Development of the Guidelines for Nursing Care of the Intra-hospital Transport for Critical care Patient, Chiangrai Prachanukroh Hospital

Abstract

This research aimed to develop and examine the guidelines for nursing care of the intra-hospital transport for critical care patients. There were consisted of Phase one, analyzing the situation of nursing care of the intra-hospital transport for critically care patients in Chiangrai Prachanukroh hospital by reviewing 50 medical records and focus group discussions in 1 director of nursing department, 10 head nurses and 40 professional nurses: all intensive care unit. Data were analyzed using the content analysis. Phase two, developing the guidelines by integrating the results from Phase one with a systematic review. Phase three, implementing the guidelines in 30 critically care patients and evaluating the outcomes of implementation. Phase four, improving the guidelines according to the results from phase three. Phase five, implementing the improved guidelines from phase four in 164 critically ill patients.

The results revealed that Phase one, nurses did not assess the early warning signs prior to the transport, inadequate crisis monitoring competencies, transportation equipment’s were not available, ineffective coordination before transportation. Phase two, guidelines consisted of 1) guidelines for assessment early warning signs 2) developing professional nurse’s competencies in monitoring early warning signs 3) maintenance of transportation equipment 4) communication before transportation. Phase three, found that there was inadequate emergency management. Phase four, improved the guidelines by add guidelines for emergency management. Phase five, there were significantly decreases in the unplanned intubation rate, the unexpected cardiopulmonary resuscitation rate, and the unexpected dead rate. In conclusion, the guidelines for nursing care of the intra-hospital transport for critical care patients that were created resulted in safer transport of critical care patients.

The recommendations are as follows before implementing the guidelines for nursing care of the intra-hospital transport for critical care patients. Personnel should be trained to have specific knowledge about an assessment of early warning signs and chain of prevention (pre-arrest signs) in order to increase their knowledge and understanding so that they can use the guidelines effectively, and the study of the use of guidelines for nursing care of the intra-hospital transport for critical care patients should be expand to other groups of patients so that they can be used for transporting all groups of patients.