The Development of Care for Stroke Patients to Safety under the Limitation of Medical Personnel in Detudom Crown Prince Hospital

Abstract

This research is an action research. The aims of the study was to develop and study the effectiveness of a safe care system for stroke patients at Detudom Crown Prince Hospital. The study applied the Donabedian model as the framework was developed and adapted to the caring system of stroke patients. The program was conducted into 3 phases: 1) The preparation period: A survey on compliance issues, resources and potential patients, caregivers and practitioners from a multidisciplinary team was conducted. A literature review and analysis of research was conducted to adjust the caring system model based on empirical evidence.  2) The operations period: The development preprogram for multidisciplinary to clarify the guidelines for the caring of the strokes. 3) The evaluation period: An analysis of based-care system was developed to reflect the care and use the feedback to adjust the process and obtain desirable results.There were 2 samples groups which included 21 multidisciplinary team who provided care for stroke patients. The study used purposive random sampling to select the 200 stroke patients admitted the hospital during the month of October 2018 - February 2019. The materials in the study were a guideline for the care of stroke patients hospitalized in Detudom Crown Prince Hospital and a record form of care for stroke patients. The data were analyzed using descriptive statistics consisting of percentage, mean and standard deviation.

The study indicated that the death rates decreased from 0.68 to 0.08 percent. The stay decreased from 4.27 days to 2.33 days. The percentage of patients who followed the guidelines was increased from of 40.75 to 90.68.The satisfaction of multidisciplinary increased from 46.23 to 97.85. The satisfaction of patients with services was at the highest level at 49.20 and 80.50 percent for caregivers.

The success of this research was due to the collaboration of a multidisciplinary team on studying problems, exploring the resources and searching for potential of patients, caregivers and practitioners from a multidisciplinary team. The studies of patients from onset of symptoms to returning to community life on applying of the past clinical outcomes and results as a foundation leaded to practical action according to the context of the hospital.