The Development of Nursing Model for Acute Ischemic Stroke at Emergency Department, Amnatchareon Hospital
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Abstract
This research and development aimed to develop and study the effectiveness of the nursing model for patients with acute ischemic stroke at emergency department, Amnatchareon Hospital. The study consisted of 4 phase: (1) situation analysis, (2) development of the nursing model, (3) implementation, and (4) evaluation. The sample composed of 72 patients with acute ischemic stroke and 32 professional nurses. The research instrument included the knowledge development program of registered nurses and nursing practice guidelines. This instrument was assessed for content validity using 5 experts. Data collecting tools consisted of the medical quality record form and personnel satisfaction questionnaire. These tools were tested for Cronbach's alpha coefficient, yielding the number of .81 for whole questionnaire. The knowledge test of the nurses was examined using KR-20, yielding a number of .88. Data were analyzed using descriptive statistics and pair t- test.
The results showed that the nursing model for acute ischemic stroke patients consisted of the professional nurse competency development program and the network, and nursing practice guidelines for acute ischemic stroke patients. The effectiveness of the model included nursing quality outcomes such as knowledge and satisfaction of the nurses, and compliance with nursing practice guidelines. Health service outcomes consisted of emergency medical service call 1669, stroke fast tract, fibrinolysis treatment rt- PA within 60 minutes, and the patient care duration from onset of the symptoms until discharge from the emergency room. It was found that the volume of 1669 emergency medical service calls increased, increased access to stroke fast tract, increased exposure to rt-PA within 60 minutes, and duration of care from the onset of symptoms until discharge from the emergency room was reduced
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