Nursing Service Management Model for Quality and Safe in Patients with Humeral Fractures Receiving A Cast at The Orthopedic Outpatient Examination Room

Abstract

Purposes : To develop and evaluate the results of using a nursing service management model for quality and safety in patients with humerus fractures receiving casts at the  outpatient orthopedic examination room.

     Study design : Action research

     Materials and Methods : A simple random sample consisted of 30 patients, who came for appointments, diagnosed by a doctor as having a humerus fracture, who received a cast, and 2 staff nurses in the group outpatient nursing work for 9 people. The research is divided in 3 phases: 1) situational study phase 2) nursing model development phase, by using the results from phase 1 to discuss with groups of personnel to create a collaborative care model, and 3) the evaluation phase of using the model to collect data, combining quantitative and qualitative methods. Research tools include (1) research tools, namely (1) document recording form (2) group discussion guideline (3) in-depth interview and brainstorming guideline (4) developed format and format usage manual. development which has a CVI = 1.00 and (2) the tools used to collect data are (1) an efficiency assessment form for using the model (2) a questionnaire on opinions on using the model (3) a project evaluation form (4) Patient-service-quality-perception-questionnaire (5) service-quality-questionnaire for staff (6) performance assessment form according to outpatient standards in patients receiving splinting services, (7) special competency assessment form for splinting nurses and (8) 4-dimensional nursing service quality indicator collection form. The quality of the instruments was 0.90, 0.91, 0.94, 0.87, 0.84, 0.92 and 0.89, respectively. Data were

analyzed using descriptive statistics and content analysis.

       Main findings : It was found that the nursing-service-management-model for quality and safety in patients with humerus-fractures receiving casts at the outpatient orthopedic-examination-room has 6 elements: 1) direction, policy and management 2) nurse manager and coordination, 3) equipment management, 4) specific competency for splint nurses, 5) nursing practice process according to nursing practice guidelines, and 6) evaluation of results using quality indicators, nursing according to the 4-dimensional outpatient nursing standards. The results of using the model were found to be 100 % possible, appropriate, accurate, and beneficial, 2) nurses who used them were satisfied and accepted them at a high level, 90%, and the results were quality, services for patients with humerus fractures receiving clinical casts have increased in every aspect, 70 % of patients are satisfied
     Conclusions and recommendations : the continuous development model should be used because it has a positive effect on the care of patients with humerus fractures receiving casts at the outpatient orthopedic examination room. Improve the quality of clinical outcomes, as expected, patients are satisfied, and have developed the competency of nurses specialized in orthopedic nursing and splinting.