การพัฒนารูปแบบการพยาบาลผู้ป่วยติดเชื้อในกระแสเลือด โรงพยาบาลมุกดาหาร A Development of Nursing Care Model for Sepsis patients in Mukdahan Hospital

Abstract

 This action research aimed to develop a nursing care model for sepsis patients in Mukdahan Hospital. was used including 3 cycles of 4-phases implementation which were planning, action, observation and reflection. The participants were 107 patients with sepsis and 83 registered nurses.

                The results were shown in 3 cycles, The 1^st cycle showed Finding from focus group and content analysis of care system revealed that three aspects 1) Policy and assignment of responsibilities are unclear 2) Develop the clinical nursing practice guideline 3) Process evaluation for continuing care and monitoring inappropriate practice, these results leaded to developing nursing care model for sepsis patients. The 2^nd development of 3 aspects 1) Policy of sepsis care process, 2) Development clinical nursing practice guideline consistency of situation and evidence, confirmation the result by  AGREE II 3) Monitoring care system. The 3^rd cycle outcome evaluation in 3 aspects 1) Policy and assignment of responsibilities for Emergency care, inpatient care unit, continuing care, intensive care unit and septic shock nursing care 2) Develop nursing practices using empirical evidence And experimentally applied to 71 patients. Clinical outcomes shown the results were presented in compared of before and after using the nursing care model for sepsis patient revealed that time of early detection were shorter, from 170 minutes to 25.5 minutes, antibiotic receiving rate rising from 65.7% to 94.44%, septic shock treatment and resuscitation in 6 hours rate increase from 42.3% to 82%          3) process outcomes showed that vital sign record rate increase from 62.9 % to 91.7 %, urine record increase from 51.4% to 95.8%