Development of Clinical Nursing Model for Acute Ischemic Stroke in Hospital with 7 Aspects Model of Care

Abstract

This research was research and development (R & D) to develop and study the effectiveness of nursing model for acute ischemic stroke patients with seven aspects model of care.  Samples included of 30 patients with acute ischemic stroke, admitted to Stroke unit ward and treated with intravenous thromboembolism(rt.PA) in Surin hospital was recruited through purposive random sampling and 12 professional nurses from the hospital. Research instruments were nursing model of acute ischemic stroke patients with 7 Aspects Model of Care, a nursing competency assessment form, and patient care outcomes assessment form. Data analysis included descriptive statistics, paired t-test, and content analysis.  The results showed two parts. Firstly, the clinical nursing model for acute ischemic stroke in hospital with seven aspects model of care consisted in seven activities: 1) assessment; 2) symptom distress management; 3) provision for patient safety; 4) prevention of complication; 5) continuing of care; 6) facilitation of patient & family selfcare; and 7) enhancement of patient satisfaction. Secondly, after applying the nursing model, a higher mean score of the nurses’ knowledge about practicing acute ischemic stroke patients was statistically significant (p-value < 0.01) and the nurses had a positive attitude towards nursing practice leading to more systematic nursing practice skills.  It was also found to be beneficial to nursing quality which Door to needle time tended to decrease below 60 minutes. Patients continuously received care and assessment. There were no falls, DVT, and urinary tract infections. Furthermore, pneumonia, pressure ulcers and mortality were below the threshold and trends were down. Patients and nurses were satisfied with the nursing model of acute ischemic stroke patients with the 7 Aspects Model of Care as it could help reduce mortality and various complications.