The Model Development of a Dispensing Patientes with Underlying Diseases before Receiving Anesthesia in Suwannaphum Hospital

Abstract

Purposes : To develop and evaluate management model for patients with underlying diseases prior to receiving anesthesia in Suwannaphum Hospital, Roi Et Province.

Study design : This study employed a Research and Development (R&D) design.

Main findings: The participants included 35 healthcare professionals and 53 patients undergoing anesthesia. Research instruments consisted of a guideline adherence questionnaire, a satisfaction survey, and a clinical outcome evaluation form. Data were analyzed using descriptive statistics including percentage, mean, and standard deviation.

Main finding: The study developed and evaluated a clinical practice model for administering medications in patients with underlying diseases prior to anesthesia at Suwannaphum Hospital, Roi Et Province. The model was constructed through three phases: (1) situational analysis using patient record reviews, interviews with 53 surgical patients with chronic conditions, and focus group discussions with healthcare personnel; (2) development of a "One Page" guideline for pre-anesthesia medication management through participatory workshops; and (3) evaluation of implementation outcomes. The implementation results showed a high adherence rate to the guideline, with a mean practice score of 8.82 out of 12. Medication groups with 100% compliance included ACE inhibitors, ARBs, thyroid medications, and bronchodilators. However, medications such as NSAIDs, statins, and warfarin had lower adherence rates (<15%). Satisfaction with the guideline was rated at the highest level (Mean = 4.63, SD. = 0.19), with ease of use, convenience, and time-saving being the most appreciated aspects (Mean = 4.74, SD. = 0.44). Patient outcome analysis showed that most surgical patients were elderly, with diabetes (28.3%) and hypertension (20.8%) being the most common chronic conditions. More than 93% of patients followed the medication instructions correctly, especially for medications requiring discontinuation, such as Enalapril and ASA.

Conclusion and recommendations : The developed pre-anesthesia medication guideline for patients with chronic conditions was found to be practical, user-friendly, and well-received by healthcare staff. It effectively enhanced medication safety, improved patient preparation, and reduced the risk of surgery delays or complications.