach cardiac catheterization has gained a lot of popularity currently.</p> <p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; This article aimed to provide knowledge for nursing interventions in patients who have been appointed to receive elective catheterization via Radial artery. It covered nursing care before and after the radial approach cardiac catheterization, as well as discharge instructions. Finally, it can increase the quality of nursing care for patients received radial approach cardiac catheterization.</p> 2020-03-07T00:00:00+07:00 Copyright (c) Digital technology: innovation for smoking prevention among children and adolescents in the twenty-first century 2020-03-13T11:52:30+07:00 Natchaya Palacheewa Pramote Thangkratok <p>&nbsp; &nbsp; &nbsp; &nbsp; Tobacco used among children and adolescents is globally important public health concern. Smoke causes numerous health problems including more frequent and severe asthma attacks, respiratory infections and chronic lung disease. Nowadays, the integration of digital technologies is significant increases in nursing care and their effectiveness in health promotion, prevention, and health risk behavior reduction.&nbsp; The aims of this article were to present the innovation for smoking prevention among children and adolescents. The innovation was integrated by using the Health Belief Model, the Theory of Reasoned Action, the Social Cognitive theory, and the Information Technology Processing Model. This article will suggest a part of process-driven of innovation to prevent smoking among children and adolescents based on effective digital technology and appropriate for digital citizenship.</p> 2020-03-07T00:00:00+07:00 Copyright (c) The expectations of post open heart surgery patients and their caregivers: perspective from the qualitative study 2020-03-13T19:36:37+07:00 Nattaya Sanonoi Prapapan Punudom Prapaipan Ritiluechai Nongnuch Taechaveerakorn Patharaporn kheawwan Surasak Treenai <p>&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; The objective of this qualitative study was to explore the expectations on nursing services among opened heart surgery patients and family caregivers. Data were collected via a focus group with semi-structure interview of 12 post open heart surgery patients and 12 family caregivers.&nbsp; Qualitative data were analyzed by using content analysis.</p> <p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; The results showed that receiving care with understanding was the main expectation of open heart surgery patients and caregivers. It reflected the senses of being respected and accepted by healthcare providers. In addition, the responsive expectations of care consisted of five themes emerged: (1) friendly service to meet health needs, (2) caring with generosity reflects the image of nursing services behaviors, (3) getting clear cut and sufficient health information for reducing anxiety (4) availability of environment for standard care, and, (5) safety of continuous care to promote feelings of safety when discharge.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</p> <p>&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; The findings of this study can enhance nurses’ awareness and understanding with the expectations of open heart surgery patients and caregivers toward nursing services. In addition, the guideline of care should be developed based on patients and caregivers’ expectation to improve the quality of care for patients undergoing cardiac surgery in the future.</p> 2020-03-07T00:00:00+07:00 Copyright (c) Factors related to beliefs about taking medicines among the monks with non-communicable diseases 2020-03-13T12:04:08+07:00 Renu Kwanyuen Somjai Puttapitukpol <p>&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; This descriptive study was purposed: (1) to evaluate the levels of beliefs about taking medicines and (2) to explore factors related to the beliefs about taking medicines in the monks with non-communication diseases. The sample of this study comprised of 370 monks with diabetes mellitus and hypertension receiving healthcare services at outpatient department, Priest Hospital. Data were collected by using the of Beliefs about Medicines Questionnaire (BMQ) of Horn,et,al., translated into Thai by Yosapon Leaungsomnapa.&nbsp; Data were analyzed by using in to descriptive statistic and Spearman's correlation.</p> <p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; The results revealed that about fifty-six percent (56.2%) of monks with non-communicable diseases had the lowest level of beliefs of taking medicines, while 43.80% had the highest level of beliefs about taking medicines. Moreover, the education levels and the discomfort of medication consuming were positively correlated with the beliefs about medicines significantly (p&lt;0.05). The duration of illness was negatively correlated with the beliefs about taking medicines significantly (p&lt; 0.05). However, age, quantity of medication consuming, and domicile were not significantly correlated with the monks’ beliefs of taking medicines (p&gt;0.05).</p> <p>&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; This study suggests that the nurses should apply beliefs about medication used to develop the program to improve drug adherence in the monks with non-communication diseases effectively.