Development of A Care System for Patients with Sepsis and Septic Shock at Warinchamrap Hospital
Keywords:
Sepsis, septic shock care, system for patientsAbstract
Septic shock causes rapid, multi-organ failure throughout the body and is life-threatening. This research and development study aimed to develop and evaluate the outcomes of an integrated care system for patients with sepsis and septic shock at Warinchamrap Hospital. The sample consisted of 164 physicians and registered nurses, and 70 patients diagnosed with sepsis or septic shock who were admitted to Warinchamrap Hospital. The patients were divided into a comparison group (n = 35) receiving routine care and an experimental group (n = 35) receiving care through the newly developed sepsis and septic shock care system. Research instruments included a collaborative practice guideline for the hospital sepsis and septic shock care committee, a clinical practice guideline for sepsis and septic shock management, data recording forms, and a satisfaction questionnaire. Data were analyzed using descriptive statistics, Mann–Whitney U test, paired t-test, Fisher’s exact test, and risk ratio regression. The findings revealed that: 1) The sepsis and septic shock care system developed for Warinchamrap Hospital was appropriate, feasible for clinical implementation, and yielded the expected outcomes. 2) Process outcomes showed that the experimental group had a shorter time to diagnosis than the comparison group, although the difference was not statistically significant. However, the time to first antibiotic administration in the experimental group was significantly shorter than that in the comparison group. For clinical outcomes, the results indicated that the experimental group had a significantly greater reduction in 3-hour lactate levels compared with baseline in the emergency department. The mortality rate in the experimental group was also significantly lower than that in the comparison group. In terms of service outcomes, it was found that the experimental group had a significantly shorter length of hospital stay compared with the comparison group. Regarding staff satisfaction, physicians and nurses reported high overall satisfaction with the care system. Therefore, the results indicate that the integrated care system for patients with sepsis and septic shock developed in this study is effective.
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บทความและรายงานวิจัยในวารสารพยาบาลกระทรวงสาธารณสุข เป็นความคิดเห็นของ ผู้เขียน มิใช่ของคณะผู้จัดทำ และมิใช่ความรับผิดชอบของสมาคมศิษย์เก่าพยาบาลกระทรวงสาธารณสุข ซึ่งสามารถนำไปอ้างอิงได้
