Krabi Medical Journal

Lean concepts utilization in outpatient nursing services improvement in lamthap hospital

Natenapa Sammuang — Tue, 25 Jun 2024 00:00:00 +0700

The purpose of this Qualitative research was to study the developing a nursing service model using the Lean concept in the outpatient department, Lam Thap Hospital, Krabi Province , evaluated results from satisfaction and service waiting time. The sample were the outpatient department service recipients from December 2023 - January 2024.The sample size was 396, selected with the Purposive Sampling.The research instrument was a questionnaire provided from the Nursing Division Ministry of Public Health. Data were analyzed by descriptive statistics, including frequency, percentage and average with standard deviation. The results showed that it was possible to reduce the work process steps in the outpatient department from 6 steps to 5 steps. Operated by combined patient triage service point and patient history taking service point for appointments together and added a self-registration point at an automatic registration kiosk. The results of evaluating the satisfaction of service recipients after improving the work process were greater than before improving the work process Increased 13.68 percent from 70.9 percent to 80.6 percent, with statistical significance at the .05 level. And the waiting time of service recipients after improving the work process was less than the waiting time before improving the work process decreased by 28.31 percent from 60.4 minutes to 43.3 minutes, with statistical significance at the .05 level. This study showed that work process development using the Lean concept Helps work to be more efficient. Therefore, a clear organizational policy should be established. There is a focus on the same goal of every department and encourage personnel in the organization to study and learn the process of applying Lean concepts in order to make the service work process at each service point efficient and service recipients are more satisfiedKeywords: Lean process waiting period satisfaction

The results of developing the competency of professional nurses in caring for patients with ST-segment elevation myocardial infarction (STEMI)

susaraporn inthongkom — Fri, 28 Jun 2024 00:00:00 +0700

Abstract

This quasi-experimental research The objective was to compare the mean knowledge scores of professional nurses before and after developing competency in caring for patients with ST segment elevation acute myocardial infarction (STEMI). and compare the mean performance scores for blood clot dissolving drugs. Streptokinase of professional nurses before and after developing competency in caring for patients with ST segment elevation acute coronary syndrome (STEMI). The sample group was professional nurses from the Tha Chang hospital network. By selecting a specific type of 30 people, data collection was done using questionnaires before and after the competency development. Statistics used in data analysis include percentage, mean, standard deviation, Paired Sample t-test.

The research results found that After joining the health promotion program The sample group's mean knowledge score of professional nurses after developing competency in caring for ST segment acute coronary syndrome patients was higher than before developing competency at the statistical significance level of .05 (p-value < .001). and had an average score of performance in administering blood clot-dissolving drugs Streptokinase of professional nurses before and after developing competency in caring for patients with ST segment elevation acute coronary syndrome (STEMI) was significantly higher than before developing competency at the .05 level (p-value < .001).

The results of research on the development of knowledge for professional nurses are therefore extremely important. Activities can be established to develop knowledge for patients with acute myocardial infarction (STEMI) by organizing training to educate professional nurses in screening assessments. Acute myocardial ischemia using the OPQRST+R principle, including electrocardiogram and results interpretation. and laboratory examinations for Quick and accurate diagnosis Patients receive timely medical treatment. Reduce death rates and complications from disease

Keywords : Developing,Competency of professional nurse, ST- elevation myocardial Infarction

Development of a system for preventing normal postpartum hemorrhage. ThaChang Hospital Surat Thani Province

wannaphon innimit — Fri, 28 Jun 2024 00:00:00 +0700

Abstract

Postpartum hemorrhage refers to the loss of blood from the vagina of 500 ml or more after the birth of the baby. It is a leading cause of maternal death and morbidity worldwide. The objective of this research and development is to evaluate the results of the care system for preventing postpartum haemorrhage in women who have had normal births. Tha Chang Hospital

The sample group consisted of 2 groups: Group 1 were 6 professional nurses working in maternity care. Group 2 was pregnant women who came to receive the service. Purposeful selection of both groups was carried out. and carried out the study as follows: Situation analysis Development and evaluation of the development of a system for the prevention of normal postpartum haemorrhage. Tha Chang Hospital A practical tool for preventing postpartum hemorrhage in women with normal births. Assessment of the use of nursing guidelines to prevent postpartum hemorrhage in Tha Chang Hospital. Assessment of nurses' satisfaction with guidelines for preventing postpartum hemorrhage which has been checked for content validity by experts. Data were collected by observation, supervision, and review of medical records between 1 November 2023 - 31 January 2024. Data were analyzed using descriptive statistics including number, percentage, mean, and standard deviation.

