Development of fast track service system for patients with ischemic stroke in the context of a tertiary care hospital and service network, Thailand

25^th World Congress on Nursing Care

July 24-26, 2017 Melbourne, Australia

Ratanaporn Yontrakul, Nisakorn Vibulchai, Wiriporn Pinnadilay, Julintorn Sripontun and Benjaphon Aengwanich

Maha Sarakham Hospital, Thailand
Sri Maha Sarakham Nursing College, Thailand

Scientific Tracks Abstracts: Adv Practice Nurs

Abstract :

The mutual collaborative action research aimed to develop the fast track service system for patients with ischemic stroke in the context of a tertiary care hospital and service network. Target groups consisted of four groups: (1) Data record forms for ischemic stroke, (2) Ischemic stroke patients, (3) Caregivers, and (4) Nurse case managers. Data from July 2013 to September 2015 was obtained. The study process composed of three phases: (1) Situational analysis, (2) Service process development and (3) Evaluation. Research instruments included the data record form for ischemic stroke, an evaluation form for practice related to the standard care pathway, questions for interviewing caregivers and questions for focused group. Data were analyzed by descriptive statistics and content analysis. In Situational Analysis Phase: Problems of fast track service were reported in process and outcome domains. In Development Phase: Three action research cycles were as following: Rapid access to stroke fast track, patient screening and care process by multidisciplinary team, consulting system, development of the standard care pathway, the clinical nursing practice guideline and referral tools and patient follow up and outcome evaluation. In Evaluation Phase: 100% of multidisciplinary team followed the standard care pathway. Average duration of door to rt-PA decreased from 67.17 to 46.79 minutes. Ischemic stroke patients receiving rt-PA within 60 minutes increased from 9.26% to 30.63%. There were no complications related to aspiration pneumonia, pressure sore and fall. 70.5% of patients had improvement in stroke outcomes.

Biography :

Ratanaporn Yontrakul has completed her Bachelor of Nursing Science. She is the Deputy Director of Nursing Services of Maha Sarakham Hospital, Maha Sarakham Province. She has considerable expertise in stroke fast track.

Email: rat_refer@hotmail.com