</p> 2020-03-07T00:00:00+07:00 Copyright (c) Factors predicting intention to practice for preventing hypertension in adults 2020-03-13T12:18:11+07:00 Patcharawadee Tongnuang Anyapaksorn Jaisomkom <p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; This predictive research aimed to describe the relationships among attitude, subjective norm, positive and negative anticipated emotions, perceived behavioral control, past behavior, desire, and intention to practice for preventing hypertension, and the influence of selected factors on intention to practice for preventing hypertension in adults. The samples were 231 adults. Data were collected by two questionnaires consisting of 1) demographic data, and 2) the influencing factors of intention to practice for preventing hypertension questionnaire. Data were analyzed using stepwise multiple regression statistics.</p> <p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; The findings illustrated that intention to practice for preventing hypertension was positively and significantly correlated with attitude (p &lt; .01, r =.40), subjective norms (p &lt; .01, r=.38), positive anticipated emotions (p &lt; .01, r=.40), perceived behavioral control (p &lt; .01, r=.31), past behavior (p &lt; .01, r=.18), and desire (p &lt; .01, r=.47). Furthermore, attitude, perceived behavioral control, past behavior, and desire accounted for 30.1% of the total variance in the intention to practice for preventing hypertension among adults (p &lt; .05, Adjusted R<sup>2</sup>=.301).</p> <p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; This study suggested that nurse should develop the program to promote adults’ behaviors for preventing hypertension, which aims to increase good attitude, boost perceived behavioral control, learning from past behavior, and increase desire of practice.&nbsp;</p> 2020-03-07T00:00:00+07:00 Copyright (c) Predictors of risk level for developing cardiovascular disease in patient with hypertension 2020-03-13T13:07:16+07:00 Nareubeth Koson Jom Suwanno <p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; This observation and crossectional study aimed to examine whether the major and minor risk factors predicted the risk level for developing CVD in person with hypertension. Participants were 492 patients attending four rural health promotion hospital in Nakhon Si Thammarat. CVD risk levels were classified into mild, moderate and high-risk groups based on the Framingham Global Risk Scoring algorithms. CVD risk scoring was calculate based on each individual six major risk factors included age, systolic blood pressure (SBP), high-density lipoprotein (HDL), total cholesteral (CHO), diabetes (DM), and smoking. Only one minor risk factor was negatively correlation Minor risk factors were boy mass index (BMI), waist circumference (WC), low-density lipoprotein (LDL), and triglyceride. Logistic regression analysis was used to test the predictive model with an odds ratio and 95% confident interval.&nbsp;&nbsp;</p> <p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; We found that two-fifth of the sample were at the high-risk level, three-fouth had hypertension stage 1. Over a half were older adult, had high cholesteral, hyperglycemia and low HDL. One-fouth (23.9%) of the high-risk group were current smokers. Univarite model found that all six major risk factors were positivtly correlated with high-risk level. Increment risk was found in advanced age, higher SBP, higher CHO, lower HDL, DM and smoking. Only one minor risk factor, waist circumference (WC) was negatively correlated with a high-risk level. Persons with abdominal obese had lower risk than those with normal waist. A model of the major risk factor was accounted for 82.5% of the variance explained on the high risk for CVD. When the four minor risk factors were added to the major risk factors model, the variance of the predictive model was increased to 84.1%.</p> <p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; This study suggests that health care providers should develop CVD risk prevention program in persons with hypertension by reduce of these major and minor risk factors. Raising risk awareness</p> <p>should be more consider in non-elder and non-obse, those who had higher risk for developing CVD.</p> 2020-03-07T00:00:00+07:00 Copyright (c) Nutritional status and experience of caregiver in food management for children with congenital heart disease aged 0 – 3 years in southern border provinces 2020-03-13T19:54:11+07:00 Tidarat Wangsawat Anyapaksorn Jaisomkom Yunee Pongjaturawit Prasert Piboonrungroj Wanisa Hayeese Lutfee Samael <p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; This descriptive research aimed to study nutritional status and explore the caregivers’ experiences of food management for children with congenital heart disease (CHD) who had malnutrition in Naradhiwat Pattani and Yala.&nbsp; A simple random sampling of 64 children and a purposive random sampling of 12 caregivers were used. Data were collected on children with CHD using a personal questionnaire and growth chart. As for the caregiver, data were collected by an in-depth interview. Descriptive statistics and content analysis were conducted to analyze the data.&nbsp;</p> <p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; The results of this study showed that children with CHD had underweight with 53.2%, low weight 23.4%, and normal weight 23.4% respectively. The food management experience of caregivers for children with CHD was based on four major components: (1) monitoring nutrition status by comparing with growth and development of normal children, (2) encouraging milk feeding and indulging in the food they like, (3) providing the same food as adults with heart disease for children with CHD, (4) impact of malnutrition on health status of children with CHD.