Development of Caring System for Patients with Severe Head Injury Admitted to Accident and Emergency Department, Songkhla Hospital

Abstract

This developmental research aimed to determine situation, success factors, development of caring system for patients with severe head injury and effectiveness of development of caring system for patients with severe head injury admitted to accident and emergency department, Songkhla Hospital. Research implantation had 3 phases. Phase 1 was study of situation and success factors of implementation of  development of caring system for patients with severe head injury. Informants for qualitative data were 10 persons who involved working in caring for patients with severe head injury, which were purposively selected. Data were collected through interview and analysed using content analysis. Phase 2 was development of caring system for patients with severe head injury admitted to accident and emergency department, Songkhla Hospital. Researcher reviewed literatures, text books and related researches and synthesized the results of phase 1. A system model was drafted and validated by a panel of 3 experts, which had the index of item-objective congruence ranging from 0.67 to 1.00. Data were analysed using paired t-test. Phase 3 was study of effectiveness of caring system for patients with severe head injury. Sample were 11 patients admitted to accident and emergency department, Songkhla Hospital. Data were analysed using mean. Research results showed that;

1. The situation of caring system for patients with severe head injury admitted to accident and emergency department, Songkhla Hospital included a lack of specialists, delayed caring process, a lack of knowledge of caring for patients with head injury, and insufficient staffing.

2. The success factors of caring system for patients with severe head injury admitted to accident and emergency department, Songkhla Hospital included access to fast services, team working, sufficient equipment and staffing, giving information to the patient relatives, development of neurotrauma fast track system, and development of knowledge and nursing competencies.

3. The caring system for patients with severe head injury admitted to accident and emergency department, Songkhla Hospital consisted of 7 phases including 1) access, 2) assessment, 3) resuscitation, 4) reassessment, 5) plan of care, 6) consultation, and 7) definitive care.

4. The phase of access to emergency room (ER) of emergency medical system, Songkhla hospital, the phase of donor to CT brain, and the phase of admission to discharge from ER after system development tended to be short.

Therefore, effective communication systems both external and internal related departments should be established in order to provide fast access to patients with sever head injury and readiness for prompt assistance.