Nakhonphanom Hospital Journal

Risk factor and incidence of Helicobacter pylori infection in patient undergoing esophagogastroduodenoscopy in Kumphawapi hospital

Kasichuch Akaraprasertkij — 2025-08-25

Objectives: To identify risk factors and incidence of Helicobacter pylori infection in patients undergoing esophagogastroduodenoscopy in Kumphawapi hospital.

Materials and Methods: A retrospective cohort study was carried out on 94 patients who underwent esophagogastroduodenoscopy and tissue sampling for rapid urease test for H.pylori infection between July 1, 2020, and June 30, 2022.

Results: From 94 patients (52 males and 42 females), the average age was 57±14.95, the average BMI was 23.11±4.29 kg/m², Smoking 23.4%, Alcohol drinking 20.2%, Herbal use 19.1%, Coffee drinking 36.2%, Cola drinking 37.2%, Stress condition 90.4%, Upper gastrointestinal hemorrhage 50%, Indigestion 27.7%, Burning pain 16%, Constipation 4.3%, Fatigue 2.1%, Abdominal pain more than 2weeks 52.1%, Change in bowel habit 16%. The incidence of H.pylori infection was 54.3%. The risk factor associated with H.pylori infection was Herbal use (p-value=0.048), Clinical symptoms of indigestion (p-value=0.018) and burning pain (p-value=0.029)

Conclusions: In this study, herbal use, clinical symptoms of indigestion, and burning pain were risk factors for H. pylori infection.

efficacy of laser lithotripsy treatment on a middle and distal ureteric calculus in Nakhon Phanom hospital

Pairat Kitisriworaphan — 2025-09-29

The efficacy of laser lithotripsy treatment on a middle and distal ureteric calculus in Nakhon Phanom hospital

Kitisriworaphan P., M.D., (Urologist), Nitidejvisit A.,M.Sc. (Biostatistics)

Nakhon Phanom Hospital,Thailand.

Abstract This study was the efficacy therapeutic research with historical controlled intervention design in patient undergoing uretero-renoscopelitholapaxy ;URSL at urological unit Nakhon Phanom Hospital.Objective: The study proposes were to demonstrate the clinical outcome of the efficacies and complications of the treatment of distal and middle ureteric stone with URSL Laser Lithotripsy (LL). Materials and methods :The target group was the patients were diagnosed with distal or middle ureteric stone and had the surgical condition with URSL Laser Lithotripsy (LL) and the data collection were taken from December,2024 to March, 2025, the patients were enrolled into study overall 60 cases. In addition the controlled group was the patients diagnosed with distal or middle ureteric stone and had to treatments with URSL Pneumatic Lithotripsy (PL). The data were taken by reviewing retro-medical record in,2020 overall 60 cases. The tool of research was ureterorenoscopic technique auxillary with ureteric fragmentation Laser Lithotripsy (LL) and Pneumatic Lithotripsy (PL).The tool of data collection were the medical recode checklist and the data sheet of case record form. The perform of data analysis was frequency, percentage, mean, median, and SD. The inferential statistics were independent t-test, Chi-square, fisher’s exact probability test, and univariable and multivariable risk regression. The considered statistically significant was the p-value < 0.05.Results: The research outcome demonstrated that the URSL Laser Lithotripsy (LL) was improve the stone free rate up to 13.33 percent with statistically significant different at p-value 0.023.In addition when analyst with multivariable risk regression showed that the stone fragment time in URSL Laser Lithotripsy (LL) faster than URSL Pneumatic Lithotripsy (PL) 1.04 fold P-value 0.012 and the duration of stone free time in URSL Laser Lithotripsy (LL) upper to 94 percent with P-value <0.001. The complications such a stone retropulsion was higher in URSL Pneumatic Lithotripsy 60 percent than URSL Laser Lithotripsy P-value 0.026 and the Urosepsis criteria in post-operative 24-48 hour had found higher incident in the URSL Pneumatic Lithotripsy 2.0 fold at P-value <0.001.Conclusion: The Uretero-renoscopelitholapaxy with Laser Litho tripsy was high efficacy in treatment of a middle and distal ureteric calculus. The research was presented the clinical outcome with higher stone free rate and smaller the serious complications than the Pneumatic Lithotripsy.

Key word; Laser Lithotripsy, Pneumatic Lithotripsy, distal and middle ureteric stone, uretero-renoscopelitholapaxy ;URSL

effectiveness of PICES model practice guideline for prevention of tracheal injury in patient undergo general anesthesia with endotracheal intubation in Nakhon Phanom hospital.

