Development of a Care Model for Patients with Sepsis in Inpatient Wards at Kantharawichai Hospital, Maha Sarakham Province, Thailand

Abstract

Abstract

            Background : Sepsis is a life-threatening condition associated with high mortality, particularly in community hospitals with limited resources. Developing an appropriate care model tailored to the local context is essential to improve the quality of care and clinical outcomes.

            Objective : To examine the current situation and problems, develop a care model, and evaluate the outcomes of a sepsis care model in inpatient wards at Kantharawichai Hospital, Maha Sarakham Province, Thailand.

            Methods : This study employed a Research and Development (R&D) design conducted from March to November 2025. The study consisted of three phases: situation analysis, model development, and outcome evaluation. The samples included medical records of patients with sepsis before and after implementation of the model (n = 30 per group). Data were collected using patient record forms, structured interviews, and the developed care model. Data were analyzed using descriptive statistics, Chi-square test, and Paired t-test or Wilcoxon signed-rank test as appropriate.

            Results : After implementation, significant improvements were observed in nursing practices. The proportion of patients assessed using qSOFA/SIRS increased from 26.67% to 83.33%, and the use of SOS score increased from 16.67% to 90.00% (p < .001). The mean time from screening to diagnosis significantly decreased from 97.60 ± 41.80 minutes to 58.90 ± 24.70 minutes (p < .001). The proportion of patients diagnosed before the onset of septic shock increased from 70.00% to 93.33% (p = 0.020). The average length of hospital stay was significantly reduced (p = 0.041). Although the incidence of septic shock and mortality decreased, the differences were not statistically significant.

            Conclusion : The developed sepsis care model improved the care process by enhancing early detection, systematic assessment, and timely management. It reduced the time to diagnosis and showed a trend toward improved clinical outcomes. This model may be applicable to other community hospitals with similar contexts.

Keywords : Sepsis, Care model, Sepsis bundles, Community hospital