การพัฒนาคุณภาพการรับส่งเวรทางการพยาบาลในหอผู้ป่วยหนัก อายุรกรรม 3 โรงพยาบาลนครพิงค์ จังหวัดเชียงใหม่

Abstract

Nursing handover is a process for transferring information and primary responsibility and authority from outgoing nurses to incoming nurses. The purpose of this developmental study was to improve the quality of nursing handover in the Medical Intensive Care Unit 3 of Nakornping Hospital, Chiang Mai Province. Study methodology was guided by DPIR (Data, Problem, Implementation & Evaluation, and Recommendation) method and the FOCUS-PDCA quality improvement process (Deming, 1993) which consisted of 9 steps; find a process to improve; organize a team that knows the process: clarify the current knowledge of the process; understand the cause of process variation; select the process improvement; plan the improvement; do the improvement; check the results, data collection and analysis; and act to hold the gain and continue improvement. The study population included 17 registered nurses working at Medical Intensive Care Unit 3. The research instruments used were the interview guideline and the nursing handover observation checklist. Data were analyzed by descriptive statistics. The FOCUS-PDCA process helped the researcher to develop the nursing handover protocol, as well as the DPIR Sending Form and the Receiving Form. The researcher then trained nurses to perform the nursing handover process in compliance with the protocol. After implementation of the nursing handover protocol, the nurses were observed and 91.27% of nurses were compliant with the protocol and handover times decreased from 52.5 minutes to 47.5 minutes. The nurses were satisfied with the outcomes of the improvement quality process, and reported that the nursing handover protocol was feasible and acceptable in practice, and as well as very beneficial to the organization. However some barriers in the nursing handover process were identified. These included that outgoing nurses sometimes did not have enough time to fill out the handover form and some nurses were still unfamiliar with the new handover protocol. The study demonstrated an improvement in nursing shift handover through FOCUS PDCA, the nursing handover protocol, the DPIR Sending Form and the Receiving Form. Nursing administrators can apply this improvement methodology to improve nursing handover process in other departments.