Development of Referral Seamless Nursing System for Critical Emergency Patient Referrals at Chaokhunpaiboon Phanom Thuan Hospital

Abstract

This study aimed to develop a seamless nursing referral system for critically ill emergency patients at Chaokhunpaiboon Phanom Thuan Hospital. The research was conducted in three phases. Phase 1 involved studying the current situations and problems related to the emergency referral system among 52 healthcare personnel. Phase 2 developed the nursing referral system in collaboration with five registered nurses from the emergency and forensic department, the inpatient department, the outpatient department, and the delivery room. Phase 3 evaluated the effectiveness of the developed referral system among 52 registered nurses.

Research instruments included an interview guide for referral service providers, a referral patient care guideline, a pre-referral readiness assessment form, an assessment form for patients during referral, and satisfaction questionnaires. All instruments were validated by five experts, yielding a content validity index of 1.00. The feasibility of the referral system was rated at 4.88. The knowledge assessment instrument had a reliability coefficient (KR-21) of .86. Data were analyzed using descriptive statistics and paired t-tests.

The results showed that professional nurses lacked knowledge and skills in the transfer of critically ill patients from the emergency department. The developed system included guidelines for the care of transferred patients and a pre-transfer readiness assessment form. Following the trial, a statistically significant increase in nurses' knowledge was observed (p < .001). 100% of patient transfers were completed according to standards, with an airway displacement rate of 1.46%. No deaths occurred during or within 24 hours of transfer. Patient satisfaction was high ( = 4.46, SD = 0.26), and staff satisfaction with the system was very high ( = 4.64, SD = 0.32).