DEVELOPING A MODEL OF CARE FOR THE MULTIPLE TRAUMA HYPOVOLEMIC SHOCK PATIENTS IN SAWANPRACHARAK HOSPITAL

Abstract

This research aimed to develop the model of care for the Hypovolemic shock multiple trauma patients in Sawanpracharak Hospital. The study was implemented between January, 2016 to August, 2016. There were three phases of research included: 1) analyzing the context and situation of multiple trauma care. 2) developing the model of the Hypovolemic shock multiple trauma patients care, and 3) evaluating the effectiveness of model. The target subjects were 20 nurses working in the trauma wards who were continuously implemented in the for the Hypovolemic shock multiple trauma patient care model, 130 Hypovolemic shock class II to class III in multiple trauma patients before receiving the model, and 65 multiple trauma patients during before receiving. The instruments used for collecting data were: 1) the Hypovolemic shock multiple trauma patient care model, 2) the protocol of caring for the Hypovolemic shock multiple trauma patient care model, and 3) the data record outcome of taking care of Hypovolemic shock multiple trauma patients. Data were analyzed using the descriptive statistic independent t-test, and exact probability test.

The findings revealed that the components influenced the model of the Hypovolemic shock multiple trauma patients care included: 1) multidisciplinary team, 2) operational plans, 3) participate of patients and families, 4) competency for nurses working in the trauma, 5) multiple trauma patient care processes, and 6) knowledge management. The model effectiveness testing showed the statistically significant differences between prior and during receiving the care for the Hypovolemic shock multiple trauma patients care model as follow: Process indicators showed The duration of the accident to the traumatic ward (78.4 and 63.3, p=0.005), Accident and Emergency Room time to physician diagnosed with Hypovolemic shock (32.4 and 25.4, p=0.001). Nursing Indicators showed The duration of the physician’s report when the patient admit ward (10.5 and 3.98, p=<0.001) and Patient indicators showed Hypovolemic shock class II to class III within 24 hours, and 72 hours (42, 31 and 6, 4, p=<0.001, 0.003) Hypoxia within 24 hours, and 72 hours (27, 19 and 2, 2, p=0.001, 0.014). However, the health status of patients within 72 hours showed moderate disability (66.2 and 69.2 (p=0.407) of the two groups were no statistically significant differences.

Results that the model of care for the Hypovolemic shock multiple trauma patients can reduce severity Hypovolemic shock from level II goes to level III and deceased Hypoxia in the hospital. And to achieve consistently good results, Should be studied to monitor the recovery phase before discharge. Both in the hospital and follow-up visits to the hospital in the network.