Development of Nursing System for the Patient with Coronavirus disease 2019 (COVID-19), Chaiyaphum Hospital

Abstract

BACKGROUND: The coronavirus disease 2019 (COVID-19) outbreak spread rapidly from one person to another. More people were becoming infected. Healthcare workers became infected and died. As a result, the nursing care system for patients infected with COVID-19 has to be adjusted so that personnel can be safe and capable of caring for many patients.

OBJECTIVE:  To develop and study the results of a nursing care system for patients who have COVID-19 infected in Chaiyaphum Hospital

METHODS: Research and development method based on the concept of Donabedian consisting of 1) structural aspects including policy, patients, and the nursing system 2) the development process of the nursing care system and nursing practice guidelines for COVID-19 patients based on evidence-based practice model of Soukup. Validation of content validity by experts, testing the guideline, evaluating the results, and improvement until a practice guideline was usable. 3) Outcomes, patients, and nurses aspects; the research tools consisted of (1) the nursing care system and the nursing practice guideline for patients infected with COVID-19 (2) an assessment of professional nurses' opinions towards the nursing system (3) a satisfaction assessment form of professional nurses toward the nursing care system (4) nursing practice assessment form for important procedures, and (5) a form to examine the compliance of the nursing care system. Data were analyzed using descriptive statistics and content analysis. 

RESULTS: Factors affecting the nursing care system for COVID-19 patients were as follows; 1. The structural aspects; there was no negative pressure isolation ward, nurses lacked the necessary skills and man powers, there was inadequate equipment, and the nursing care system was still unclear. 2. Process Developing the nursing care system It combines nursing staff from several nursing fields and assigns a team-based patient care system with a functional patient care system. The head of the nursing team was a nurse who had received specific training in critical care nursing and supervision by the head ward and the head of the intensive care nursing supervisor. The nursing practice guidelines consist of 1) screening and laboratory testing, 2) patient admission, 3) assisting physicians with procedures and use of medical equipment, 4) controlling and preventing the spread of COVID-19, 5) giving patients and their families information, 6) co-ordination and 7) discharge of patients. And 3. The outcomes: Patient outcomes: 1) the percentage of patients who underwent rapid antigen testing before retiring for treatment increased from 85% to 100%, 2) the frequency of closed contact decreased from 3 times per month to 1, and 3) the rate of endotracheal tube slippage decreased from 14.97 per 1,000 ventilator days to 5.46 per 1,000 ventilator days. Nursing component: 1) attitudes toward the nursing system went from being moderate to being highly favorable, 2) satisfaction with the nursing care system was raised from a moderate to a high level, 3) the samples' ability to accomplish more crucial tasks than they could before working in a COVID-19-infected ward, 4) Nursing care system compliance rose from 95.16 % to 100 %. 5) COVID-19 infections dropped from 5 people to 3 people.

CONCLUSIONS AND RECOMMENDATIONS:

This developed nursing care system for the Patient with Coronavirus disease 2019 was effective, and should be applied the guide for another infection or newly emerging diseases, and should be updated regularly.