A Development of Assessment and Nursing Management Model to Preventing Sepsis in Critical Burned Patients

Abstract

Sepsis in critical burned patients is a vital problem leading to risk of severity and mortality. Assessment and nursing management are important factors to reduce the points and be suitable the situation. This research and development aimed to 1) study the situation on assessment and nursing management model to preventing sepsis in critical burned patients, 2) develop of assessment and nursing management model to preventing sepsis in critical burned patients, and 3) evaluate an assessment and nursing management model to preventing sepsis in critical burned patients. The samples consisted of 28 critical burned patients admitted to the Burn Unit, and 12 registered nurses. The instruments consisted of 1) a guideline to the assessment and nursing care management model to preventing sepsis in critical burned patients, 2) the patient record form, 3) the evaluating form the knowledge of nurse about the assessment and nursing care management to preventing sepsis in critical burned patients, 4) the evaluating form of difficulty and ability to implement the model, 5) the evaluating form for compliance with the assessment form of professional nurses, and 6) the evaluating form on the satisfaction of nurse. The data were analyzed by percentage, mean, standard deviation, Chi-square, and Wilcoxon test. The finding showed that previous pattern of assessment and nursing management at the burn unit was not unclear.  Most of the nurses had insufficient assessment of burn wound infection and delayed the assessment. They also had a lack of nursing management in organizing units to each patient's problem condition. There was an incidence of septic shock, three cases (11.53 %), and one death (3.85%). After using the assessment and nursing management model to prevent sepsis in critical burned patients developed, there was only one sepsis, no septic shock and death. Median scores of knowledge of preventing sepsis in critical burned patients (11.81 to 17.08) and the practice score (from 16.16 to 22.70) were improved among registered nurses. Both of them were significantly different at the .05 level (p- value = .002). Most of the nurses had the highest level of satisfaction (58.34 %), the easier use (91.67 %), and utilitarianism (85.19 %).