อนันตพร นิธิเดชวิศิษฏ์ — 2025-08-25

Abstract

Objectives: The main purpose was to compare the effectiveness of the perioperative guideline for tracheal injury prevention in patient undergoing general anesthesia before and after the PICES model guideline was implemented, and to measure the average of satisfaction level with the overall implementation of the guideline.

Materials and method: This study was a Quasi-experimental research implemented between October 2024 and April 2025 in operating theatre at Nakhon Phanom hospital.The patient’s undergoing general anesthesia was included overall 160 cases. Comparing the effectiveness of the PICES model practice guideline of tracheal injury prevention in patient’s undergoing general anesthesia with endotracheal intubation. After consent was given ,the patients were taken in the PICES model process that divided into two groups. Each group of the groups were before the PICES model guideline from retro-medical records in October 2023 to September 2024 for 62 cases and after the PICES model guideline from October 2024 to April 2025 for 62 cases, and 21 anesthetic nurses staff. The study tool included the PICES model guideline for tracheal injury prevention in patient undergoing general anesthesia .The content validity was examined by 3 experts, yielding a number of 1. The Data were collected by using 1)retro-medical record checklist 2) case record form 3) anesthetic record and 4) satisfaction of anesthetic nurses staff form. The content validity was examined by 3 experts and the reliability for satisfaction were 0.90 ,0.95 and 0.97 respectively. Statistical analyses were performed using Chi square, t-tests, Fisher’s exact ,and multivariable logistic regression at statistical significant level 0.05. Results: The incident of tracheal injury in patient undergoing general anesthesia before and after guideline had presented the statistically significant difference of postoperative sore throat in recovery room and post-operative within 24 hour at P-value<0.001 and P-value<0.001 respectively. Otherwise, there were no statistically significant difference of the post-operative hoarseness within 24 hour between before and after guideline. The average sore throat pain score was lower in after guideline group at p-value <0.001.In addition, after adjusted the nuisances factor using the multivariable logistic regression presented the intra endotracheal cuff pressure in before guideline was increasing the incident of tracheal injury in patient undergoing general anesthesia than after guideline 6.7 fold with p-value = 0.002 and the higher intubation attempt > 2 time in before guideline group had a higher risk of tracheal injury in patient undergoing general anesthesia than after guideline group 11.33 fold with p-value p-value = 0.006.Satisfaction with the overall implementation of the PICES model guideline, the average satisfaction level was high( =3.87).

Conclusion: The effectiveness of PICES model practice guideline of tracheal injury prevention in patient’s undergoing general anesthesia , including Proven airway injury, Intubation management, cuff pressure management, Extubation Management, and Shift Records can decline of the incident of tracheal injury in patient’s undergoing general anesthesia.

Keywords: Endotracheal tube cuff pressure, Clinical nursing practice guideline of perioperative tracheal injury prevention, Endotracheal tube cuff pressure monitoring, general anesthesia.

Development of drug prescribing and dispensing, parameter monitoring guidelines of high alert drug using technology to communicate and connect. For reduce medication errors and adverse drug reactions at Phukhieo Chaleom Phra Keit Hospital,Chaiyaphum Provi

piyanuch jindamart — 2025-08-25

Abstract

Objective : Study the development of drug prescribing and dispensing Parameter monitoring guidelines of high alert drug using technology to communicate and connect reduce medication error and adverse drug reactions

Method : Developed prescription for Norepinephine, Dopamine, Dobutamine, Nicardipine, Nitroglycerin link to the paperless prescription system. Developed guidelines for monitoring adverse events. Lock drug interaction of high alert drug. Developed record focus risk of nurse note. Compare prescription, follow monitoring information using the Chi-square, drug interaction and adverse event

Results : After development found prescription of Norepinephine was clear statistically significant ( P valve < 0.01) guidelines for monitoring adverse events increase of Norepinephine, Dopamine, Dobutamine statistically significant ( P valve < 0.05). No incidence of drug interactions. Medication error of high alert drug grade A-E decreased. Monitoring blood pressure and heart rate by nurse Dopamine(54.05%), Norepinephirine(37.55 %), Nicardipine ( 81.97%), Nitroglycerin (45.45%). Monitoring phlebitis Norepinephine (73%), Nitroglycerin( 72.73%), Dopamine(62.16%), Dobutamine(60%) และ Nicardipine(44.26%)

Conclusion : Development of high alert drug administration system. Create system use necessary information and technology for medical personnel. Use Efficiency Data results reduce medication error. Drug management system of high alert drug safe and appropriate.