The results of the research found that overall satisfaction with the use of guidelines for preventing postpartum hemorrhage was at the highest level ( = 2.9). When considering each item, it was found that the group was satisfied with the benefits to service providers in Nursing practice is at a high level ( = 2.6 ). Birth outcomes from the use of guidelines to prevent postpartum hemorrhage by nurses in the delivery room. Tha Chang Hospital from 1 November 2023 - 31 January 2023 found that there were 50 pregnant women who came for delivery services, with 98 percent of all giving birth vaginally. Blood loss was < 500 milliliters. Most of the women who gave birth did not. Severe complications occurred that required him to be sent for further treatment to Surat Thani Hospital.

Keyword: Development of a system , Postpartum hemorrhage

Perceived Patient Safety Culture Among Nursing Personnel, the Thonburi-Chumphon Hospital

สุวีณา หลิมวัฒนา, Petsunee Thungiaroenkul, Apiradee Nantsupawar — Fri, 28 Jun 2024 00:00:00 +0700

The purpose of this descriptive study was to explore the perception of patient safety culture among nursing personnel in the Thonburi-Chumphon Hospital. The samples were 116 nursing personnel in the hospital. The research instrument was a patient safety culture questionnaire that was developed by Kanokwan Methaphan (2013). Data were analyzed using descriptive statistics.

The results showed that the overall patient safety culture in the Thonburi-Chumphon Hospital was at a moderate level (=3.63, SD=0.36). Considering the results of subscale of patient safety culture, the study revealed that there were 5 subscale of patient safety culture at moderate level, including Non punitive Response to Error, staffing, Handoffs & Transitions, Communication Openness , Frequency of Events Reported Meanwhile, there were 7 subscale of patient safety culture at high level, including Supervisor/Manager Expectations & Actions Promoting Patient Safety, Organizational Learning -Continuous Improvement, Teamwork Within Units, Management Support for Patient Safety, Feedback & Communication about Error, Teamwork Across Units, and Overall Perceptions of Patient Safety These findings could be used as fundamental information for hospital administrators to improve patient safety management and enhancing patient safety culture in the hospital.

Keywords: Patient Safety, Patient Safety Culture, Nursing Personnel

Effectiveness of Patient Centered Care Program for Reducing Cardiovascular Risks in Chronic Disease, Primary Care Unit Krabi Hospital

Pikulkaew Payungpun — Thu, 20 Jun 2024 00:00:00 +0700

This quasi-experimental research aimed to study the effectiveness of patient centered care program for reducing cardiovascular risks in chronic disease, primary care unit Krabi hospital. This research used a representative random sampling method to select the instance, with 33 participants. They were collecting the data from June to November 2021. The instruments composed of personal data form, the Guidelines for Assessment of Cardiovascular Risk, Knowledge questionnaire, and hearth behaviors questionnaires.Data were collected through questionnaire before and after the experiment 6 months. Data were analyzed by descriptive statistics, Wilcoxon Signed Ranks Test and McNemar Chi-squared.

The result found that in the sample after receiving the program, there was a statistically significant increase in stroke knowledge and healthy behavior about diet control and exercise before receiving the program (p<0.001). and an decreasing CVD risk score score significantly (p<0.001.The healthcare outcome was decreased fasting blood sugar, Hemoglobin A1C, blood pressure, Cholesterol and low density lipoprotein after receiving the program (p<0.05), respectively.

The patient centered care program applied to prevent cardiovascular risks can help diabetes or hypertension patients have better knowledge and health behavior and good glycemic control, decrease blood pressure and lipid profile. The relevant health personnel should also continually conduct follow-up and health condition assessments.

Performance Indicators for Dengue Hemorrhagic Fever Disease Control and Prevention in Community by Village Health Volunteers: A Factor Analysis Research from Krabi Town Municipality

atjima chanakul — Fri, 21 Jun 2024 00:00:00 +0700

This quantitative research on community Dengue Hemorrhagic Fever Disease Control and Prevention operations by village health volunteers (VHVs) aimed to study the components and indicators of their performance in Krabi Town Municipality. The sample was 225 village health volunteers, working under the Krabi Town Municipality. They were selected by stratified random sampling. The research tool was a questionnaire, validated for content validity with an index of item objective congruence (IOC) between .67 – 1.00. The Cronbach's alpha coefficient of the entire questionnaire was .96 Data were analyzed by Exploratory Factor Analysis (EFA), including the process of factor extraction and factor rotation by means of Varimax method.

