Problems and Obstacles of Using the Initial Assessment of Form for Evaluating Multiple Injury Patients In the Trauma and Nervous System Units

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Vasana Sookgun
Chulawaree Chaiwongnakkapun
Kodchaporn Pongtae


          This research is a qualitative research that uses focus group discussion. The objective is to study the problems and obstacles to the use of the first multiple injury patients assessment model. The current form used in the accident and neurological surgery ward. Implemented 2 times in November 2018 and December 2018. Informants were 15 professional nurses, purposive sampling was chosen. The research instruments consisted of 1) questionnaire in group discussion 2) record while in group discussion 3) voice recorder data were collected by group discussion. The data were analyzed by using Typological Analysis of Miles and Huberman (1994), with the data subjects giving meaning to important messages or sentences and used to organize the information system.

          The results of the research from the focus group discussion were as follows:
1) the patient's meaning. Multiple system injuries comes from work experience that finds patients admitted in the wards into patients. The injury occurs in two or more systems of
the body or may occur at the same time 2) the most likely cause come from traffic accident. The most common time for seeing a patient is on the weekends or during various festivals
3) assessment characteristics of obstacles encountered during the present evaluation found the following points difficulty in evaluating multiple injury systems using the Gordon framework. there are broad in scope and difficult because there are many questions, no specificity in trauma assessment, make use of the time period for evaluation In terms of dimension, value, and belief (Value-Belief Pattern). In case of unconsciousness or have delirium, or have no relatives, will not be able to assess patients. Assessment depends on the competencies of professional nurses in nursing who have experience of caring for trauma patients in the novice group or in the advance beginner group, unable to fully evaluate the important details compared to the more experienced assessors and 4) the characteristics of the first condition assessment form for injury patients who need to develop physical examination should be recorded according to guidelines. Assessment of injury patients by systematic examination have pictures or have a check list system such as details of wound, type deformation of the injured organ make it easy to understand, easy to communicate, convey information in a multidisciplinary team. Assessing the severity of the injury and information on behavior, expression at the first reception of patients. This will lead to the determination of nursing diagnosis and able to provide accurate and comprehensive nursing for trauma patients


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บทความวิจัย (Research articles)


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