การพัฒนารูปแบบการพยาบาลสำหรับแผลเบาหวานที่เท้าในโรงพยาบาลกาฬสินธุ์ Nursing Care Model Development for Diabetic Foot Ulcer at Kalasin Hospital

Abstract

This research and development study aimed to develop a nursing care model for patients with diabetic foot ulcers (DFU) at Kalasin Hospital. The study was conducted at the Outpatient Department, Accident and Emergency Department, and Surgical Ward and Surgery Intensive Care Unit during June 2017 to June 2018. The research participants included 86 nurses and 68 patients with a diabetic foot ulcers and their relatives. Results from the initial phase showed that there were no formal practice guidelines for diabetic foot ulcer nursing care. Additionally, screening process for related complications and foot ulcer severity was inconclusive. Lastly, there was inadequate skill and guideline to provide acute complications care among nurses. The nursing care model was developed in the second phase consisted of screening and history taking guide, foot deformity and ulcer assessment with ulcer severity screening tool, clinical and laboratory investigation, patient and relatives education and consultation, and referral and acute nursing care and continuing care protocol. In the third phase, the implementation phase, it was found that nurse participants needed to be further promoted DFU screening competency. Consequently, there was a competency building session provided for the nurses, in which knowledge was evaluated before and after the session. In the fourth phase, after nursing care model implementation, it was demonstrated that nurses’ knowledge and skills related to DFU care increased from 18.65 to 27.12 and from 19.12 to 27.05, respectively. The patients and relatives’ satisfaction had the highest satisfaction for the DFU care.