Development of Nursing Care Model for Open Heart Surgery Patients in Surgical Intensive Care

Abstract

The research and development aim to develop and study the outcomes of a nursing model for heart surgery patients in the Surgical care unit at Maharaj Nakhon Si Thammarat Hospital. The model is developed by applying the nursing process framework through four stages: 1) Situational analysis, 2) Nursing model development, 3) Implementation and outcome study of the model, and 4) Outcome evaluation. The sample includes 20 Registered Nurses, 32 heart surgery patients, and 32 caregivers. Data were collected for 3 months, utilizing personal and illness data recording forms, a knowledge assessment form about open-heart surgery nursing, a nurses’ opinion survey on the nursing model, a compliance assessment form for the nursing model, a caregivers’ satisfaction survey, and a nursing practice manual. The data was analyzed using descriptive and paired t-test.
The study results on the nursing model using the nursing process for heart surgery patients are divided into two phases: preoperative and postoperative care. The nursing interventions are conducted in five steps according to the nursing process framework: 1) assessment 2) nursing diagnosis 3) planning 4) implementation and 5) evaluation. The findings are as follows: 1) Process Aspect: Nurses’ knowledge significantly increased after following the model (p<.05) and the opinions about the nursing model were satisfied, and the adherence rate to the developed model was 96.9%., 2) Clinical Aspect: The incidence of postoperative complications decreased and the success rate of extubation increased., and 3) Organizational Aspect: The length of hospital stay was reduced, and caregivers’ satisfaction was high. And suggested that there should be a channel for consultation when patients are moved out of the intensive care unit.