The Development of Head Injury Patient Care Model and Undergoing Cranial Surgery in Uthai Thani Hospital

Abstract

Objectives:  Developing of head injury patient care model and undergoing cranial surgery by applying a model to Enhanced Recovery After Surgery (ERAS) and study the results of head injury patient care model and undergoing cranial surgery. Methods: This research was research and development. The samples group in this study were 30 professional nurses with experience working and caring for head injury patients who had undergone cranial surgery and medical record of 30 patients who had undergone cranial surgery by selecting purposive sampling. This was consists of 3 phases as following: Phase 1: study the nursing situation for patients undergoing cranial surgery by tools include data recording form and semi-structured interview group discussion guide. Phase 2: develop of head injury patient care model and undergoing cranial surgery in Uthai Thani Hospital. The research tools consisted of (1) nursing model for head injury patient care and undergoing cranial surgery by applying a model to Enhanced Recovery After Surgery (ERAS). Phase 3: study the results before and after using the model. The research tools consisted of (1) a questionnaire regarding general information of professional nurses (2) a recording form for evaluation nursing practice for head injury patients who received cranial surgery, consisting of preoperative, intra-operative and postoperative nursing care and (3) patient outcome records collect information from medical records. The research instrument was checked for content validity with an item consistency index equal to 1.00 and Cronbach's alpha coefficient was used to find confidence equal to the appropriateness at 0.95 - 0.98. Qualitative data were analyzed in Phases 1 and 2 by content analysis and drawing conclusions. Quantitative data was analyzed in Phases 1 and 3. Quantitative data was analyzed using descriptive statistics. Comparative statistics: Paired t-test and Independent t-test were performed for data collection in June to December 2023. Results: Developing of head injury patient care model and undergoing cranial surgery consisting of preoperative, intra-operative and postoperative nursing care. The results was a higher adherence to the guidelines than before used, with a statistically significant difference (p < .05, p < .01, p< .001). The nursing outcomes for head injured patients that undergoing cranial surgery on the patient after using the model had better results than before using the model. Including postoperative death, Length of Stay (LOS) and re-operation are decreased. As for surgical wound infection, there was no significant difference. Conclusion: The development of head injury patient care model and undergoing cranial surgery by applying a model to Enhanced Recovery After Surgery (ERAS) could increase nursing care outcomes for head injury patients who undergoing cranial surgery and could be better result  nursing care for head injury patient care model and undergoing cranial surgery.