Keywords : High alert drug, Drug management system, Medication error

Evaluation of Drug delivery system and Tele-pharmacy service in noncommunicable disease patients in Chatturat hospital, Chaiyaphum

jurarut hadwesad — 2025-09-22

Abstract

Objective: To evaluate the implementation of drug delivery service (Health rider) and remote pharmaceutical care in patients with diabetes and hypertension.

Meterials & Methods: To evaluate the project by reviewing relevant literature, conducting in-depth interviews with 9 stakeholders involved in the project, and interviewing all 86 patients who participated in the project. The research was conducted between November 2024 and January 2025.

Results: Chatturat Hospital has been implementing a drug delivery service since June 2024. The service model provides care for patients with all types of health insurance. There is a delivery service through riders and private transport. A total of 472 patients have participated in the program, averaging eight patients per day. From the treatment rights of all patients, it was found that the majority were under the Universal Coverage scheme (UC), with 456 people (96.6%) from other schemes. Most patients were referred from the out-patient department, totaling 164 people, followed by Primary Care Cluster (PCC), totaling 130 people, accounting for 34.7% and 27.5%, respectively. Most of the drug delivery services are handled by 380 riders (80.5%). Patients who participated in the program due to publicity by the staff 250 people (52.97%). The service users were most impressed with the follow-up calls from pharmacists.

Conclusion: The project aimed to reduce the waiting period for patients receiving medication at the pharmacy. However, for patients who received their medication at the pharmacy, the waiting period did not differ when compared before and after project implementation. Most patients were very satisfied with the services they received. To ensure the sustainability of the project, it is necessary to continuously promote the project and provide telepharmacy services after each patient receives their medication.

keywords: drug delivery service, congestion in hospital, tele-pharmacy service

The effectiveness of Clinical Nursing Practice Guideline Oral stimulation on the transition period from tube feeding to oral feeding of Preterm Infants

chantana promhas — 2025-10-20

บทคัดย่อ

วัตถุประสงค์ : เพื่อเปรียบเทียบระยะเปลี่ยนผ่าน (วัน) จากการให้นมทางสายยางให้อาหารสู่การ กินนมได้เองทางปากและปริมาณน้ำนมที่ทารกดูดได้ต่อวัน (มิลลิลิตร) ระหว่างทารกเกิดก่อนกำหนดที่ใช้แนวปฏิบัติการพยาบาลทางคลินิกการนวดปากกระตุ้นการดูดกลืน กับทารกที่ได้รับการพยาบาลตามมาตรฐานเดิม

วัสดุและวิธีการศึกษา : เป็นวิจัยชนิด therapeutic intervention research รูปแบบ prospective interrupted time design ทำการศึกษาผลของแนวปฏิบัติการพยาบาลทางคลินิกการนวดปากกระตุ้นการดูดกลืนด้วยโปรแกรม PIOMI ในทารกเกิดก่อนกำหนดอายุครรภ์ 28^0/7- 36^6/7สัปดาห์ น้ำหนักแรกเกิดน้อยกว่า 2,500 กรัม ที่เข้ารับการรักษาหอผู้ป่วยเด็ก2 โรงพยาบาลนครพนม ระหว่างเดือนธันวาคม พ.ศ.2566 ถึงเดือนเมษายน พ.ศ.2567 เปรียบเทียบระยะเปลี่ยนผ่าน (วัน) จากการให้นมทางสายยางให้อาหารสู่การกินนมได้เองทางปากและปริมาณน้ำนมที่ทารกดูดได้ต่อวัน (มิลลิลิตร) ระหว่างทารกเกิดก่อนกำหนดที่ใช้แนวปฏิบัติการพยาบาลทางคลินิกการนวดปากกระตุ้นการดูดกลืน กับทารกที่ได้รับการพยาบาลตามมาตรฐานเดิมวิเคราะห์ข้อมูลทั่วไปด้วยสถิติ แจกแจงความถี่ ร้อยละ วิเคราะห์เปรียบเทียบค่าเฉลี่ย ส่วนเบี่ยงเบนมาตรฐาน เปรียบเทียบผลลัพธ์ที่ศึกษา ระยะเปลี่ยนผ่านจากการให้นมทางสายยางให้อาหารสู่การกินนมได้เองทางปาก และปริมาณน้ำนมที่ได้รับต่อวัน ด้วยสถิติ t-test , exact probability test วิเคราะห์ปรับลักษณะพื้นฐานที่แตกต่างกันด้วยสถิติ generalized linear regression model ใช้สถิติ multilevel mixed-effects linear regression ภายใต้การวัด outcome of intervention แบบ repeated measurement