</p> <p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; The results of this study could be provided as the basic information to develop the guideline of health education for caregivers to prepare foods and to promote better nutritional status for their children with CHD.</p> 2020-03-07T00:00:00+07:00 Copyright (c) Prevalence of metabolic syndrome (mets) and metabolic risk components in non-obese hypertension 2020-03-13T20:07:10+07:00 Chonchanok Bunsuk Jom Suwanno <p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; This observation and crossectional study aimed to examine the prevalences of Metabolic Syndrome (MetS), components and amount of metabolic risk in non-obese hypertension. Participants were 492 patients attending four rural health promotion hospitals in Nakhon Si Thammarat. Non-obese is defined as body mass index of less than 25.0 kg.m2. MetS was diagnosis based on the criteria of the American Heart Association and the National Heart Lung and Blood Institute (AHA/NHLBI). Descriptive statistic was used for prevalence. Chi-square, crude odds ratio, and 95% confident interval were used to compare the prevalences of MetS and components among normal weight and overweigt groups.</p> <p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; The results found 292 (59%) patients with non-obese. Prevalence rates of MetS in overall, normal weight, and overweight groups were 66%, 61%, and 76%, respectively. Mean of metabolic risk amount was 2.96±1.16, where 13% had only one risk, and 39% had at less four risk components. Over a half of them had low high-density lipoprotein (54%). Approximately a half who had hyperglycemia (48%), hypertriglyceridemia (48%) and abdominal obesity (46%). overweight group was more liklely had higher rates of MetS (OR 2.05, 95%CI 1.19-3.56), and more amount of metaboloric risk (3.35±1.21 vs. 2.77±1.08, p&lt;0.0001), compared with normal weight. Higher rates of hyperglycemia (57% vs. 44%, OR 1.72 [95%CI 1.05-2.81]) and abdominal obesity (71% vs. 34%, OR 4.78 [95%CI 2.81-8.13]) were also found in obese or overweight compared with normal weight groups.&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;</p> <p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; The prevalence of MetS in non-obese hypertension was higher than our expected, and overweight had higher odds of MetS than normal weight. Therefore, screening hypertensive patients with non-obese is very important in prevention of cardiovascular disease.</p> 2020-03-07T00:00:00+07:00 Copyright (c) Factors influencing antiplatelet therapy adherence among patients with acute ST- elevation myocardial infarction in post percutaneous coronary intervention 2020-03-13T13:21:01+07:00 Ketsarin Sriphet Chongjit Seneha Sarinrut Sriprasong Anek Kanoksilp <p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; The present study was a predictive correlational research which aimed at investigating the cognitive illness representation, emotional response and patient-provider relationship on antiplatelet therapy adherence among patients with acute ST- elevated myocardial infarction (STEMI) six months to one year post percutaneous coronary intervention (PCI). The study sample consisted of 177 patients with STEMI post PCI at a specialized tertiary hospital in Nontaburi province.&nbsp; Data were collected by survey of the demographic characteristics questionnaire, the health and medication intake questionnaire, the Brief Illness Perception Questionnaire, Trust in Physician Scale, and the Medication Adherence Report Scale.&nbsp; Descriptive statistics, Spearman’s rho and logistics regression analysis were used to analyze data.</p> <p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; The findings revealed that 79.7% of the participants were male with the mean age of 58.75 years old (S.D. = 11.1).&nbsp; Almost three quarters, or 70.1%, had good medication adherence. Moreover, cognitive illness representation, emotional response and patient-provider relationship could co-predict antiplatelet therapy adherence among patients with STEMI post PCI by 32.3% (Negelkerke R2 = 0.323). Finally, emotional response to illness “fear of relapses” (OR = 1.14, 95%CI = 1.06-1.21, p &lt; 0.001) and relationship between patients and healthcare providers were the two factors that had an influence on antiplatelet therapy adherence (OR = 1.30, 95% CI = 1.15-1.46, p &lt; 0.001) with statistical significance.</p> <p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Based on the study findings, it is recommended that nurses should raise the patients’ awareness about chance of relapses and promote the relationship between patients and healthcare providers to ensure antiplatelet adherence therapy among patients with STEMI post PCI.</p> 2020-03-07T00:00:00+07:00 Copyright (c) Predictors of readmission after one-year hospital discharge with acute decompensated heart failure 2020-03-13T13:25:45+07:00 Suppawan Lertpongpakpoom Chennet Phonphet Jom Suwanno <p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; This study aimed to investigate the predictors of 1 year-readmission in patients with acute decompensated heart failure within a year. A retrospective study was applied with a sample of 461 eligible HF patients, who were admitted to a tertiary care hospital. Reviews of annual medical records were conducted for data collection which consisted of two domains, including demographic domain (age and gender) and heath and illness (length of stay, co-morbidity, serum creatinine, serum sodium, heart rate [HR], and systolic blood pressure [SBP]). Descriptive statistic was used to analyze frequency and percentage of demographic data and binary logistic regression was used to model the effect of predictors of 1 year-readmission after hospital discharge.