Effect of using nursing guides for monitoring symptom changes and warning signs of pre-critical conditions in the accident and emergency department at Phan hospital, Chiang Rai province
Keywords:
nursing guidelines, warning signs, accident and emergency departmentAbstract
Monitoring symptoms and warning signs leading to life-threatening condition in patients receiving services in trauma and emergency department is importance to manage patient. The study was a quasi-experimental research. The objective was to examine the effect of using nursing guides for monitoring symptom changes and warning signs of pre-critical in the emergency department. The sample of 406 individuals was selected purposively and divided into an experimental group receiving surveillance variations change and early warning signs monitoring, and a control group receiving routine nursing care. Data were analyzed using descriptive statistics, chi-square and independent t-test. The results indicated that 1) The experimental group showed statistically significant increase in early detection (temperature assessed, Glasgow coma score assessed, NEWS assessed and NEWS score interpreted) compare to control group (p<0.001). 2) The experimental group showed statistically significant increase in continuous monitoring (vital signs reassessed according to NEWS level and NEWS reassessed according to NEWS level) compare to control group (p<0.001). 3) The experimental group showed statistically significant increase in nursing response to clinical deterioration (nursing response according to NEWS level and evaluation) compare to control group (p<0.001). Number of ET-tube insertion are statistically significant different between experimental and control group (p=0.008). Number of unexpected death are not statistically significant different between experimental and control group (p=0317). The overall level of satisfaction with the implementation of nursing guides for monitoring symptom changes and warning signs of pre-critical in the accident and emergency department is high ( = 4.20, SD = 0.77). Therefore, it can be concluded that using nursing guides for monitoring symptom changes and warning signs of pre-critical in the emergency department leads to increased detection of changes, proper nursing care, and reduction of unexpected deterioration incidents.
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