Development of Scrub Nurses’ Abilities in Nursing Care for Patients Who Received Open Reduction and Internal Fixation Femur Fracture at Phra Nakhon Si Ayutthaya Hospital Network

Abstract

     The purpose of this action research was to study the situation and to develop the abilities of scrub nurses in nursing care for patients who received of open reduction and internal fixation (ORIF) femur fracture at Phra Nakhon Si Ayutthaya Hospital Network, and to evaluate the development. This study was divided into 3 phases: 1) Situational study phase; 2) Development the abilities of scrub nurses in nursing care for patients who received of ORIF of femur fracture phase and 3) Evaluation phase. The participants for the research consisted of 23 people which were comprised of orthopedics nurses, and head nurses of operating room department. The research was conducted from October, 2015 to September, 2017. The data was collected through the general information questionnaires, the open-ended questions, the incidence report forms, the evaluating coaching competency and operating competency of nurse in ORIF questionnaires, the evaluating nursing process forms, and the evaluating nursing record forms. The quantitative data was analyzed by using frequency distribution, percentage, mean, Dependent t-test and qualitative data was analyzed by content analysis. The results of the study regarding the 1st phase found that there is increasing number of open reduction and internal fixation (ORIF) femur fracture every year. Also, the results found that limited access to surgical services of patients due to operating room structure, staff availability, and availability of nurses and necessary equipment. These findings lead to the 2nd phase which deals with the ability of the staff, appropriate training and lack of coach. The results of this study were applied to development of nurse’s abilities, such as the coaching skills and the abilities in ORIF surgery of staff nurses behaved differently at 0.05 level of significant. (p<.05). The organization had the competency evaluation guideline and the ORIF surgery ability of nurse’s development guideline. As for the process of development, there were no incidences of cancellation of ORIF surgery, inefficient use of operating room time and a waste of resources.