Role of Nurses in Pediatric Critical Care: Clinical Career Ladder

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Role of Nurses in Pediatric
Critical Care: Clinical Career Ladder
ÿ¿“√—µπå ‰«¬´’µ“
°“√欓∫“≈ºŸªâ «É ¬«‘°ƒµ‡¥Á° ‡ªìπ°“√ªØ‘∫µ— °‘ “√
欓∫“≈‡æ◊ÕË ™à«¬‡À≈◊Õ‡¥Á°∑’°Ë ”≈—߇º™‘≠°—∫ªí≠À“§«“¡
‡®Á∫ªÉ«¬∑’«Ë °‘ ƒµ§ÿ°§“¡™’«µ‘ ‚¥¬‰¡à‰¥â§“¥°“√≥å¡“°àÕπ
¡’°“√„™â‡∑§‚π‚≈¬’ ¡—¬„À¡à„π°“√µ√«®√—°…“欓∫“≈
àߺ≈„À⇰‘¥ªí≠À“§«“¡µâÕß°“√°“√¥Ÿ·≈ ÿ¢¿“æ∑—ßÈ ∑“ß
√à“ß°“¬ ®‘µ„® Õ“√¡≥å —ß§¡·≈–®‘µ«‘≠≠“≥¢ÕߺŸªâ «É ¬
·≈–§√Õ∫§√—«∑’Ë¡’§«“¡ ≈—∫´—∫´âÕπ¬‘Ëߢ÷Èπ 欓∫“≈
ª√–®”°“√ÀÕºŸâªÉ«¬«‘°ƒµ‡ªìπ∫ÿ§≈“°√∑’Ë¡’§«“¡ ”§—≠
Õ¬à“ß¡“°„π∑’¡ ÿ¢¿“æ∑’Ë„Àâ°“√欓∫“≈ºŸâªÉ«¬∑’ˉ¥â√—∫
°“√„™â‡∑§‚π‚≈¬’·≈–°“√√—°…“∑’Ë´—∫´âÕπ‡æ◊ËÕ√—°…“‰«â
´÷ßË ™’«µ‘ ·≈–™à«¬ à߇ √‘¡øóπô øŸ ¿“æ ‚¥¬¡’°“√ªØ‘∫µ— °‘ “√
欓∫“≈∑’‡Ë πâπ°“√∑”ß“π‡ªìπ∑’¡ À “¢“∑’¡Ë ¡’ “µ√∞“π
“°≈ ∑—ßÈ π’¡È ‡’ ªÑ“À¡“¬‡æ◊ÕË ≈¥Õ—µ√“µ“¬ ¿“«–·∑√°´âÕπ
≈¥§«“¡æ‘°“√∑’ËÕ“®‡°‘¥¢÷Èπ„À⺟âªÉ«¬ “¡“√∂√Õ¥™’«‘µ
„Àâ§√Õ∫§√—«¡’§«“¡ “¡“√∂„π°“√¥Ÿ·≈ºŸâªÉ«¬Õ¬à“ßµàÕ
‡π◊ÕË ß¥â«¬§«“¡¡—πË „® ·≈–¡’§≥ÿ ¿“æ™’«µ‘ ∑’¥Ë ‡’ ¡◊ÕË µâÕß°≈—∫
‰ªÕ¬Ÿ∫à “â π √«¡∑—ßÈ ™à«¬‡À≈◊Õ„Àâ§√Õ∫§√—«‡º™‘≠°—∫ªí≠À“
¢—πÈ «‘°ƒµ‰¥âÕ¬à“ß¡’ª√– ‘∑∏‘¿“æ ·≈–‡ªìπ∑’¬Ë Õ¡√—∫«à“„π
§«“¡À≈“°À≈“¬¢Õß°“√¥Ÿ·≈√—°…“ºŸªâ «É ¬«‘°ƒµ‡À≈à“π’È
®–ª√– ∫§«“¡ ”‡√Á®·≈–¡’ª√– ‘∑∏‘¿“æπ—πÈ °“√∑”ß“π