</p> <p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; The results show that fifty-one percents of HF patients were 1 year-readmissions with ADHF. Three variables, including comorbidity, SBP, and HR variable, were significant association with 1 year- readmission. The final predictive model with binary logistic regression test was 57.3% variance explained. Increment risk for hospital readmission was found in patient with comorbidity (OR 2.83, 95%CI 1.36-5.91). Patients with HR &gt; 80 bpm had predicted hospital readmission (OR 1.60; 95%CI 1.10- 2.33). Additionally, patients with SBP ≥ 140 mmHg had lower risk of hospital readmission by 41% (OR 0.59; 95%CI 0.37-0.91).</p> <p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; The findings of this study offer insight information for caring HF patients. The nurses should provide appropriately continuity of care for HF patients who were cormobidity, HR higher than 80 bpm, and SBP lower than 140 mmHg before hospital discharge.</p> 2020-03-07T00:00:00+07:00 Copyright (c) The development of breastfeeding support model for premature infants with a high risk of having critical condition at Queen Sirikit National Institute of Child Health 2020-03-13T13:34:23+07:00 Sunetra Kaewvichien Siriluck Thavonvattana Wannee Junmast Sukanya Sangtun Suputar Thaor <p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; This research and development design was aimed to develop and to study the effectiveness of the breastfeeding support model at Queen Sirikit National Institute of Child Health. The purposive sample of 57 nurses and 17 mother-premature infant dyads participated in the study. The research instruments consisted of (1) breastfeeding support model for premature infants, and (2) instruments for data collection among nurses and mother - premature infant dyads groups. This study consisted of 3 phases and each phase utilized the continuous quality improvement cycle. Phase I: analyzing the situation and factor that influenced breastfeeding support to sick infants based on Spatz’s model. Phase II: developing the breastfeeding support model for premature infants. Phase III: evaluating the effectiveness of the model. The data were analyzed by descriptive statistics and paired t-test.</p> <p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; The findings revealed that the model named QSNICH’s Breastfeeding Model for Preterm Infants (QSNICH’s BFMPI) was developed from the continuous quality improvement cycle. After participating in the program, there was statistically significant increase in the scores of nurses’ knowledge, attitude, and nurses’ satisfaction with the QSNICH’s Breastfeeding Model (p&lt;.001). Additionally, nurses could follow correctly and practice all steps of the model. Moreover, mother’s attitude was statistically significant increase (p&lt;.001). 76.5% of mothers with premature infants group were satisfaction with model in a very high level. The rates of receiving exclusive breastmilk at discharge and 14 days after discharge among the premature infants were 82.4%.</p> <p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; This study suggests that this model was effective to increase the receiving of breastmilk after birth among premature infants and should support breast feeding for premature infantscontinuously at home.</p> 2020-03-07T00:00:00+07:00 Copyright (c) Factors relating pre - hospital delay in patients with ST elevated myocardial infarction (STEMI) of hospitals in medical service department, Bangkok Metropolitan Administration 2020-04-04T09:24:15+07:00 Pattarasiri Potjamanpong Duangkamon Suktongsa Benchamart Trakoolngamden Yupa Wongrodtri <p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; This retrospective descriptive research aimed to study the factors of the pre-hospital delays in the patients with the ST-elevation myocardial infarction (STEMI) in the hospitals in the Medical Service Department, Bangkok Metropolitan Administration. Data were collected from 200 medical records. Samples were selected with the proportion stratified random sampling method by selecting the medical records of the patients from January 1, 2017 to December 31, 2018. The instru-ments were composed of demographic information and factors associated with pre-hospital delay questionnaire. The data were analysed by means, standard deviations and conducting the binary logistic regression analysis.&nbsp;</p> <p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Results revealed that the factors significantly related with the pre-hospital delays over six hours (p&lt;.001) were chest pains. Chest pain was the obvious symptoms of the patients and the symptoms were reference variables. It was found that the patients acknowledging symptoms and then having back and epigastric pains would be possible to receive treatments with longer delays than the patients with the chest pains for 72 times. By considering underlying diseases, it was found that the patients with diabetes were possible to receive treatments with longer delays than the patients without diabetes for 7.5 times.