The Development of a Long-Term Care Model for Dependent Elderly with Complex Conditions: A Case-Based Study case management at Kan Subdistrict Health Promoting Hospital, Sanom District, Surin Province.

Abstract

     This retrospective survey research aimed to study nursing management, patient outcomes, and the relationship between nursing management and outcomes in patients with suspected sepsis. The sample consisted of 140 medical records of patients who received services at the Emergency and Forensic Department of Doi Saket Hospital, Chiang Mai Province, during fiscal years 2022–2025. Data were analyzed using descriptive statistics and inferential statistics, including Chi-square test, Fisher's Exact test, Mann-Whitney U test, and Kruskal-Wallis test, with a statistical significance level set at .05.

     Results: The majority of patients were male (56.43%), with a mean age of 69.34 years (SD = 15.86). Overall, 52.14% were in the high-risk group (NEWS ≥7), with a mean NEWS score of 7.39 (SD = 3.58). Regarding clinical management: antibiotic administration within 1 hour had the highest compliance rate at 88.57% (Median time = 10 minutes); blood culture collection prior to antibiotics was 80.00% (Median time = 44 minutes); and fluid resuscitation ≥1,500 ml was achieved in only 49.29%. Overall Sepsis Bundle compliance was 38.57%, below the international standard of 80%. Patient outcomes showed that 50.00% were referred to higher-capability hospitals, 43.57% were discharged home, and 6.43% died, with a median hospital stay of 6.0 days (IQR = 3.0–7.0 days). The NEWS ≥7 group had the highest mortality rate at 10.96%. Correlation analysis revealed no statistically significant associations between any nursing management variable and the four outcome measures (p > .05 for all variables)