The results showed that the performance of Dengue Hemorrhagic Fever Disease Control and Prevention operations in the community by the VHVs consisted of 3 components and 17 indicators. These could explain the variability of the indicators at 51.30 %, consisting of: 1) surveillance disease in the community performance (8 indicators), 2) introduction to disease prevention and symptoms performance (4 indicators), 3) elimination of aedes mosquito larvae performance (5 indicators)

The components obtained from this research might be used to assess the efficiency of Dengue Hemorrhagic Fever Disease Control and Prevention operations in the community, in accordance with the roles of village health volunteers, and this, prior to formulating any model or method for developing disease control operations.

The results of Therapeutic Apheresis treatment on patients with hematological diseases who received treatment at Krabi Hospital during the period of 2016 to 2023

Kanoksak Wisutthisup, Wipa Pruitoun — Fri, 21 Jun 2024 00:00:00 +0700

Therapeutic Apheresis is a treatment for patients by separating components in the blood, such as white blood cells, lymph, and substances in the lymph that cause disease, from the patient. Apheresis in the long term will help chronic patients reduce the dosage of immunosuppressive drugs. resistance, such as steroids Reduce the duration of inpatient treatment as well as resulting in patients living and working normally. This research design was Retrospective descriptive study aimed at studying the results of Therapeutic Apheresis treatment on patients with hematological diseases who received treatment at Krabi Hospital. The objectives were to examine the efficacy of treating patients by separating blood components and to study the side effects of this treatment method. The research period is December 2023 to March 2024. A specific random sample was drawn from patients diagnosed with TTP and AIHA disease. There were 9 cases treated as inpatients and received treatment using Therapeutic apheresis. Data were collected using patient records from medical records and analyzed using descriptive statistics, presenting numbers, percentages, means, and ranges.

The results found that Sample groups that received treatment with the method Therapeutic Plasma Exchange (TPE) 9 cases. 8 cases (88.89%) survived and were discharged, while 1 case (11.11%) passed away. Among the surviving patients, 1 case (11.11%) had TPE discontinued. Laboratory test results showed a decrease in lactate dehydrogenase (LDH) levels from an average of 1,688 U/L before TPE to 919 U/L after TPE, an increase in hematocrit (Hct) from an average of 20% before TPE to 21% after TPE, and an increase in platelet count from an average of 50,556 cell/mm³ before TPE to 95,778 cell/mm³ after TPE. Minor adverse effects were observed in 3 cases (33.33%) during TPE, including pruritus in 2 cases and tremors and pruritic rash in 1 case.

In conclusion, Therapeutic Apheresis treatment for patients with hematological diseases, specifically Thrombotic Thrombocytopenic Purpura (TTP) and Autoimmune Hemolytic Anemia (AIHA), showed efficacy in treating TTP and AIHA. Therefore, Therapeutic Plasma Exchange doctors and related medical personnel should be considered as a first-line therapy for TTP patients and should also be considered for AIHA patients. Additionally, to reduce complications, administration of 10% calcium gluconate to prevent hypocalcemia and the use of male donor fresh frozen plasma (FFP) to mitigate other adverse effects should be considered

Nursing care of patients with hyperglycemia combined with ketone retention in the critical period: a case study

saowalee maneesri — Fri, 14 Jun 2024 00:00:00 +0700

Abstract

Controlling blood sugar levels in diabetic patients to reach target values. and follow-up to monitor for vascular complications It is an important guideline in caring for diabetic patients to have a good quality of life without complications. A case study of 2 patients with hyperglycemia combined with ketone retention in critical stages. Purpose for Comparative study of nursing care for patients with hyperglycemia combined with ketone retention in the critical period. In diabetic patients with Diabetic ketoacidosis, this condition occurs in diabetic patients who have inappropriate health behaviors or severe health complications. Causes abnormally high blood sugar levels at the outpatient department Patong Hospital. Between February 2023 - October 2023 data were collected. With patient medical records, observation, interviews, data analysis by comparison. From the study, it was found that the 2 patients were different in their unique characteristics, causes, and pathologies of the disease. They had Diabetic ketoacidosis with comorbid conditions. Doctors' treatment approaches and nursing practices are therefore specific to the patient's condition. There will be a longer period of hospital stay. There is more difficulty in maintaining it. and having effective care guidelines for diabetic ketoacidosis patients It will help patients get through the critical period safely. And there are guidelines for continuous care in order to be effective in reducing blood sugar levels to the target value. Reduce the rate of hospital readmissions and long-term monitoring of vascular complications. This study is useful in planning development in the care of patients with diabetic ketoacidosis

Keyword: Diabetic, Diabetic ketoacidosis