Development of a Nursing Care Model for Patients with Sepsis in Nakhon Phanom Hospital

Abstract

The incidence of sepsis continues to increase despite the advancement of current treatments. This research and development method (R&D) study aimed to develop and examine the effectiveness of a nursing model for patients with sepsis at Nakhon Phanom hospital. The study was divided into 3 phases: 1) the development of the nursing model for patients with sepsis; 2) the implementation of the developed plan; and 3) the evaluation of the nursing model. The sample included 180 registered nurses and 108 patients with sepsis. The research instruments were 1) the nursing model for patients with sepsis that was developed, 2) an opinion and satisfaction assessment of the nursing model, 3) a nursing knowledge and skill assessment form, and 4) the patients care outcomes form. The obtained data were analyzed using descriptive statistics, including percentages, means, standard deviations, and inferential statistics including the Wilcoxon Signed-Rank tests and Chi-square tests.

The Results: 1) The sepsis nursing model that was developed consisted of three parts: (1) work instruction manuals that specified the scope and purpose of, and how to conduct the nursing practice guidelines, (2) nursing activities comprised of seven components containing 55 activities and procedures, and (3) policies and the roles of case manager nurses for improving and developing the service system. 2) The outcomes of nursing model implementation were as follows: the nurse’s knowledge increased from 58 % to 68 % and patient care guideline compliance reached 98 %. Additionally, the incidence of septic shock decreased from 33 % to 5.6%, the performance of blood cultures based on established guidelines increased from 22 % to 91 %, and the administration of antibiotics within 1 hour increased from 37% to 83%, which was statistically significantly different at the 0.05 level (p-<.00). Furthermore, the assessment of early warning signs for sepsis in patients increased from 22 % to 52 % and the death rate decreased from 16.7 % to 11.1 %. The feedback on effectiveness and satisfaction on the nursing model were 99 % and 86 %, respectively. In conclusion, the developed nursing care model for sepsis patients provide care guidelines for nurses providing patient care that are applicable in practice, help reduce the occurrence of septic shock, and improve the outcomes of care.