√à«¡°—π‡ªìπ∑’¡¢ÕߺŸ„â Àâ∫√‘°“√‡ªìπ¥—™π’™«’È ¥— ∑’ Ë ”§—≠Õ¬à“ß
Àπ÷Ëß∑’Ë™’È„Àâ‡ÀÁπ∂÷ߧÿ≥¿“æ°“√¥Ÿ·≈√—°…“欓∫“≈ ´÷Ëß
Scope of practice in critical care nursing ¡’ 3 Õߧå
ª√–°Õ∫1
1. ºŸâªÉ«¬¿“«–«‘°ƒµ‡¥Á° (Critically ill patient)
2. 欓∫“≈∑’Ë„Àâ°“√¥Ÿ·≈ (Critical care nurse)
3. ‘Ëß·«¥≈âÕ¡„πÀÕºŸâªÉ«¬«‘°ƒµ (Critical care
environment)
∑—Èß 3 Õߧåª√–°Õ∫π’È¡’§«“¡ ”§—≠·≈–¡’ªØ‘ —¡æ—π∏å´÷Ëß°—π·≈–°—π ‚¥¬‡©æ“–欓∫“≈∑’Ë„Àâ°“√¥Ÿ·≈
ºŸâªÉ«¬«‘°ƒµ ®÷ß¡’§«“¡®”‡ªìπ∑’Ë欓∫“≈„πÀÕºŸâªÉ«¬
«‘°ƒµµâÕß¡’§«“¡√Ÿâ ∑—°…– ·≈– ¡√√∂¿“æ∑’Ë· ¥ß∂÷ß
∫∑∫“∑∑’¡Ë §’ «“¡‡©æ“–∑“ß ·≈–Àπâ“∑’§Ë «“¡√—∫º‘¥™Õ∫
‡©æ“– “¢“ √«¡∑—ßÈ §√Õ∫§≈ÿ¡∑—°…–°“√„Àâ∫√‘°“√√—°…“
欓∫“≈ºŸâªÉ«¬„π¿“«–©ÿ°‡©‘π
Pediatric Critical Care Nurse ‡ªìπ欓∫“≈
«‘™“™’æ∑’ˉ¥â√—∫„∫ª√–°Õ∫‚√§»‘≈ª AACN2-3 ‰¥â„À⧔
®”°—¥§«“¡«à“ ‡ªìπ∫ÿ§≈“°√∑“ß°“√欓∫“≈∑’Ë„Àâ°“√¥Ÿ
·≈ºŸâªÉ«¬¿“«–«‘°ƒµ ¡’§«“¡√Ÿâ ∑—°…– ·≈– ¡√√∂π–∑’Ë
πÕßµÕ∫µàÕ§«“¡µâÕß°“√¢ÕߺŸâªÉ«¬¿“«–«‘°ƒµ·≈–
§√Õ∫§√—« “¡“√∂ªØ‘∫µ— °‘ “√欓∫“≈‰¥â¥«â ¬µπ‡Õß ´÷ßË
§«“¡√Ÿâ ∑—°…– ·≈– ¡√√∂π–¢Õß欓∫“≈®– –∑âÕπ„Àâ
‡ÀÁπ∂÷ß∫∑∫“∑·≈–§«“¡√—∫º‘¥™Õ∫∑’˵Õ∫ πÕߧ«“¡
µâÕß°“√¢ÕߺŸâªÉ«¬«‘°ƒµ‰¥â‡À¡“– ¡µ“¡√–¥—∫§«“¡
210 Current Concepts in Pediatric Critical Care
√ÿπ·√ߢÕß ¿“æ°“√‡®Á∫ªÉ«¬ ‚¥¬„™â°√Õ∫·π«§‘¥„Àâ°“√
¥Ÿ·≈ºŸâªÉ«¬·∫∫Õߧå√«¡4-5 ‡ªìπ·π«∑“ß„π°“√„Àâ°“√
