การพัฒนาแนวปฏิบัติการพยาบาลเพื่อเคลื่อนย้ายผู้บาดเจ็บวิกฤตฉุกเฉินในโรงพยาบาล  กลุ่มงานการพยาบาลผู้ป่วยอุบัติเหตุ-ฉุกเฉิน โรงพยาบาลมหาราชนครราชสีมา

Surat Kamsuk; Ratchanee  Siriwat; Nitaya  Rojtinnakorn; Jiraporn  Pokpoonsrap

Authors

Surat Kamsuk Maharat Nakhon Ratchasima hospital https://orcid.org/0000-0003-1869-3020
Ratchanee Siriwat Maharat Nakhon Ratchasima hospital
Nitaya Rojtinnakorn Maharat Nakhon Ratchasima hospital
Jiraporn Pokpoonsrap Maharat Nakhon Ratchasima hospital

Keywords:

critical nursing practice guideline, intrahospital transfer in critically ill patients

Abstract

This action research aimed to 1) develop clinical nursing practice guideline (CNPG) for intrahospital transfer in critically ill patients and 2) study the effect of CNPG for critically ill patients on caring outcomes. This study was carried out at the emergency nursing division of Maharat Nakhon Ratchasima hospital, during August 2018 to March 2020. The samples were 182 critically ill patients. Research instruments included 1) CNPG for intrahospital transfer record sheet, 2) participate observationchecklist, 3) the complications checklist and time record, 4) nurses’ satisfaction. The content validity index was verified by five experts at .88, .88, 1.00 and 1.00. Data was analyzed by using descriptive statistic,Fisher's exact test, independent t-test and content analysis.
A statistically significant level was set at .05. The results of this study revealed that:

The content of CNPG for intrahospital transfer in critically ill patients comprised 3 phases: 1) the pre-transfer phase, including preparation of patients, equipment and personnel, 2) the during-transfer phase, including warning signs assessment in patients, and 3)the post-transfer phase, including recording and nursing communication by SBAR technique.
The process evaluation showed that emergency nurses complied with CNPG at 96.12% and were satisfied with using the CNPG at 94.82%.
Clinical outcome showed that 1) the adverse events of accidental extubation, hemodynamic instability, disconnection of intravenous fluid, loss of monitoring and loss of identify was significantly reduced, and 2) The average intrahospital transfer time was statistical significantly reduced at .05.

In conclusion, this study reflects that CNPG for intrahospital transfer in critically ill patients could develop knowledge, personnel competency, innovation and routine nursing practice with more effective for critically ill patients. Therefore, this CNPG could be continuously practiced.

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Author Biography

Surat Kamsuk, Maharat Nakhon Ratchasima hospital

1.The Prevalence and Factors Related to Intracranial Hemorrhage in the Mild Traumatic Brain
Injuries of Patients Admitted to the Emergency Room of Maharat Nakhon Ratchasima Hospital

2.Box for Transporting Samples for Arterial Blood Gas Analysis

3.Development of a Seamless Nursing Communication Model Using SBAR Techniques during Transitional Care Period, Emergency Nursing Division, Maharat Nakhon Ratchasima Hospital

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