Development of Guidelines for Monitoring Unstable or Deteriorating Conditions in Patients Waiting for Examination at the Outpatient Department of Fao Rai Hospital, Nong Khai Province.

Abstract

This research aimed to develop and evaluate the effectiveness of a surveillance guideline for unstable or deteriorating conditions in outpatients waiting for examination at Fao Rai Hospital, Nong Khai Province. The study employed an action research methodology (PAOR) with a sample of 200 participants, comprising 25 medical personnel, 170 patients and relatives, and 4 experts. Research instruments included a current situation assessment form, a patient symptom surveillance record, a satisfaction evaluation form, and an incident record form. Data were analyzed using descriptive statistics such as frequency, percentage, mean, and standard deviation, and inferential statistics including the Chi-square test to compare proportions before and after the implementation of the surveillance guideline.              

The results showed that the implementation of the EWS-ABCDE Integrated Surveillance Model for monitoring unstable or deteriorating conditions in outpatients increased the detection rate of deteriorating conditions from 15.00% to 28.00% (χ² = 10.02, p<0.001). It also reduced the response time to symptom changes from 22.5 minutes to 12.8 minutes and decreased the number of patients requiring emergency room treatment by 60%. Medical personnel reported high satisfaction with the new guideline (mean=4.48, S.D.=0.63). The EWS-ABCDE Integrated Surveillance Model effectively enhanced the safety and quality of care for outpatients. It is recommended that this model be applied in other hospitals with similar contexts, and further long-term outcome studies should be conducted.