Development of a Seamless Nursing Service System for Sepsis Patients in Sawangdaendin Crown Prince Hospital
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Abstract
This research and development study on a seamless nursing service system for patients with sepsis was conducted in 3 phases: 1) situation analysis by reviewing medical records of patients with sepsis between fiscal year 2022- 2023 (n = 255) and focus group discussion with 10 nurses. Data were analyzed using descriptive statistics and content analysis. 2) developing a seamless nursing service system, and 3) evaluating the system's effectiveness. The sample consisted of 30 patients with sepsis and 30 nurses. Data were collected using nurses’ and patients’ satisfaction questionnaires with Cronbach's alpha coefficients of .89 and .91, respectively. Descriptive statistics, the McNemar test, and the t-test were used for data analysis. The study results revealed:
1. There were patients with a high rate of septic shock at 46.27%. The personnel involved in patient care with sepsis identified issues regarding inter-departmental coordination, delays in treatment, and a lack of clear guidelines.
2. The system for patients with sepsis applies the principles of seamless care and human caring, consisting of 1) patient assessment and screening, 2) patient care, 3) patient transfer guidelines, 4) discharge planning, 5) communication and understanding of practice guidelines, and 6) monitoring and evaluation.
3. The patient’s satisfaction was at the highest level (M = 4.66, SD = .48). The rate of mortality, severe sepsis, and the number of patients admitted to the intensive care unit significantly decreased (t = 3.82, 3.02, 28.05; p < .01). Additionally, the achievement of the indicators for fluid resuscitation, antibiotic administration, and hemoculture test significantly increased (t = 61.23, 92.34, 100.52; p < .01). Nurses reported a high level of satisfaction (M = 4.45, SD = .64), and their knowledge and skills significantly increased at the statistical significance levels of .01 and .001, respectively.
The seamless nursing service system for patients with sepsis can be applied in hospitals with limited resources to reduce the screening and patient transfer delays.
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References
AGREE Next Steps Consortium. (2017). The AGREE II Instrument. http://www.agreetrust.org
Boonchan, T., Tantalanukul, S., & Mingkhuan, W. (2021). Compare the use of the MEWS with the SOS score in the evaluation of new pneumonia patients, male medical ward, Uttaradit Hospital. Health Science Clinical Research, 36(2), 58–65. (in Thai)
Chaiwong, D., Isarangura Na Ayudhaya, P., Chompusup, J., & Khantarak, P. (2022). The development of nursing-care system for sepsis and septic shock patients in Chiang Mai Province, Thailand. Journal of Nakornping Hospital, 13(2), 57-74. (in Thai)
Chantara, P., Sritundorn, S., Watthanachai, T., Yuwanich, N., Munketkit, K., Samritmanoporn, W., & Kiennukul, N. (2022). The 1-hour sepsis bundle practical outcomes of registered nurses in caring for severe sepsis patients at the emergency department, Nopparat Rajathanee Hospital. Journal of Prachomklao College of Nursing, Phetchaburi Province, 5(3), 68-83. (in Thai)
Kumhnongkoo, B. (2019). The impact of compliance with Surviving Sepsis Campaign Guideline 2018 on hospital mortality in patients with sepsis and septic shock. Nakhonphanom Hospital Journal, 7(2), 5–15. (in Thai)
Levy, M. M., Evans, L. E., & Rhodes, A. (2018). The surviving sepsis campaign bundle: 2018 update. Intensive Care Medicine, 44(6), 925-928. https://doi.org/10.1097/ccm.0000000000003119
March, A. (2006). Perspective: Consistency, continuity, and coordination-The 3Cs of seamless patient care. The Commonwealth Fund. https://www.commonwealthfund.org/publications/newsletter-article/perspective-consistency-continuity-and-coordination-3cs-seamless
Nilwachararung, R., Sroysuwan, P., Wannasopha, D., Chueaphan, Y., Khamkararuecha, S., Kaewkanlaya, S., Wiphatthanaphon, S., Srichon, A., Naebniad, R., Phuaop, C., Simalee, S. (2021). Effect of sepsis clinical pathway in surgery NKP (SCPS) in the surgical elderly patients at Nakhonphanom Hospital. Nakhonpanom Hospital Journal, 5(3), 25-35. (in Thai)
Office of Strategy and Planning, Permanent Secretary Office, Ministry of Public Health. (2023). Public health statistics A.D. 2022. Ministry of Public Health. https://spd.moph.go.th/wp-content/uploads/2023/11/Hstatistic65.pdf
Phromsut, P. (2024). Effect of nursing clinical supervision on bloodstream infections (sepsis) in patients at Sakhrai Hospital, Nongkhai Province. Journal of Health Research for Hospitals and Communities, 2(1), 30-40. (in Thai)
Puripan, N., Katsakun, A., & Palavutitotai, N. (2020). Outcome of development of the Lerdsin Hospital sepsis protocol checklist. Journal of Health and Nursing Research, 36(1), 12–21. (in Thai)
Rudd, K. E., Johnson, S. C., Agesa, K. M., Shackelford, K. A., Tsoi, D., Kievlan, D. R., ... & Naghavi, M. (2020). Global, regional, and national sepsis incidence and mortality, 1990–2017: Analysis for the global burden of disease study. The Lancet, 395(10219), 200–211. https://doi.org/10.1016/S0140-6736(19)32989-7
Sawangdaendin Crown Prince Hospital. (2024). Report of infected patients 2019–2023. Sawangdaendin Crown Prince Hospital. (in Thai)
Schorr, C. (2018). Surviving sepsis campaign hour-1 bundle: This 2018 update to the sepsis bundle focuses on beginning treatment immediately. American Nurse Today, 13(9), 16-20.
Senasaeng, W. (2023). Development of a care system for patients with sepsis at Somdet Hospital. Journal of Environmental Health and Community Health, 8(3), 661–667. (in Thai)
Sernthaisong, S. (2019). Effect of Modified Early Warning Scores (MEWS) on the treatment of patients with sepsis at the ward in Ban Phue Hospital. Udonthani Hospital Medical Journal, 27(2), 223–230. (in Thai)
Singer, M., Deutschman, C. S., Seymour, C. W., Shankar-Hari, M., Annane, D., Bauer, M., ... & Angus, D. C. (2016). The third international consensus definitions for sepsis and septic shock (Sepsis-3). JAMA, 315(8), 801-810. https://doi.org/10.1001/jama.2016.0287
Tancharoen, L., Pairattanakorn, P., Thamlikitkul, V., & Angkasekwinai, N. (2022). Epidemiology and burden of sepsis at Thailand’s largest university-based national tertiary referral center during 2019. Antibiotics, 11(7), 899. https://doi.org/10.3390/antibiotics11070899
Tuekta, P. (2022). Comparison of the accuracy between SIRS, qSOFA, and NEWS in screening for diagnosing sepsis in patients admitted to the emergency department. Chiang Rai Medical Journal, 14(2), 45–55. (in Thai)
Unkeaw, T., & Suwanphan, A. (2021). Development of sepsis guideline in Khunhan Hospital, Sisaket Province. Science and Technology Journal of Sisaket Rajabhat University, 1(2), 40–52. (in Thai)
Watson, J. (2008). Nursing: The philosophy and science of caring (Rev. ed.). University Press of Colorado.
Wiriya, S., Jantanui, K., & Khusakunrat, P. (2023). Developing a system of care by sepsis alert team for patients with severe sepsis in secondary care hospital. Journal of Environmental and Community Health, 8(2), 594–606. (in Thai)
World Health Organization. (2024, May 3). Sepsis. https://www.who.int/news-room/fact-sheets/detail/sepsis
