การประเมินโครงการพัฒนาระบบบริการผู้ป่วยฉุกเฉิน ณ จุดเกิดเหตุ จังหวัดขอนแก่น

Abstract

Evaluation of emergency service system at the scene of Khon Kaen provinve This descriptive research aimed to evaluate emergency service system at the scene of Khon Kaen province. An evaluation issues emphasized on helping capability of the rescuer worker and rescuer volunteer, quality control of the rescuer, communicating system, people's peraption and participation, cost of rescuer project run by Khon Kaen Hospital, and obstacle on operation and coordination. Quantitative method including survey of knowledge, perception as well as participation, and qualitative method including observation, in-depth interview ; and focus group discussion were used in this study. Six rescuer workers, Seventy two rescuer volunteers, 77 patients, 900 residential of Khon Kaen municipality 5 first aid training officers and key informance officers participated in the study. Data were analysed by using descriptive, inferential statistics and content analysis. Major findings were as followed. 1) Eighteen percent of an accident patient were sent to ths hospital by an emergency service system. Thirty nine percent of them received first aid treatment and twenty six percent ofthe first aid treatment were appropriate. Seven percent of the patients who could not move were moved by using appropriate technique. Forty nine percent of the patients were within 3 kilometer from the hospital and the rescuing time was seven minute. For patients who were 20 kilometer from the hospital, the rescuing time was thirty three minutes. 2) All rescuer participated in this study did hight score (>70 %) on knowledge test. However, only half to the rescuer voluteer obtained hight score. About knowledge of emergency practice, only 2 rescuer workers (n=6) and 3 rescuer volunteers (n=72) abtained adequate knowledge. They got high score in casting procedure and low score in stop breading procedure. Eventhrough majority of rescuer were trained on emergency practice by they all needed more skill and knowledge. Training organizer suggested that content and trainning method should be revised. 3).Communication system covered all needed but a number and quality of communicating tools were not well enough. An improvement of the system should emphasize on management and increasing two-way communication. 4) Administrator's and operator's perception on success of prevention of accident project were high, while people's perception on emergency system was weak and unclear. 5) Cost forcommunicating and preparing for one operation was 1,019 baht, transporting a patient was 1,912 baht, and helping a severe patient was 6,849 baht. 6) Major problems found in the system were ineffective management in resculing among rescuer organization, communication management, and rescues's lack of important knowledge and skill for rescuing, especially assessment and reporting condition of patient. In conclusion, the emergency service system at the scene of Khon Kaen province is good in terms of structure, component, and a potential for development. An improvement of the system should emphosize on managing system, communication system, rescuer's knowledge andcapability on assessment, reporting condition of patient and rescuing. In addition, promotion recuing knowledge for people and increasing public information about the system should be supported.