Development of Early Warning Signs Assessment Model for Adult Critical Patients at Sakon Nakhon Hospital

Abstract

This research and development aimed to develop and study the effect of the early warning signs assessment model for Adult Critical Patients at Sakon Nakhon Hospital. The study conducted during October 2017 - March 2019 and employed Mahdjoubi (2009) as a research methodology. The subjects were 72 nurses and 437 patients. The research tools consisted of Early Warning Signs, Assessment Model, group discussion questionnaire, medical review records, nursing competency assessment form, clinical supervision assessment form and satisfaction assessment form. Data were analyzed using group content, mean, percentile, Wilcocxon Signs Ranks test and Chi-square test.

The results revealed that the Early Warning Signs Assessment Model at Sakon Nakhon Hospital consists of 3 components; (1) The Sakon Nakhon Modified Early Warning Signs assessment (S-MEWs) included the pre - arrest signs assessment were admission quick check, and the early warning signs assessment included vital sign, sign and symptom, laboratory and electrocardiography alert were ongoing assessment (2) The critical nursing competency framework of Benner's 7 components and (3) The clinical supervision guidelines were formative, normative and restorative clinical supervision including 7 activities; content conference, coaching, consultation, nursing conference, nursing round, observation and participation. The outcomes of model development on the patients showed reduction of cardiac arrest, shock and respiratory failure (p<.05). The outcomes on healthcare providers’ competency showed knowledge improvement (p<.05), assessment skill improvement 86.55% and follow the model’s practice protocol 88.24 %.  The satisfaction towards using the model also was at the highest level (mean=4.53, SD=0.51).