</p> <p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Based on the findings, this research should concentrate on interventions that target high-risk populations; social, cognitive, and emotional factors contributing to delay; and the contribution to delay for healthcare</p> 2020-03-07T00:00:00+07:00 Copyright (c) The development of ventilator weaning model in critically ill surgical patients in Maharaj Nakhon Si Thammarat Hospital 2020-03-13T14:50:17+07:00 Tarntip Wisettharn Kunjana Pukkham Somjit Yodrabum <p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; This research and development aimed to develop the ventilator weaningmodeland to study the effectiveness of using the model in critically ill surgical patients in Maharaj Nakhon Si Thammarat Hospital. The development of this model was based on the Conduct and Utilization of Research in Nursing: CURN evidence-based framework. There were three sample groups including 1) 18 pro-fessional nurses 2) 70 critical ill surgical patients and, 3) 72 caregivers. The research instruments were 1) a recorded form of personal data and illness data 2) evaluation form of knowledge related to ventilator weaning 3) evaluation form of nurses ‘opinions 4) evaluation for weaning performance of nurses 5) evaluation form of caregivers’ satisfaction, and 6) a manual of ventilator weaning practice called “ABC<sub>2</sub>D<sub>2</sub>E<sub>2</sub>F bundle “developed from evidence-based practice.</p> <p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; The result showed that the ventilator weaning model developed in this study focused on enhancing nursing competencies in the weaning process, utilizing a manual for weaning from ven-tilator, and having more family participation. The outcomes after using this model consisted of 3 aspects. First, the process outcome, after getting a training session, the nurses gained a significantly higher knowledge in the weaning (p=.05). Moreover, the nurses expressed their opinions that the ventilator weaning model was appropriate for utilization at a high level, and more than 80% of them complied with this weaning model. For a clinical outcome, achievement of ventilator weaning was 92.86%. in the group of simple weaning with 52.86%. The average duration of ventilator weaning was 4 days. The organizational outcomes showed that the average length of stay in the intensive care unit was 9.61 days, and 43.05% of the caregivers were satisfied with the care in the intensive care unit.</p> <p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; This study suggests that ventilator weaning model using the “ABC<sub>2</sub>D<sub>2</sub>E<sub>2</sub>F bundle” for practice could increase the care process, clinical, and organizational outcomes, Critical care nurses play a crucial role in collaboration between health team and family. This ventilator weaning model should be used at other critical care in order using an evidence-based practice as a guideline and to improve quality of patients care.</p> 2020-03-07T00:00:00+07:00 Copyright (c) The development of a clinical supervision model for severe sepsis patients 2020-03-13T14:59:37+07:00 Rachaneewan Rachaneewan Pitchayanan Chantara Patcharee Yimyam Sureeporn Khumpakum Rachanee Namjuntra <p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; This research and development study aimed to develop a clinical supervision model for severe sepsis patients by using Proctor’s model and to evaluate the outcomes of this developed model. There were 5 steps in study process; 1) survey of clinical supervision problems, 2) development of a clinical supervision model for severe sepsis patients, 3) pilot study of the clinical supervision model in clinical practices, 4) evaluation of the clinical supervision model 5) use of the clinical supervision model in the institution. The samples were 22 head nurses, 327 registered nurses, and medical records of severe sepsis patients before and after the development of the clinical supervision model, 73 patients’ records in each group. The research tools were 1) Focus group question, 2) clinical supervision model utilization questionnaires, 2) nursing knowledge tests, 3) records of care process and outcomes.</p> <p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; The results showed that the developed clinical supervision model to solve the problems and obstacle consisted of identifying roles and functions of supervisor, identifying issues of clinical supervision, collaboration between head nurse and staff nurses in planning and doing clinical supervision, including evaluation of clinical supervision. After development of a clinical supervision model for severe sepsis patients, the head nurses had improved knowledge and attitude on clinical supervision. The registered nurses had increased nursing care knowledge for severe sepsis patients after clinical supervision model implementation. There were significantly increased in rate of detection patient sign changes, rate of blood collection for hemoculture before antimicrobial administration, rate of antimicrobial administration within 1 hour, and rate of adequate tissue perfusion within 6 hours (p&lt;.01).</p> <p>&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Nurse administrators should continuously evaluate outcomes in caring of severe sepsis patients, and further develop clinical supervision models for other groups of patients.</p> 2020-03-07T00:00:00+07:00 Copyright (c)