欓∫“≈ºŸâªÉ«¬«‘°ƒµ‡¥Á°∑’Ë¡’√–¥—∫°“√‡®Á∫ªÉ«¬∑’Ë«‘°ƒµ
∑—Èß√–¥—∫1 ·≈– 26 ( PICU Level I and Level II) „π
acute care/ tertiary care setting ´÷ßË ∫∑∫“∑·≈–§«“¡
√—∫º‘¥™Õ∫¢Õß欓∫“≈¡’≈”¥—∫¢—Èπ«‘™“™’æ∑“ߧ≈‘π‘°7-8
(clinical career ladder) ¥—ßπ’È
Staff Nurse Role
1. ¡’§«“¡√—∫º‘¥™Õ∫∫πæ◊Èπ∞“π¢Õß«‘™“™’æ„π
°“√¬Õ¡√—∫·≈–‡§“√æ ‘∑∏‘¢ÕߺŸâªÉ«¬À√◊Õ‡ªìπºŸâ·∑π„π
°“√√—°…“º≈ª√–‚¬™πå„Àâ°—∫ºŸâªÉ«¬
2. ¡’Õߧ姫“¡√Ÿâ‡©æ“– “¢“ ∑—°…– ·≈–ª√– ∫
°“√≥å„π°“√¥Ÿ·≈ºŸâªÉ«¬«‘°ƒµ
3. „Àâ°“√欓∫“≈·∫∫Õߧå√«¡µ“¡¡“µ√∞“π
«‘™“™’æ/¢âժؑ∫—µ‘∑’Ë„™âÀ≈—°∞“πÕâ“ßÕ‘ß∑“ß«‘∑¬“»“ µ√å
¿“¬„µâ°“√π‘‡∑»ß“π¢ÕߺŸâ∑’Ë¡’§«“¡™”π“≠°«à“ ‡™àπ
ºŸµâ √«®°“√欓∫“≈ À—«Àπâ“ÀÕºŸªâ «É ¬ 欓∫“≈™”π“≠
°“√ ‡ªìπµâπ
4. ¬Õ¡√—∫„π§ÿ≥§à“ §«“¡‡™◊ÕË ·≈– ‘∑∏‘¢ÕߺŸªâ «É ¬
·≈–§√Õ∫§√—«
5. ™’·È π–/„À⧫“¡√Ÿ·â ≈– π—∫ πÿπ™à«¬‡À≈◊ÕºŸªâ «É ¬
·≈–§√Õ∫§√—«„Àâ¡’ à«π√à«¡„π°“√µ—¥ ‘π„®‡°’ˬ«°—∫°“√
√—°…“欓∫“≈
6. ‡ΩÑ“√–«—ß·≈–µ√–Àπ—°∂÷ߧ«“¡√—∫º‘¥™Õ∫∑’Ë
‡°’¬Ë «¢âÕß°—∫§ÿ≥¿“æ°“√¥Ÿ·≈·≈– ¿“æ·«¥≈âÕ¡‡æ◊ÕË „Àâ
°“√ªØ‘∫µ— °‘ “√欓∫“≈∑’ºË ªŸâ «É ¬/§√Õ∫§√—«‰¥â√∫— ª≈Õ¥¿—¬
7. ¡’§«“¡‡™◊ËÕ·≈–µ√–Àπ—°∂÷ߧ«“¡ ”§—≠„π
§«“¡‡ªìπÕߧå√«¡¢Õß·µà≈–∫ÿ§§≈ ·≈–§«“¡·µ°µà“ß
¢Õß∫ÿ§§≈∑“ߥâ“π«—≤π∏√√¡ §«“¡‡™◊ËÕ —ߧ¡·≈– ‘Ëß
·«¥≈âÕ¡
8. „™â√–∫∫欓∫“≈‡®â“¢Õ߉¢â (Primary nursing) ·≈–°√–∫«π°“√欓∫“≈‡ªìπ√Ÿª·∫∫„π°“√ª√–‡¡‘π
ªí≠À“ ÿ¢¿“æ·≈–„Àâ°“√欓∫“≈·°àºŸâªÉ«¬«‘°ƒµ·≈–
