Development and Effectiveness of Clinical Practice Guidelines (CPGs) for Initial assessment among tertiary trauma survey (TTS) in patients with multiple traumas in Trauma and neurosurgical ward, Phrae Hospital

Abstract

Background:    Initial assessment among tertiary trauma survey (TTS) in patients with multiple traumas, if there is a mistake in the assessment from the initial stage, the receiver will cause subsequent damage. Causing the patient to receive delayed treatment, and receive additional procedures and affect the day of the hospital to stay longer.

Objective:        In order to develop and study the effectiveness of Clinical Practice Guidelines for initial assessment among multiple trauma patients.

Study design: This research was a Mixed Methods design. Study in Trauma and neurosurgical ward, Phrae hospital. By studying the problem obstacles to using the original patient assessment form with Focus Group Discussion methods between 1 January to 30 June 2019. Used to develop and study the Effectiveness of Clinical Practice Guidelines (CPGs). The control group began to study between 1 January to 30 June 2019, of 76 subjects. The experimental group began to study between 15 July to 15 December 2019, of 78 subjects. The instruments used in this study were the CPGs, assessment of trauma patients, and the TTS assessment form. Data collection were 1. The patient data recording form and coverage in the assessment of multiple trauma patients and 2. The questionnaires of registered nurses who use Clinical Practice Guidelines. Data were analyzed by using descriptive statistics,       t-test, and exact probability test.

Conclusions:   Trauma patients assessed Initial assessment among tertiary trauma survey (TTS) in patients with multiple traumas. Will receive a quick, timely, and comprehensive assessment of the nursing process in determining nursing diagnoses.

Results:            The results of the study showed that the injury error rates from both groups were not statistically different (p=1.000). The CPGs discovered more injury errors in the wards within 24 hours more than the group that not using the CPGs (100% and 61.1%). The group that using the CPGs can correctly determine the problem of diagnosis according to the patient problem more than the group that not using the CPGs (93.6% and 68.4%). Regarding the satisfaction of registered nurses on using the CPGs at a high level of 86.7 percent.

Keywords:        Development, Effectiveness of Clinical Practice Guidelines(CPGs), initial assessment, tertiary trauma survey (TTS)