Development of Nursing Service System for Patients with Stroke, Nan Hospital

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สุปราณี ยะวิญชาญ
วรวรรณ ชำนาญช่าง


Care for stroke patients needs a care service system developed by multi-disciplinary teams. This research and development study aimed to develop a nursing service system for patients with stroke in Nan hospital. The study involved 3 stages, including 1) analyzing data obtained from patient charts and interviews with stakeholders, 2) developing and testing the nursing service system, and 3) evaluating the efficacy of the developed system. Participants consisted of 3 groups of stakeholders, including 110 stroke patients, care givers, a multi-disciplinary team, and professional nurses working at an emergency room. The study had been conducted from April 2017 to September 2018. The research instruments consisted of the nursing services system, including care maps for stroke patients, practice guidelines for stroke patients, and plans for improving nurses’ competencies regarding stroke care. Data were collected using a chart auditing form, interview form, Barthel ADL index, questionnaires assessing caregivers’ understanding and competences regarding stroke care, and a questionnaire assessing nurses’ competences regarding stroke care. The findings revealed that after the implementation of the nursing service system for stroke patients, participating patients reported a higher level of ADL at 30 days after discharge, compared to the score at discharge day. Also, caregivers had a high level of understanding and skills, and gave sufficient care to stroke patients; consequently, patients’ clinical outcomes reached an acceptable standard of care. Regarding health care professions’ competencies, over 90% of the multi-disciplinary team followed the practice guidelines. The competency score regarding the care for stroke patients of the nurse working at acute and emergency department was significantly increased (p<.001). This study suggests that the systematic development of a nurse service system for stroke patients can improve health professionals; competencies, and helps stroke patients to get a high standard of service. However, the nursing service system should be continuously developed for attaining a higher standard of care.


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ยะวิญชาญ ส, ชำนาญช่าง ว. Development of Nursing Service System for Patients with Stroke, Nan Hospital. NJPH (วารสาร พ.ส.) [Internet]. 2019 Dec. 20 [cited 2023 Feb. 1];29(3):205-18. Available from:


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