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Therapeutic Radiation Ward (Kanda Wiboonsanti)

Nursing service division, Maharaj Nakorn Chiang Mai Hospital

Faculty of Medicine , Chiang Mai University ,THAILAND

Therapeutic Radiation ward (Kanda Wiboonsanti) of Maharaj Nakorn Chiang Mai Hospital is situated on Boonruangrit road,  Amphur Muang, Chiang Mai , 50,200 THAILAND.

It accommodates 19 patients .

Type of patients who attend this ward

       This ward accommodates cancer patients aged 15 up, both male and female who have been treated with chemotherapy, radiotherapy, brachytherapy and supportive care. This also provide support and training to patients of the department of radiology. Many of patients come from 17 provinces in northern of Thailand.

The four major disease groups that present to this unit are identified below :
   1: Nasopharyngeal cancer.
   2: Cervical cancer.
   3: Colono-rectal cancer.
   4: Breast cancer.

These cases are the major groups who present for care and support to this unit.

Ward philosophy

Initial focus on self care management skills for patients who are undergoing treatment related to their Cancer and quality of life management, planning and developing appropriate care and support for patient comfort and health management during their treatment for cancer. Inpatient treatment for the medical and holistic care for cancer patients attending this Unit are undertaken by skilled and professional health care workers, who understand the individual needs for patients who attend this unit. Quality professional standards are implemented within the unit for all care and support. Patients are cared for to provide relief from the suffering, Safety from serious complications related to their individual conditions and medical treatment plans. Patients are trained with the knowledge and ability to perform self-care and management during their different stages of the disease process. Potential development with regard to training and supervision is done on an individual basis for each person for their personnel and behavioral aspects to better manage each client’s needs within this service.

Key requirements for the patient care and support :

Patients : To recover / receive relief from the disease process and symptoms related to the course of their condition. To provide information and procedures that is required during their treatment. The alleviate distress, to provide safe, fast and quality service as acknowledged with respect to the patients individual needs of the service.
Personnel : The Communications coordinator works in a prompt, accurate and knowledgeable manner so as to implement well-timed patient care.

Most important quality issues:

Cancer patients will receive holistic care, with the focus of care to meet their individual needs, whilst identifying in consultation with all team members, family members and patients to manage care and support comprehensively. To provide care and treatment according to professional standards in line with current health care guidelines. Patients and their relatives have the power of self confidence, self determination and care management planning for the most effective and appropriate support so that patients have continuous improvement in line with their individual health care requirements.

Focusing on the aim of the hospital in the administration of this Unit :

1. Organizational strength: The Patient Care Team has a role in guiding the treatment planning.
2. Patient safety: focus on proactive risk management.
3. Services quality: A continuous quality improvement.
4. Personnel health: health promotion throughout all consultations and procedures,
and monitoring of / for any risks and complications that may arise, both preventatively and unforeseen during their course of treatment.

The issue of patient safety indicators and Suandok Hospital’s Patient safety goals are to determine which quality issues are important.
1. That patients who may have complications from the chemotherapy and radiation treatments are managed on a case by case holistic manner. Providing intervention, treatment and information about any identified risks from treatment by all health professionals as deemed necessary by assessment indicators.
2. Patients who may be at clinical risk, the risk of major 4 diseases and any related symptoms, as well as their behavioral, psychosocial and spiritual wellness.
3. Patients receive relief from pain.
4. Cancer patients receive appropriate care.
5. A patient and family / caregiver (Care giver) has a learning disability. Have the confidence to take care of themselves properly and to seek assistance when required.
6. Personnel are capable of taking fitting care of cancer patients.
7. Personnel health management.

Challenges for the staff and the patient:
1. Cancer as a life threatening disease and chronic disease must be treated as a special focus on holistic care and support. Empowerment and self-care management are regarded as important self esteem aspects for the patient who has cancer. Awareness of symptoms, management styles and attending to any risk factors are part of the training aspects patients receive.
2. To provide tertiary patients with the dignity, respect and excellence in their care needs.
3. Focused on the development of the Safety, Health Promotion and self Learning management.
4. Maintain a strong confident and holistic approach to health promotion and quality of life.

Nursing personnel

       1     Head Nurse                       

       8     Register nurse             

       7     Practical nurse            

       3     Nurse   Aide                       

Staffing of the team for each shift :

Day shift (8.00 AM– 4 .00 PM)     :      3 RN :   2 PN: 1HP

Evening shift (4.00 PM- 12.00 PM) :     2 RN :   1PN : 1HP

Night shift (12.00 PM-8.00 AM)    :     2 RN : 1PN : 1HP

The unit has committees to develop nursing excellence in the ward   such as quality assurance, infection control, human resource development, health promotion and occupational health and safety. These committees have responsibilities to monitor and manage these aspects of service delivery within the ward.

Quality assurance committee:

• Collect nursing indicators both clinical risk and common risk tasks such as falling, pressure sores, infection control , airway obstruction , post-op bleeding and SSI monthly
• Continually evaluate and monitor risks in ward
• Develop improved nursing problem indicators with head nurse
• Setting the year plan for nursing excellence according to the   nursing section planning and implementation of any changes identified by the committee.

Infection control:

• Inspection and monitoring for contagion in ward
• Collect frequency & incident of infection in ward
• Infection control knowledge management training
• RCA when an incidence of infection is identified – implement ward protocols.
• Setting year plan for infection control according to nursing section plan.

Human resource development:

• Evaluation of competency of all personnel in ward every year or as identified as being necessary.
• Personal training delivered by the head nurse to enhance competency and career path for all staff.
• Setting the years plan for human resource development according   to nursing section planning committee.
• Training when new information and protocols are required to be undertaken in regard to work specific indicators.
• Self development – as required, support the personal development of each staff member to build their skills and knowledge base.
• Conference – provide updated information, material specific to the current needs of the ward
• New staff   - preceptor support for orientation and training inward protocols.

Health promotion and occupational health and Safety:

• Quality care and promotion of personal health in the ward of all staff and patients and regular drills in regard to fire and earthquake incidences.
• Review regularly guidelines and update information and training, so as to continually improve guide lines to prevent further risks & incidences within the ward.
• Setting healing unit guidance (HUG) in ward

Specific Competency for Therapeutic Radiation nurse

• Chemotherapy care
• Radiotherapy care
• Palliative care
• Tracheotomy tube care
• Basic counseling  

Thank you for your participation and involvement during the time you have been here with all of here at the Therapeutic Radiation ward (Kanda Wiboonsanti).

Ampawan Jaipear

Assting head nurse   of Therapeutic Radiation ward

(Kanda Wiboonsanti)

Maharaj Nakorn Chiang Mai Hospital.

Faculty of   Medicine,   Chiang Mai University

Amphur Muang, Chiang Mai , 50200 THAILAND

Tel.+ 66(53) 945955 ; + 66(53) 947745

E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.