การพัฒนาระบบบริการพยาบาลสำหรับผู้ป่วยที่เข้ารับการตรวจวินิจฉัยรักษา ด้วยหัตถการการส่องกล้องโรงพยาบาลน่าน

Sukumal Toikaew; Rungtip Kaladee; Worrawan Chamnanchang

Authors

Sukumal Toikaew Nan Hospital
Rungtip Kaladee Nan Hospital
Worrawan Chamnanchang Nan Hospital

Keywords:

quality improvement, research and development, nursing service system, endoscopic procedure

Abstract

This research using a research and development methods, aimed to develop and to evaluate developed nursing service system for patients undergoing endoscopic procedure at Nan hospital. It had 3 phases, including preparation, development, and evaluation phases. Participants were a group of 30 physicians and other multi-disciplinary teams, and a group of 275 patients undergoing endoscopic procedure. Research instruments consisted of; 1) a form surveying organization structure of the unit providing endoscopic procedure, 2) a self-assessment report of service quality, 3) a semi structure interview guide, and 4) an outcome reports including an incident report, a patient satisfaction questionnaire. Data were analyze using a thematic analysis, a descriptive statistic, and comparison statistic using t-test comparison.

The findings were found as following; 1. the preparation phase, a problem study, found some structural restrictions as following; 1.1)structural restrictions such as limited spaces, insufficient numbers of nursing staff and material, 1.2) procedural restrictions such as improper nursing and transferal services for endoscopic procedures, and 1.3) service outcomes indicating unqualified standard as; health education was given to only 48.50% of the patients; 14% of the patients were reschedule because of improper preparation; and 8%of the patients were transferred lately. 2.the development phase involved developing nursing services to improve a quality of nursing services for endoscopic procedures. It included the improvement of staff’s competencies, a re-design workflow of nursing services, a renovation of endoscopic unit, and a provision of medical material; and 3) the evaluation phase, a number of incidences related to reschedule and transferal services was decrease significantly. No incidence of lateness was reported. A level of staff’s satisfaction and of patients’ satisfaction was significantly higher that before the development. Hence, should be investigated, and a development of nursing services to address such problems should be implemented to improve a continuity of nursing service quality

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