Development of Care Guidelines for End-of-Life Patients in the Private Medical Ward, Roi Et Hospital

Abstract

Purposes: To develop, evaluate the effectiveness of clinical nursing practice guidelines for palliative care, and to assess the satisfaction of professional nurses regarding the implementation of these guidelines at the Medical Private Ward, Roi Et Hospital.

Study design: This study employs a Research and Development (R&D) model, divided into four phases based on the PDCA cycle.

Material and Methods: The sample consisted of 12 registered nurses and 30 end-of-life patients with their families. The research instruments included holistic care guidelines (covering physical, psychological, social, and spiritual dimensions) and evaluation questionnaires. Data were analyzed using descriptive statistics (frequency, percentage, mean, and standard deviation).

Main finding: 1) The developed guidelines included key activities such as ESAS assessment, breaking bad news protocols, family meetings for advance care planning, and spiritual support. 2) After implementation, the percentage of patients receiving care at a "high level" increased significantly from 20% to 100%. Critical improvements were observed in symptom management and spiritual care. And 3) Registered nurses reported the highest level of satisfaction with the guidelines, citing increased clinical confidence and clarity in practice.

Conclusion and recommendations: These findings suggest that structured holistic guidelines are essential for improving the quality of end-of-life care in private ward settings.