Development of a Care System for Hemorrhagic Stroke Patients from Hypertension at Somdetphraphutthaloetla Hospital, Thailand

Abstract

This research aimed to develop a care system for hemorrhagic stroke patients from hypertension at Somdetphraphutthaloetla Hospital and examine system outcomes. The research progressed sequentially through the following three steps: (1) situation analysis (2) design and development a care system and (3) evaluation of system effectiveness. Research tools included: a review of medical record forms for hemorrhagic stroke patients from hypertension, a questionnaire of care situations, a knowledge test for those who treat hemorrhagic stroke patients from hypertension, a compliance with clinical practice guidelines, the assessment of caregiver knowledge and ability, questionnaire of nurses and caregivers’ satisfaction including clinical outcomes evaluation form. Data were analyzed using content analysis, descriptive statistics, and paired t–test. The results showed a care system for hemorrhagic stroke patients from hypertension with 5 elements: the first element was development of registered nurses’ knowledge and competency; the second was resource availability management; the third was the care guidelines; the fourth was follow-up practices and the fifth element was the effectiveness after implementation of a care system. The outcomes were: (1) the registered nurses’ knowledge were improved statistically significant at p<0.05; good levels in practice and satisfaction were at a good level, (2) the knowledge of caregivers were improved statistically significant at p<0.05; their skills in patient care were at a moderate level and satisfaction were at a good level, and (3) evaluation of important clinical outcomes found that door to operation was target, decreased complications, including mortality rate and length of stay were decreased. Therefore, this care system could produce better treatment outcomes for patients. The results of this study should be considered for planning in continuous quality improvement of nursing care.