การพัฒนาแนวปฏิบัติการวางแผนจำหน่าย สำหรับผู้ป่วยโรคหลอดเลือดสมอง ศูนย์ศรีพัฒน์ คณะแพทยศาสตร์ มหาวิทยาลัยเชียงใหม่

Abstract

Stroke is a disorder of the central nervous system caused by dysfunction of the cerebral blood vessels. Stroke is a major cause of disability, it limits daily activity and it impairs self-caring after an acute attack. Discharge planning is essential for these patients in order to prevent unsatisfactory conditions. This developmental study aimed to develop discharge planning guidelines for stroke patients. The study setting was Sriphat Medical Center, Faculty of Medicine, Chiang Mai University. A multidisciplinary care team, composed of 2 physicians, 6 nurses, and 1 physiotherapist, participated in the study. The process of guideline development was based on the framework of evidence-based guideline development as proposed by the National Health and Medical Research Council [NHMRC] (1999). The developed guidelines were approved by 3 clinical experts and were then tested by 3 stroke patients. The result of the study yielded a set of evidence-based discharge planning guidelines for stroke patients, which included 4 categories of practice recommendations. They were 1) practice ethics and protecting the rights of patients; 2) preparing the patient prior to discharge; 3) discharging the patient; and 4) following up after discharge. The developed guidelines were approved by 3 experts. All recommendations presented by these guidelines were proved for feasibility, appropriateness, and meaningfulness with 3 stroke patients. The discharge planning guidelines for stroke patients developed during this study can be used in the study setting. This guidelines should be systematically implemented to improve quality of discharge planning. Further study should be done to test the outcomes of guideline implementation.