The Development of a Model of Care for Patients with Sepsis In Patient Department at Kaedam Hospital Kaedam District, Mahasarakham Province

Abstract

The objective of this research is to develop and evaluate a care model for patients with bloodstream infections in the inpatient building of Kaedam Hospital. The research is divided into 3 phases as follows: Phase 1) Study of the situation among 17 patients with bloodstream infections and a multidisciplinary team of 16 people. 2) Model development phase. Trial and put into practice in a group of 36 patients with bloodstream infections and a multidisciplinary team of 19 people, and 3) evaluation phase Research tools Patient record form Personal information In-depth interview group chat Participatory observation and results Quantitative data were analyzed using descriptive statistics including percentages, means, and qualitative content analysis.

The results of the research found that the care model for patients with bloodstream infections includes: There is an evaluation and screening system in place from the beginning (Early detection). The evaluation and screening criteria are clearly defined. Criteria for continuous monitoring and evaluation of patient symptoms There are guidelines. Criteria for treatment Criteria for referring patients Urgent laboratory testing system and waiting for test results before sending for admission. Require that patients receive complete fluids before being sent for admission. Treat infection and restore circulation quickly according to Sepsis Bundles. Scheduled reporting of critical laboratory results. Physician reporting using SBAR includes a nursing practice manual. Working as a multidisciplinary team. Review of medical records Bedside supervision while transferring shifts, setting criteria for reviewing care for inpatients whose symptoms deteriorate, are transferred, or die. Nurse competency assessment Academic rehabilitation training. After using the care model for patients with bloodstream infections, it was found that 1)Rate of blood collection for culture (Hemoculture) before giving antibiotics 97.22% 2) Rate of receiving antibiotics within 1 hour after diagnosis 100% 3) Rate of receiving intravenous fluids of at least 30 ml/Kg in the first 1 hour (case There are no contraindications to giving fluids) 94.44 percent 4) Rate of referral for further treatment 25 percent 5) Rate of severe complications reduced to 13.88 percent 6) Death rate from  Infections in the bloodstream decreased with no deaths.