Development of Early Warning Sign Model in High-Risk Patient, Songkhla Hospital

Abstract

This research aimed to develop and study the results of a early warning signs model in high-risk patients at Songkhla Hospital. There were 3 phases of this research: (1) situation analysis by reviewing medical records of 10 deteriorate patients, focus group discussions of which 15 head nurses and 20 professional nurses were used for qualitative data analysis; (2) developed model by literature review to create a guideline for monitoring the warning signs of a crisis; and (3) evaluated the results of the developed model. The samples were 150 registered nurses and 200 high-risk patients from whom the data were collected before and after development. Quantitative data were analyzed by using percentage, mean, standard deviation and independent t-test. The results showed that in Phase 1, there was no use of alarm monitoring tools. From the focus group discussion, it was found that crisis monitoring capability was insufficient combining with late doctor’s report. The early warning signs model in high-risk patients Songkhla Hospital consists of 2 components: (1) guidelines for monitoring early warning signs of crisis, and (2) guidelines for developing professional nurses’ competency of early warning signs. As for the results, the number of deteriorations after development was lower than before; and the mean scores of nursing performance after development were significantly higher than before (p<0.01). In addition, the scores of compliance with the guidelines for monitoring early warning signs of crisis were at a high level (90.5%). Thus, this early warning signs model should be introduced into the management system for critical conditions in high-risk patients in order to increase the competency of nurses and the safety of patients.