Quality Improvement in Caring for Patients with Multiple Trauma, Male Surgical Ward 1, Buddhachinaraj Phitsanulok Hospital

Abstract

     This study aimed to improve the quality of care for patients with multiple trauma by using the FOCUS-PDCA continuous quality improvement process comprising of nine steps: identify the process requiring improvement; establishing a knowledgeable and competent team; analyzing the existing process; determining the causes of process variation; select appropriate improvement strategies; planning the improvement; implementing the plan; evaluating the outcomes; and ensuring implementation and continuous improvement. The study population consisted of 15 nurses working in Male Surgical Ward 1 at Buddhachinaraj Phitsanulok Hospital divided into a development team and an operational team. The research instruments included a focus group discussion guideline, a case manual of the care of patients with multiple trauma, an incident recording form for multiple trauma care, and a checklist for the multiple trauma care practice which an inter-rater agreement of 0.90. Data were analyzed using frequency distribution, mean, percentage, and standard deviation.

     The study results showed that, following the quality improvement for patients with multiple trauma at Male Surgical Ward 1, Buddhachinaraj Phitsanulok Hospital, the operational team can correctly and completely perform caring for patients with multiple trauma at 95.83%. At the admission and continuing care phase, the operational team can correctly and completely perform at 100.00%. At the discharge phase, the operational team can correctly and completely perform at 87.50%. No unplanned intensive care unit admissions were found within the first 24–48 hours after admission.  Nursing administrators should promote the use of the continuous quality improvement processes throughout the hospital.