ผลลัพธ์การจัดการผู้ป่วยที่มีภาวะติดเชื้อและช็อกจากการติดเชื้อในกระแสเลือด หน่วยงานอุบัติเหตุฉุกเฉินและนิติเวช โรงพยาบาลสว่างวีระวงศ์ : การศึกษาย้อนหลัง 12 เดือน

Narknoi  Nontawee; Teepatad Chintapanyakun; Sukamon  Wongkoon; Watcharaphan  Wongkhamphan; Thawannarat  Sanjornkoksung

Authors

Narknoi Nontawee Nursing Department, Sawangweerawong Hospital
Teepatad Chintapanyakun Department of Nursing Service, Ramathibodi Hospital, Mahidol University
Sukamon Wongkoon Nursing Division, Trakan Phuet Phon Hospital
Watcharaphan Wongkhamphan Nursing Division, Detudom Crown Prince Hospital
Thawannarat Sanjornkoksung Nursing Department, Sawangweerawong Hospital

Keywords:

sepsis, septic shock, patient management outcomes

Abstract

This retrospective cohort study aimed to examine the outcomes of management for patients with sepsis and septic shock in the Emergency Accident and Forensic Unit at Sawangweerawong Hospital. The sample consisted of 40 patients with sepsis and septic shock who received care in this unit. Participants were selected using purposive selection. The research instrument was a data recording form that included personal information, treatment received, process outcomes, and treatment outcomes. Data were analyzed using descriptive statistics, a one-sample t-test, and the Wilcoxon signed-rank test.

The research findings revealed that: 1) For the process outcomes, the mean time for patient assessment and screening by registered nurses was 17.35 minutes (SD = 5.05), and the mean time to diagnosis by physicians was 41.88 minutes (SD = 25.93). Both durations were significantly longer than the 15-minute standard set by the Ministry of Public Health, with statistical significance at the .05 level (p = .005 and p = .000, respectively). The median time from diagnosis to antibiotic administration was 27.50 minutes (IQR = 10.00 - 53.75), which was significantly shorter than the Ministry’s 60-minute standard, also with statistical significance at the .05 level (p = .016). Additionally, the mean volume of intravenous fluids administered within the first 3 hours for patients without contraindications was 695.75 mL (SD = 468.25), significantly lower than the recommended 1,500 mL, with statistical significance at the .05 level (p = .000). 2) Treatment outcomes showed that 77.50% of patients were admitted to the general ward. The average length of hospital stay was 4.85 days (SD = 3.14), and the average cost of treatment was 10,277.16 bath (SD = 4,891.25).

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