The Development of a Surveillance Guideline for Patients with Deteriorating Symptoms While Waiting for Examination at The Medicine Outpatient Department, Sawanpracharak Hospital
Article Sidebar
Main Article Content
Abstract
Abstract
This participatory action research aimed to develop and evaluate the outcomes of using the surveillance guidelines for the deteriorating-symptoms patients while waiting for examination at the medical outpatient unit, Sawanpracharak Hospital. There were 2 phases of study: (1) situation analysis and developed the guidelines, and (2) implantation and evaluation the guidelines. The sample of phase 1 included 7 physicians and nurses. Data were collected using semi-structured group discussion questions. The sample of phase 2 included 26 nurses, working at the medical outpatient examination room, and 11,252 patients, received services during the study. The research instruments comprised of (1) the surveillance guidelines, (2) Sakon Nakhon Hospital Modified Early Warning Signs (S-MEWS), (3) Search Out Severity (SOS), and (4) MOPH ER Triage assessments in conjunction with the patient symptoms. Data collecting tools consisted of (1) observational forms, and (2) satisfaction questionnaire. Data were analyzed using percentages, means, standard deviations, and independent t-tests.
The findings revealed that the surveillance guidelines for the deteriorating-symptoms patients while waiting for examination at the medical outpatient unit consisted of (1) color-coded criteria for categorized the patient urgency, and (2) nursing actions according to the patient’s groups. After using the guidelines, 89.31% of the cases were non-urgent patients. All of the urgent patients received nursing care until their symptoms improved. All of the emergency patients were promptly referred and cared for in the emergency department. After the guideline’s implementation, the nurses could correctly classify the patients according to their urgency level and could follow the guidelines more accurate than before using the guidelines, yielding statistically significant at p < .05. The nurses had a high level of satisfaction (Mean 2.79, SD 0.47). There was no incidence of the patient death, while waiting for the examination
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
References
References
News and media relations mission group Information Bureau, Office of the Permanent Secretary, Ministry of Public Health. Drive safety policy for personnel, patients, and the public. [Internet].2023 Nov 26 [cite 2024 Jan 20]; Available from:
http://www.pr.moph.go.th/url=pr/detail/2/04/202841. Thai
Darunee Chanruechai,Panarat Thao Udom, Patchalin Huntirath. Research report on development of a system for sorting patients for outpatient work Phra Achan Fan Acharo Hospital, Sakon Nakhon Province. [Internet]. 2022 Sep 7 [cite 2024 Jan 20]; Available from: https://skko.moph.go.th/dward/document_file/oa/research_file_name/20220907100431_585175189.pdf. Thai
Tepirat Thetprasit. Development of patient classification system Outpatient and emergency work Chokchai Hospital. RHPC9.2564;15(36):160-178. Thai.
Bureau of Nursing. Nursing standards in hospitals. 3rd ed. Nonthaburi: War Veterans Organization Printing House; 2008. Thai.
The Royal College of Surgeons of England. Outpatient clinics: A guide to good practice London. The Royal College of Surgeons of England; 2017.
Sawanpracharak Hospital. Summary of annual work 2563-2565. [Internet]. 2023 March [cite 2023 Sep 20]; Available https://static.spr.go.th/index.php?r=statisticdata/reports. Thai
Nittayaporn Channakorn, Tasanee Daekuntut, Uraiwan Sridama, Piyanuch Boonkong. Development of a model for evaluating crisis warning signs for seriously ill adults Sakon Nakhon Hospital.NDJ. 2563; 47(1): 39-60. Thai.
Bureau of Medical Sciences, Department of Medical Services, Ministry of Public Health. MOPH ED. Trige Nonthaburi: Ministry of Public Health; 2018. Thai.
National Institute of Emergency Medicine. Criteria for separation of emergency patients and remember the order of care at Emergency Department according the criteria prescribed by National Institute of Emergency Medicine. (No.1). Bangkok: National Institute of Emergency Medicine; 2013. Thai.
Saisamorn Chaleoykitti, Pornnapa Kamprow, Sompis Promdet. Safty and Qualityof Nursing Service. JRTAN.2014;15(2):66-70. Thai.
Orawan Rittarangkun, Worawut Khaothong, Parinan Kongsomboon, Somsri Khiao-on. Development of emergency patient triage system. Sawan Pracharak Hospital. JDMS. 2018; 43(2): 146-151. Thai.
Watcharee Kraisingdecha. Improving the efficiency of monitoring patient symptoms while waiting to be examined in the surgical examination room, Outpatient Group, Buddhachinnarat Hospital, Phitsanulok. Journal of Health Nursing and Public Health. 2022; 1(1): 40-52. Thai.
Nittayaporn Channakorn, Tasanee Daekuntut, Uraiwan Sridama, Piyanuch Boonkong. Developing a model for evaluating crisis warning signs. For seriously ill adults Sakon Nakhon Hospital. NDJ. 2020; 47(1):39-60. Thai.
Sanya Yueran, Civilize Wanaratwijit. Participatory action research towards successful policy change in the health system. 1st ed. Phitsanulok: Naresuan University; 2014. Thai.
Theeradej Riwmongkol. Teamwork. Bangkok: Ramkhamhaeng University; 2013. Thai.
Netphanna Yaviraj.Leadership and strategic leadership.8th ed. Bangkok: Triple; 2013. Thai.
Juntima Pornsensaworaphong, Junnapa Khamwachanang, Kawinnat Bunchu. The results of developing guidelines for the care of patients with acute myocardial infarction. High-lift ST type Accident and Emergency Department, Nakhon Nayok Hospital. JFONUBUU. 2015; Burapha University. 23(3) :97-111. Thai.