§√Õ∫§√—«
9. ªØ‘∫—µ‘ß“π‡ªìπ∑’¡√à«¡°—∫ À “¢“«‘™“™’æ
10.æ—≤𓧫“¡√Ÿâ·≈–∑—°…–Õ¬à“ßµàÕ‡π◊ËÕß
Role of APN (Advanced Practice Nurse)2,7-10
‡ªì π ∫∑∫“∑¢Õß欓∫“≈∑’Ë „ Àâ ° “√ªØ‘ ∫— µ‘ ° “√
欓∫“≈¢—Èπ Ÿß·°àºŸâªÉ«¬«‘°ƒµ‡¥Á°/§√Õ∫§√—«„π°“√„™â
∑—°…–·≈– ¡√√∂π–„π°“√®—¥°“√¥Ÿ·≈ºŸâªÉ«¬·≈–„™â
§«“¡√Ÿâ∑—Èß„π¥â“π°«â“ß·≈–¥â“π≈÷° ‚¥¬¡’À≈—°ªØ‘∫—µ‘∑’Ë
”§—≠ 2 ª√–‡¥Áπ §◊Õ
1. °“√„™â«‘®“√≥≠“≥À“‡Àµÿº≈‡æ◊ËÕ°“√µ—¥
‘π„®∑“ߧ≈‘π‘° (Clinical Judgment) „π°“√®—¥°“√
°—∫ºŸªâ «É ¬/§√Õ∫§√—«∑’¡Ë §’ «“¡µâÕß°“√°“√¥Ÿ·≈∑’´Ë ∫— ´âÕπ
2. °“√‡ªìπºŸâπ” (Leadership) „™â∑—°…–·≈–
°√–∫«π°“√µ‘¥µàÕ ◊ËÕ “√∑—Èß¿“¬„π·≈–¿“¬πÕ°‡æ◊ËÕ
𔉪 Ÿ‡à ªÑ“À¡“¬∑’µË ßÈ— ‰«â “¡“√∂Õ∏‘∫“¬ ‘ßË ∑’‡Ë °‘¥¢÷πÈ ·≈–
§“¥°“√≥剥âµ√ߧ«“¡‡ªìπ®√‘ß ¡’‡Õ° ‘∑∏‘Ï Ÿß„π°“√
ªØ‘∫—µ‘ß“π “¡“√∂µ—¥ ‘π„®‰¥âÕ¬à“ßÕ‘ √– ‚πâ¡πâ“«„Àâ
∫ÿ§§≈Õ◊Ëπ°√–∑”µ“¡ ·≈–¡’§«“¡√—∫º‘¥™Õ∫„πº≈≈—æ∏å
∑’˵“¡¡“ American Nurses Association (ANA) ‰¥â
√–∫ÿ§≥ÿ ¡∫—µ°‘ “√»÷°…“¢Õß欓∫“≈ªØ‘∫µ— °‘ “√欓∫“≈
¢—Èπ ŸßµâÕ߉¥â√—∫ masters or doctoral education ‡æ‘Ë¡
‡µ‘¡ ·≈– ¿“°“√欓∫“≈‰¥â°”Àπ¥„À⺟âªØ‘∫—µ‘°“√
欓∫“≈¢—È π Ÿ ß ®”‡ªì π µâ Õ ß¡’ «ÿ ≤‘ ª √‘ ≠ ≠“‚∑∑“ß°“√
欓∫“≈
´÷Ëß·π«§‘¥°“√ªØ‘∫—µ‘°“√欓∫“≈∑—Èß 2 Õ¬à“ß
∑’Ë°≈à“«¡“·≈â«π—Èπ ®–™à«¬„Àâ欓∫“≈ “¡“√∂«‘‡§√“–Àå
·≈–æ— ≤ π“°“√ªØ‘ ∫— µ‘ ° “√欓∫“≈¢—È π Ÿ ß ‰¥â Õ ¬à “ ß¡’
ª√– ‘∑∏‘¿“æ ¿“§«‘™“欓∫“≈»“ µ√å §≥–·æ∑¬»“ µ√å
