การพัฒนารูปแบบการพยาบาลผู้ป่วยใส่เครื่องช่วยหายใจชนิดควบคุม ด้วยปริมาตรและแรงดันในหอผู้ป่วยไอซียูอายุรกรรม โรงพยาบาลศูนย์แห่งหนึ่ง*(Development of a Nursing Care Model for Caring Patients on Ventilator Controlling by Volume and Pressure at the Medical Intensive Care Unit of a Tertiary Care Hospital)

บทคัดย่อ

This research and development aimed to develop a nursing care model for caring patients on aventilator controlled by volume and pressure at the medical intensive care unit of a tertiary care hospital.Thisresearch was divided into three phases. First, situational analysis was done by literature review, observation,in-depth interview of 23 health care personnels including physicians and professional nurses who took care ofpatients on the ventilator at the medical intensive care unit. The professional nurses took the test of caring forpatients on the ventilator controlled by volume and pressure. Second, the preliminary model was developedbased on focus group discussions of professional nurses who worked at themedical care unit. After that, thenursing care model was implemented and modified for three months. Third, the final model was evaluated. Datawere collectd by using the instruments developed by the researcher included a record of personal data, a test ofcaring for patients on the ventilator controlled by volume and pressure, and satisfaction questionnaires. Data wereanalyzed by using percentage, mean, t-test, and content analysis.The results revealed that the final model for caring of patients on the ventilator controlled by volumeand pressure at the medical intensive care unit should include the following: 1) building up readiness ofprofessional nurses; 2) specifying how to use and adjust the ventilator; 3) monitoring abnormal signs and symptomsof patients on the ventilator; 4) setting up guidelines to do when facing problems and notify physicians; and 5)stating how to wean the patients from the ventilator. The results of model evaluation showed as follows: 1) thescores of the test done by professional nurses after implementing the model were significantly higher than thosebefore implementing the model (p<.001); 2) the rate of doctor notification increased from 43.14% to 76.40%;and 3) professional nurses were highly satisfied with the model.