Development of Nursing Practice Guidelines for Triage System of Patients with Acute Stroke in Department of Accidental Emergency and Forensics at Wang Sam Mo Hospital, Udon Thani Province

Abstract

     This study was action research to develop nursing practice guidelines of triage system to classify patients with acute stroke in Department of Accidental Emergency and Forensics at Wang Sam Mo Hospital, Udon Thani Province.  The study process included 4 phases: 1) planning; 2) doing; 3) checking; and 4) action.  Data were collected from the key informants, 10 registered nurses, and 15 general informants including two general physicians, four emergency medical technician, seven nurse aids and two stretcher workers.  The instruments included 1) questionnaire on knowledge and skills in triaging acute stroke patients, 2) structured in-depth interview, 3) group discussion guide and 4) participatory observation guide. All instruments had a consistency index of 1, reliability of knowledge and skill questionnaires was 8.2 and 9.2, respectively.  Quantitative data was analyzed using descriptive statistics and compared mean between before and after the development of nursing practice guidelines using paired sample t-test.  Qualitative data was analyzed using content analysis.

     The results showed that the nursing practice guidelines for caring patients with acute stroke in 9 steps including: 1) first patient admission, 2) emergency assessment and screening, 3) patient care planning, 4) patient care practice, 5) discharge planning both inside and outside the hospital, 6) reassessment, 7) information and empowerment, 8) continuous care and 9) parallel activities.  The outcome of Stroke Fast Track patients who were transferred within 30 minutes was 100 percent.