การพัฒนาระบบบริการพยาบาลผู้ป่วยอุบัติเหตุฉุกเฉินที่ต้องเข้ารับการผ่าตัดช่องท้อง ภายใต้การระงับความรู้สึกแบบทั่วตัว โรงพยาบาลอุดรธานี

Pulsil Khomon; Watjana Sukontawat; Siamrat Joongthai; Kamonthip Tanglakmankhong; Thanyarat Prommahachai; Sukanya Khunjamnongpak; Areeluk Thongwiti

Authors

Pulsil Khomon Udon Thani Hospital
Watjana Sukontawat Boromarajonnani College of Nursing Udon Thani, Faculty of Nursing, Phraboromarajchanok Institute
Siamrat Joongthai Udon Thani Hospital
Kamonthip Tanglakmankhong Boromarajonnani College of Nursing Udon Thani, Faculty of Nursing, Phraboromarajchanok Institute
Thanyarat Prommahachai Udon Thani Hospital
Sukanya Khunjamnongpak Udon Thani Hospital
Areeluk Thongwiti Udon Thani Hospital

Keywords:

nursing service system, emergency patients, abdominal injuries, general anesthesia

Abstract

Introduction: Emergency accident patients with abdominal injuries requiring surgery under general anesthesia often experience prolonged preoperative preparation times, leading to high postoperative complication rates. Therefore, developing an efficient nursing service system is essential for improving patient survival.

Research objectives: To examine the current situation, develop a nursing service system, and evaluate the outcomes of emergency accident patients requiring abdominal surgery under general anesthesia.

Research methodology: This research and development study consisted of three phases. The sample included: 1) 35 nurse anesthetists and 25 emergency room nurses, and 2) 70 patients with abdominal trauma (35 in the control group and 35 in the experimental group). The intervention tool was a nursing service system for emergency accident patients requiring abdominal surgery under general anesthesia. Four data collection instruments were used: 1) demographic information form, 2) nursing knowledge assessment, 3) clinical outcome assessment form, and 4) satisfaction questionnaire. Content validity was verified by five experts, yielding CVI values of .89, .91, .99, .97, and 1, respectively. Data were analyzed using descriptive statistics, paired sample t-test, and independent t-test.

Results: Situational analysis revealed delays in preoperative patient preparation, inconsistent nursing standards, and ineffective communication. Following the implementation of the developed nursing service system, the experimental group showed significantly fewer postoperative complications within the first 24 hours and a shorter average time from the emergency room to the operating room than the control group. However, the length of hospital stay did not differ significantly between the groups. Nurse satisfaction with the system was at the highest level (M = 4.30, SD = .52).

Conclusions: The nursing service system reduced preoperative preparation time and postoperative complications, resulting in improved clinical outcomes and increased survival.

Implications: The developed nursing service system can be adapted for use in other hospitals with similar contexts. Further research should investigate long-term outcomes.

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