Outpatient nursing is a service and care for outpatients with treatment for all diseases along with experts in all fields, the “hope” of patients and “care” with understanding, especially the most popular disease of Thais in this era, which is allergies and respiratory diseases that Thammasat University Hospital gives importance to and has established as the “Center of Excellence for Allergy, Asthma and Respiratory Diseases” or TU-CAAP [Center of Excellence For Allergy Asthma and Pulmonary Diseases], which is considered 1 of the 5 centers of excellence of the hospital.
From the previous episode, everyone must have seen the story of caring with concern that seemed to be about children but it wasn’t at all childish. Because when we go back to solve the problem at its root, it becomes a matter of adults like parents or guardians who must be good examples for children and take care of children in the right way. I’m talking about pediatrics and nutrition clinics that have the goal of making children run and play brightly again because children are the cutest when they smile happily.
This time, it’s the turn of the team that we have headaches, fevers, stomachaches, neck pains, diarrhea with. We meet them first. They are the outpatient nursing department. When we delve deeper, we will definitely find familiar sub-units. We will get to know this department seriously from an interview with Ms. Patchara Boon-anuchit, Head of Outpatient Nursing, and Assoc. Prof. Dr. Orapan Pochanukul, Director of the Center of Excellence in Allergy, Asthma, and Respiratory Diseases, Thammasat University Hospital.
13 agencies + 2 units
Outpatient nursing consists of 13 units, such as Internal Medicine Nursing, Surgery Nursing, Orthopedic Surgery Nursing, Rehabilitation Medicine Nursing, Obstetrics and Gynecology Nursing, Pediatrics Nursing, Ear, Nose and Throat Nursing, Ophthalmology Nursing, General and Family Medicine Nursing, Mental Health Clinic, Sterile Disease Screening Unit, Dermatology Unit, and 2 more units, such as the Center of Excellence in Allergy, Asthma and Respiratory Diseases and the Thammasat Heart Center.
Access to the service
Outpatients are divided into two groups: those with appointments and walk-ins. Walk-in patients are those who come for the first time or have come many times but do not have an appointment. When they enter, they start by walking to the queue machine.
- Press 1 for new patients or patients who do not have an appointment, walk in. But if you already have an appointment and the patient comes to the appointment, press the number. You want to check the medical treatment rights.
- Press 2 for patients who already have an appointment, come on the day and time as scheduled by the doctor, or want to check medical treatment rights.
- Press number 4 for patients who can screen themselves, such as those who want to receive services such as dentistry. We can check the initial symptoms of pain ourselves or come for a specific X-ray.
For new patients
When you press number 1 at the queue machine, you will get a queue card with an explanation on the card about what to do next, such as going to measure blood pressure and screen symptoms at the point where the nurse is in charge. The nurse will help assess the initial symptoms of the patient to determine what symptoms the patient has and which department the doctor should be seen in.
Center of Excellence in Allergy, Asthma and Respiratory Diseases
There are many allergies in the public. Thammasat University Hospital is interested in solving this problem and has created this center of excellence. Inside the center, there will be experts working in a multidisciplinary manner, with many professions working together to operate the center of excellence, such as doctors, nurses, pharmacists, medical science, nutrition, etc.
“Asthma 30%, allergies 80%”
Most groups of children have a lot of allergies. Asthma 30%, allergies 80%, which has increased by 3-5 times from before. Allergies and asthma have increased significantly. Next in line are food allergies, which are caused by the way of life, lifestyle, and environment, which has changed the way of life to live more in the city. When exposed to a lot of pollution, it has a negative effect on the body.
“It is a model for treatment.”
In addition to being a collaboration between various professions, the center also develops research, innovations, and creates networks with other hospitals. The Chalermprakiat Hospital will be a model or template for standard treatment. Another important thing is that it must receive Disease Specific Certification (DSC), a standard certification for specific disease certification.
“Excellence”
In fact, the word excellence must include excellence in treatment, service, and innovation, emphasizing sustainable knowledge transfer and providing holistic services because allergies are diseases that involve many systems in the body. Therefore, the center of excellence must have specialists in many fields, including both pediatric and adult doctors, providing care as a team. In treating one patient, there will be constant consultation and information sharing.
“Thailand has a lot of allergy medicine but still lacks innovation in treatment.”
In addition to doctors, the center also has nurses, pharmacists, physical therapists, and nutritionists because allergies are related to the use of medications and physical therapy. In fact, Thailand has a lot of medications for allergies. What is lacking is innovation, for example, medical equipment, inhaler equipment, or the use of technology to care for patients. At this center of excellence, innovation is used in the care and production of medications to treat patients.
“Communication with patients is the key.”
The most important thing in caring for patients with chronic diseases is communication. This will help patients understand their illness better and be able to take care of themselves properly, knowing when to see a doctor. Therefore, communication should cover all dimensions. For example, sometimes patients have an appointment 3-4 months in the future, so they may forget. We need to find a way to communicate to remind patients to come for treatment as scheduled.
ASTHMA CARE application
It has been developed for more than 7 years. It originated from a case of a patient dying from asthma, a disease that causes acute bronchial constriction. If symptoms appear, emergency inhalers must be administered immediately. If the inhaler is not administered in time, the patient will die from lack of oxygen. However, in that case, the patient died because he was short of breath and inhaled the medication slowly. The patient did not remember how to inhale it. Therefore, the hospital realized that teaching patients to learn and remember required media that patients could open and view at any time. Most people nowadays are already addicted to their mobile phones, so this application was created.
ALLERGY CARE APPLICATION
After developing ASTHMA CARE for a year, we noticed that there were a lot of patients with allergies, coupled with the severe impact of PM 2.5, the center has developed another useful application: Allergy Care. This application helps in the care and assessment of rhinitis, allergies, or allergic symptoms. Symptoms can be checked along with the PM 2.5 values in the surrounding area. When you open it, it will show you the air quality index, so you know how to take care of yourself.
When COVID-19 came
Technology has been increasingly used in patient care during the COVID-19 pandemic, with three main objectives:
- Patients must receive continuous treatment.
- The patient does not miss medication.
- The patient has no recurrence of symptoms.
The center needs to develop in leaps and bounds because patients do not dare to come to the hospital, but doctors do not want patients to miss out on their medication. Therefore, we need to develop media and communication channels to plug this gap. We need to meet all needs. We do not focus on taking care of Thammasat patients, but the center is ready to take care of anyone who wants to ask questions or needs information.
4E Treatment
- Exercise has a special place for teaching exercise.
- Eating: Eating good, nutritious, safe and clean food.
- Environment Adjust the environment
- Emotion teaches how to take care of your mind.
Don’t be discouraged. Everything can be fixed. If you follow the doctor’s advice, your symptoms will improve. The important thing is that we take care of ourselves, not wait for others to take care of us.
Conclusion
Outpatient nursing work and every center works with the goal of caring for patients with heart, not seeking profit from those who come to use the service at all. Providing complete care, there are medical equipment, doctors, knowledge corners, health education, teaching behavior modification. It is a dream center that takes care of patients in every dimension. Sometimes, the doctors and staff themselves are very tired, but when they see patients asking for help and sending encouragement, it makes the center’s staff regain their strength.
“One reason we have the strength to work today is because we have received encouragement from our patients.”
Outpatient nursing work that is at the heart of service | Thammasat University Hospitalติ
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