ผลการศึกษา : ลักษณะทั่วไปของทารกเกิดก่อนกำหนดทั้งสองกลุ่มไม่แตกต่างกัน เมื่อเปรียบเทียบค่าเฉลี่ยระยะเปลี่ยนผ่านจากการให้นมทางสายยางสู่การกินนมเองทางปาก กลุ่มที่ได้รับการนวดปากกระตุ้นการดูดกลืนด้วยโปรแกรม PIOMI มีค่าเฉลี่ยระยะเปลี่ยนผ่านจากการให้นมทางสายยางสู่การกินนมเองทางปากเท่ากับ 3.15 วัน (SD=2.64) น้อยกว่ากลุ่มที่ได้รับการพยาบาลตามมาตรฐานเดิม มีค่าเฉลี่ยระยะเปลี่ยนผ่านจากการให้นมทางสายยางสู่การกินนมเองทางปากเท่ากับ 8.75 วัน (SD=3.31) อย่างมีนัยสำคัญทางสถิติ (p-value<0.001) และเมื่อวิเคราะห์ด้วยสถิติ multilevel mixed-effects linear regression ภายใต้การวัด outcome of intervention แบบ repeated measurement กลุ่มที่ได้รับการพยาบาลตามมาตรฐานเดิม เริ่มต้นวันแรกทารกดูดนมได้ 22.8 มล.และดูดนมได้เพิ่มขึ้นในวันต่อๆมา วันละ 36.2 มล. ในกลุ่มที่ได้รับการนวดปากกระตุ้นการดูดกลืนด้วยโปรแกรม PIOMI วันแรกทารกจะดูดนมได้ 70.6 มล.และดูดนมได้เพิ่มขึ้นในวันต่อๆมาวันละ 36.2 มล.อย่างมีนัยสำคัญทางสถิติ (p-value 0.008)

ข้อสรุป : ควรนำการนวดปากกระตุ้นการดูดกลืนด้วยโปรแกรม PIOMI ไปใช้เป็นแนวทางในการปฏิบัติพยาบาลเพื่อสร้างทักษะและส่งเสริมการดูดกลืนในทารกเกิดก่อนกำหนดได้ดีขึ้น เพื่อให้ทารกได้รับสารอาหารเพียงพอ มีภาวะโภชนาการที่ดีนำไปสู่การเจริญเติบโตที่เหมาะสม

คำสำคัญ: ทารกคลอดก่อนกำหนด,การนวดปากกระตุ้นการดูดกลืน, โปรแกรม PIOMI, ระยะเปลี่ยน

ผ่านการให้นมทางสายยาง

Development of a Model for Organs donation in Transplant coordinator nurses, Mahasarakham Hospital

Jeeraphan Intawan — 2025-08-25

Objective: To develop and evaluate the effectiveness of a Model for Organ donation in Transplant coordinator nurses at Mahasarakham Hospital.

Materials and Methods: This research and development study was in 4 phases. The sample groups consisted of 42 brain-dead patients and 6 Transplant coordinator nurses. Research instruments included: 1) brain-dead patient data records, 2) focus group discussion guides, 3) organ donation model structure assessment form, 4) nursing practice assessment form, 5) nurses' organ donation competency assessment form, and 6) model feedback questionnaires. The research was from October 2020 to September 2023. Data were analyzed using descriptive statistics, inferential statistics, and content analysis.

Results: 1) The developed organ donation model consists of 3 components: Input, process and outcomes. After implementing the model, significant improvements were observed. The number of organ donation registrations increased (p < 0.001), The percentage of brain-dead patients consenting to organ donation increased (p < 0.001), (3) Nurses showed significantly higher organ donation competencies compared to before and after implementation (p < .001), (4) Nurses followed the developed model 100%, and (5) Nurses rated the model quality as good at 86.54% with high satisfaction (M = 4.35, SD = 0.87).

Conclusion: The developed model consists of 3 components: input, process, and outcomes. After implementing the developed model, it was found that the predetermined indicators were achieved. Hospitals with similar contexts should adopt this developed model, though some aspects of the model or outcomes may need to be adjusted to align with the specific context of each area.

editorial

นทวรรณ หุ่นพยนต์ — 2025-07-17