The Development of Nursing CARE Model for Medical Critically Ill Patient in the Intensive Care Unit, Detudom Crown Prince Hospital

Abstract

This research and development study aimed to develop a care model for critically ill medical patients in the intensive care unit at Detudom Crown Prince Hospital and to compare clinical outcomes of critically ill patients before and after the model development. The study was conducted in two phases with a purposive sampling approach. The sample consisted of 16 professional nurses and 192 critically ill medical patients. The research instruments included: (1) a care model for critically ill medical patients, (2) patient data recording forms, and (3) clinical outcome recording forms. Qualitative data were analyzed through content analysis, while quantitative data were analyzed using frequency distribution, mean, standard deviation, independent sample t-test, and Fisher’s Exact test. The research findings revealed that: (1) the developed care model for critically ill medical patients, termed “CARE Model” comprised four components: C (Care team) – establishment of a patient care team; A (Activity) – organization of nursing activities to provide care according to FAST HUG protocol; R (Review) – review of FAST HUG guideline implementation in critically ill medical patient care and documentation of work process results according to FAST HUG protocol; and E (Evaluation) – clinical outcome evaluation conducted monthly with feedback provided to the team to continuously improve quality of care and evaluate care outcomes. (2) Comparison of clinical outcomes before and after model development revealed that following implementation of the developed care model, there were significant statistical reductions in the incidence of patients unplanned extubation, ventilator-associated pneumonia rate, incidence of acute delirium, duration of mechanical ventilation weaning, and length of stay in the ICU compared to the pre-implementation period (P<0.05)