Development of Nursing System in chronic wound patient, Lamphun Hospital ; การพัฒนาระบบการพยาบาลผู้ป่วยแผลเรื้อรัง โรงพยาบาลลำพูน

This action research aimed to develop a nursing system for patients with chronic wounds at Lamphun Hospital. The Donabedian's systemic approach was used as a conceptual framework. The purposive sampling included 112 health care providers giving care to 622 patients with chronic wounds who received treatment at Lamphun Hospital between October 1, 2015 to September 30, 2017. The developmental process comprised four phases. The research instruments consisted of the Evaluation and Monitoring of Wound Healing Form, the Customer Satisfaction Assessment Form, and the Provider Satisfaction Assessment Form. Data analyses used basic statistics to measure percentages and means. Development of a Nursing system for patients with chronic wound started from the establishing the board and meeting to review problems arising from operations. Development of a plan for working together with multidisciplinary teams and knowledge sharing of the health team. Selecting professional nurses from each department to head as a leader in caring the patients having chronic wounds. We established a triage wound clinic to develop nursing practice guidelines for chronic wound patients and pain relief to improve communication between networks. Communication by applying the Line group and develop information systems to be up-to-date, convenient and fast. The results showed that after implementation of the developing system, the results showed an improvement when comparing each development phase as follows: The length of hospital stay (day) decreased by 5.29%, 5.02%, 5.00% and 4.98%, respectively. 2) A return for re-admission within 28 days decreased by 1.45%, 0.88%, 0.86%, and 0.52%, respectively 3) There was no mortality rate from severe septic ulcers. 4) Wound healing improved by 85.21%, 90.00%, 93.55% and 97.10%, respectively. 5) Cost of services had decreased from 25.92%, 23.40%, 21.78% and 20.60%, respectively and 6) Satisfaction of chronic ulcer patients in the overall picture was at a high level (Mean score = 2.70, S.D. = 0.45). The service ...