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Ear Nose and Throat Ward 2

Nursing Service Division. Maharaj Nakorn Chiang Mai Hospital.

Faculty of Medicine , Chiang Mai University ,THAILAND

The Ear Nose and Throat Ward 2of Maharaj Nakorn Chiang Mai Hospital is situated on Intavarorot road, Amphur Muang, Chiang Mai , 50,200 THAILAND.

It accommodates 22 patients .

Type of patients who attend this ward

This ward accommodates patients who have diseases and abnormality related to the ENT. Many of the patients come from one of the 17 provinces in northern of Thailand. The patients are women and children who are under 15 years of age.

Ward philosophy

The Ear Nose and Throat Ward 2 believes that:

     The patient and caregiver have ability to take care themselves and rights to get a quality nursing care

       The nursing process assists the nurse in providing continuous quality care in response to physical, mental and spiritual needs of the patients.

       Promote co-operation between both patient and service providers in a safe and secure environment to enhance timely intervention and support for the patient and their significant others.

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

    1.Organizational strength: The ENT 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.

Top 3 diseases

    1.Subglottic and tracheal stenosis

    2.Head & neck cancer

    3.Diseases of the ear, sinus and tonsil

Type of service

There are 3 kinds’ patients who attend this ward

1. In patients that come from OPD ENT

2. Out patient in 16.00PM – 8.00 AM

3. Consult from other departments

The treatment period

• Surgery in SGS , EAR , Nose and Tonsil   Surgery , Chemotherapy and radiation therapy in H&N cancer

Nursing personnel  total 17 :

             Head Nurse                        1

             Register nurses                   8

             Practical nurses                  5

             Nurse   Aide                       3

Nursing service

   Nursing service related to the basic needs of a person , patient condition , number of patient . Staffing of the team for each shift :

Day shift:               3 RN :   2 PN: 1HP

Evening shift:         2 RN :   1PN : 1HP

Night shift:            1-2 RN : 1PN : 1HP

There are 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
• Review & up date regularly guidelines , nursing standard and EBP
• Setting the year plan for nursing excellence according to the nursing service division plan and implementation of any changes identified by the committee.

EBP / Standard / Guidelines:

• SSI   prevention
• Suction prevention
• Falling prevention
• Pressure sore prevention
• Mucositis prevention
• Constipation management
• Pain management

Human resource development committee:

• 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 service division plan 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

Specific Competency for ENT nurse

–       Pre / Post operative care

–       Upper airway obstruction care

–       Chemotherapy care

–       Radiation therapy care

–       Tracheostomy tube care

Infection control committee :

• 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 service division plan.

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 earth quake incidences/disaster.
• Review regularly guidelines and update information and training, so as to continually improve guide lines to prevent further risks & incidences within the ward.
• Setting HUG ( healing ward guild line ) in ward

Thank you for your participation and involvement during the time you have been here with all of here at the Ear Nose and Throat Ward 2 (women & children)

Kanuengnit Panichkrajang  

Head nurse   of Ear Nose and Throat Ward 2

Nursing Service Division. Maharaj Nakorn Chiang Mai Hospital.

Faculty of   Medicine,   Chiang Mai University

Amphur Muang, Chiang Mai , 50,200 THAILAND

Tel.+ 66(53) 945953

E-mail: kpanichk@ mail.med.cmu.ac.th