Development of an Integrated Care for Sepsis at Rattanawapi Hospital , Nong Khai Province.

Abstract

      This study aimed to investigate the problems in the management of patients with bloodstream infections in the local area and to develop an integrated care system for patients with bloodstream infections in Rattanawapi District, Nong Khai Province, Thailand. This research employed an Action Research design consisting of four stages: (1) Planning studying the existing problems and care management system for patients with bloodstream infections in Rattanawapi District; (2) Action implementing interventions; (3) Observation monitoring the implementation process; and (4) Reflection and Evaluation assessing outcomes and extracting lessons learned. Both quantitative and qualitative research methods were used. The study sample consisted of 65 patients with bloodstream infections, 44 healthcare providers, and 30 key informants for qualitative investigation. Research instruments included questionnaires and interview forms. Quantitative data were analyzed using percentage, mean, and standard deviation, while qualitative data were analyzed using triangulation techniques. The study was conducted from January to June 2026.

      The findings revealed that the development of the bloodstream infection care system involved both proactive community-based and hospital-based approaches. Community interventions included establishing village health volunteer leaders and subdistrict health personnel to provide health education and early disease screening using a mobile application, with patient referral through the Line-based Sepsis Referral Coordination Center in Rattanawapi District. Hospital interventions included competency development workshops for healthcare personnel, training, competency assessments, supervision, standardized clinical practice guidelines, and health education for high-risk populations, particularly patients with chronic diseases, older adults, postpartum women, mothers and children, and bedridden patients. Village health volunteers played a critical role in improving knowledge dissemination, early screening, and rapid referral, which are essential for disease prevention and mortality reduction. After implementation, the average score increased from 84.53 points (80.50%) before intervention to 99.63 points (91.68%) after intervention, representing an improvement of 15.10 points.