Development of a Nursing Service Model for Stroke Patients in Bueng Kan Hospital

Abstract

Objectives: 1) To develop a nursing service model for stroke patients in Bueng Kan Hospital. 2) To evaluate the outcomes of the nursing service model for stroke patients in terms of: 1) service providers, 2) quality, and 3) service users. Methods: This was a research and development (R&D) study. Data were collected between July 20, 2023 and January 31, 2024. The samples were: 1) stroke patients admitted to Bueng Kan Hospital between November 1, 2023 and January 31, 2024, and 2) 74 professional nurses working in the care of stroke patients in the male medical ward (12 nurses), female medical ward (12 nurses), male surgical ward (12 nurses), female surgical ward (12 nurses), special ward (9 nurses), and intensive care unit (17 nurses). The research instruments were: 1) a questionnaire on the nursing service situation for stroke patients, 2) an evaluation form for the nursing service model for stroke patients in Bueng Kan Hospital, 3) the nursing model for stroke patients in Bueng Kan Hospital, 4) a knowledge assessment form for professional nurses on stroke nursing, 5) a satisfaction assessment form for professional nurses on the nursing model for stroke patients in Bueng Kan Hospital, 6) a record form for compliance with the nursing service model for stroke patients in Bueng Kan Hospital, 7) a data record form for stroke patients with ischemic stroke, 8) the Barthel Index (BI-ADL) for assessing the ability to perform daily activities, and 9) a satisfaction assessment form for patients/caregivers on the nursing practice guidelines for stroke patients in Bueng Kan Hospital. Descriptive statistics and Paired Samples t-test were used for data analysis. Results: The nursing service model for stroke patients in Bueng Kan Hospital consisted of 2 components: 1) Guidelines for the administration of nursing workforce for stroke patient care. 2) Nursing practice guidelines for stroke patients. The evaluation of the nursing service model for stroke patients showed that: 1) The knowledge of professional nurses about stroke nursing after using the nursing service model for stroke patients had a mean score increase and was statistically significant (p<.005). 2) The level of satisfaction with the nursing model for stroke patients in Bueng Kan Hospital was at a very satisfied level (60.8%), followed by the most satisfied level (35.1%). The overall mean score was 3.98. 3) Compliance with the nursing practice guidelines for stroke patients showed that all 7 activities of the nursing practice guidelines for stroke patients were highly practiced. The overall mean score was 13.5. 4) Compliance with the guidelines for the administration of nursing workforce for stroke patient care showed that all 7 activities of the guidelines for the administration of nursing workforce for stroke patient care were highly practiced. The overall mean score was 13.8. 5) No complications of increased intracranial pressure, pressure sores, and pneumonia were found after using the nursing model for stroke patients. The incidence of urinary tract infection was 1.70%. The average length of stay was 4.8 days. 6) The level of ability to perform daily activities (BI-ADL) before discharge was higher than that at admission. 7) The satisfaction of patients/caregivers with the nursing practice guidelines for stroke patients had an overall mean score of 3.93, which was at a very satisfied level (62.3%), followed by the most satisfied level (20.8%). Conclusion: The nursing service model for stroke patients in Bueng Kan Hospital, which was developed, resulted in high satisfaction of service users and a reduction in complications. Service providers had increased knowledge and high satisfaction.