Development of Surgery System and Patients care of One Day Surgery : ODS Kumphawapi Hospital, Udon Thani

Abstract

Purposes : To study a situation, develop service system, and evaluate of outcomes on surgery system and patients care of One Day Surgery in Kumphawapi Hospital.

Study design : Mutual collaborative action research.

Materials and Methods : Key informants were patients receiving One Day Surgery and related providers, The research was conducted between January and April 2023 and divided into 3 phases: a situation analysis, developed a service system and evaluated of outcomes. Data were collected using the patient information form, practice assessment form questions for group discussions and guidelines for interviewing patients and caregivers. Data were analyzed using frequency, percentage, mean, standard deviation and content analysis.

Main findings : Phase 1;found problems and needs of 1) patients and relatives, such as stress and anxiety of patients and relatives, lack of knowledge about pre- and post operative practices and care. The time of surgery was unclear. As a result, the patient did not undergo surgery as scheduled, and there was a risk during surgery and 2) service system and management, such as practices, locations, coordination within the network and worker. Phase 2;The researcher therefore brought above problems to develop a care system for patients undergoing ODS which has been examined for feasibility by experts and found that it was of good quality and can be used in practice. Phase 3; results of system development evaluation revealed that ten paticipants  were service recipients underwent hernia, correction surgery, 50%, colonoscopy 30%, and hemorrhoids 20%, respectively. After being taken care of according to developed system, it was found that non post operative infection were found. Report system for 28-day re-admission was none(0.0%). And there was no complication such as pain, swelling or bleeding in rehabilitation section and it was found that 2 hours after surgery, the patient could lived a normal life. But there was a slight stiffness in wound and still unable to lift heavy objects within 2 months to prevent high abdominal pressure.

Conclusion and recommendations : The results of this research could be effective, but there are some observations for applying a research results have to a preparation process for patients and relatives teamwork must be designed together, including surgeons, anesthesiologists, nurses at all levels involved, and the home ward team.