Effectiveness of Development of Emergency Severity Index in Patient's Model at Khaowong Hospital, Kalasin Province

Abstract

     This study is action research that aims to study the effectiveness of the development of the emergency patient's Triage Model at Khaowong Hospital, Kalasin Province. The purposive samplings were registered nurses and advanced emergency medical technician Emergency Severity Index. The sample was drawn from specific random sampling, including 9 professional nurses and emergency medical officers. Data were collected. Between 1 January 2021 - 30 June 2021 using the Emergency Severity Index (ESI) screening guidelines. Research tools include knowledge and skills assessment for emergency patient triage. Quality assessment form for sorting emergency patients and satisfaction assessment form for emergency patient classification. Data were analyzed using descriptive statistics, pared t-test. 

     The results found that After the following developments, it was found that emergency patients (Emergency & Urgent) waiting to be examined were screened slowly at 79.00 percent, followed by MI patients waiting to be screened at 9.00 percent and critically ill patients were screened slowly at 5.00 percent according to Sequence The development process consists of 7 important measures as follows: Measure 1: Have a multidisciplinary team meeting. Measure 2: Study criteria for screening and classify illness severity. Measure 3: Analyze data on disease symptoms of emergency patients receiving services. Measure no. 4 Improve the Emergency Severity Index (ESI) screening guidelines to have clearer, more comprehensive screening criteria. Measure 5: Meeting relevant personnel to use the revised (ESI). Measure 6: Develop knowledge and skills of personnel in screening. Patients, Measure 7: Evaluation and review of the suitability of screening guidelines. Follow up with follow-up meetings every 3 months. Results from the development of the model found that the screening rate for grading illness severity correctly was 96.8% Over triage 1.74% % Under Triage 1.46% Training to develop staff knowledge found that the average score Before the training, there was a value of 6.67 points (SD 1.23 points). The average score after training was 8.22 points (SD 0.94 points). Tested with paired t-test statistics, it was found that the average score of knowledge and patient sorting skills after training More than before the training with statistical significance at the .05 level (t = 9.36). The accuracy of severity and urgency at the Less-Urgent level increased the most at 96.00 percent, followed by the Urgent level at 94.00 percent and the Resuscitation level. 90 percent respectively. Satisfaction assessment results. The average before development was 50.61 points (SD 5.53 points). The satisfaction score after training was 56.00 points (SD 5.96 points). Tested with paired t-test statistics, it was found that the satisfaction score after developing the classification model. The number of patients after development increased more than before development at a statistical significance of .05 (t = 5.73).