‚√ß欓∫“≈√“¡“∏‘∫¥’‰¥â°”Àπ¥∫∑∫“∑°“√ªØ‘∫—µ‘°“√
欓∫“≈¢—Èπ Ÿß “¢“ºŸâªÉ«¬«‘°ƒµ‡¥Á°¥—ßπ’È
1. Clinical practice
1.1 „Àâ°“√ªØ‘∫—µ‘°“√欓∫“≈¢—Èπ Ÿß∑—Èß∑“ß
µ√ß·≈–∑“ßÕâÕ¡∑’‡Ë ©æ“–‡®“–®ß·°à°≈ÿ¡à ºŸªâ «É ¬‡¥Á°¿“«–
«‘°ƒµ·≈–§√Õ∫§√—«∑’Ë¡’ªí≠À“·≈–§«“¡µâÕß°“√°“√
Role of Nurses in Pediatric Critical Care: Clinical Career Ladder, ÿ¿“√—µπå ‰«¬´’µ“ 211
¥Ÿ·≈∑’´Ë ∫— ´âÕπ¥â«¬°“√∫Ÿ√≥“°“√§«“¡√Ÿ‚â ¥¬Õ‘ßÀ≈—°∞“π
®“°»“ µ√å “¢“°“√欓∫“≈·≈–»“ µ√å “¢“Õ◊Ëπ ·π«
§‘¥ ª√– ∫°“√≥å∑“ߧ≈‘π‘° ·≈–º≈ß“π«‘®—¬¡“ª√–‡¡‘π
«‘‡§√“–Àåªí≠À“∑“ß°“√欓∫“≈∑’˧√Õ∫§≈ÿ¡·∫∫Õߧå
√«¡ „Àâ Õ¥§≈âÕß°—∫¢âÕ«‘π‘®©—¬ ·ºπ°“√√—°…“¢Õß
·æ∑¬å ‚¥¬‡πâπ„π 4 ¡‘µ‘ °“√¥Ÿ·≈√—°…“·≈–µ‘¥µ“¡§«“¡
°â“«Àπâ“¢Õß‚√§ °“√ à߇ √‘¡ ÿ¢¿“æ °“√ªÑÕß°—π¿“«–
·∑√°´âÕπ ·≈–°“√øóôπøŸ ¡√√∂¿“æ¿“¬À≈—ß°“√‡®Á∫
ªÉ«¬ ‡æ◊ÕË „À⺪⟠«É ¬∑’‡Ë ¢â“√—°…“‰¥â√∫— °“√¥Ÿ·≈·≈–ª√–‡¡‘π
°“√µÕ∫ πÕßµàÕ°“√√—°…“欓∫“≈
1.2 °”Àπ¥·≈–ª√— ∫ ·ºπ°“√欓∫“≈∑’Ë
‡©æ“–‚¥¬¡’¢Õâ ¡Ÿ≈ π—∫ πÿπ∑“ß«‘∑¬“»“ µ√å ·≈–„Àâ°“√
欓∫“≈Õ¬à“ßÕ‘ √–¡’√–∫∫‡æ◊ÕË √Õß√—∫ºŸªâ «É ¬∑’®Ë ”‡ªìπµâÕß
„™â‡∑§‚π‚≈¬’√–¥—∫ Ÿß„À≥â√—∫°“√¥Ÿ·≈∑’ˇÀ¡“– ¡
1.3 ®—¥°“√°—∫§«“¡‡ª≈’ˬπ·ª≈ߢÕߺŸâªÉ«¬
Õ¬à“ß√«¥‡√Á«·≈–¡’ª√– ‘∑∏‘¿“æ ·°â‰¢ªí≠À“·≈–§«“¡
µâÕß°“√¢ÕߺŸâªÉ«¬/§√Õ∫§√—« ‡®â“Àπâ“∑’Ë欓∫“≈∑ÿ°
√–¥—∫ √«¡∑—ßÈ ‡ªìπ∑’ªË √÷°…“·°à欓∫“≈ª√–®”°“√„π°“√
«“ß·ºπªØ‘∫µ— °‘ “√欓∫“≈ ‡æ◊ÕË „À⺪⟠«É ¬·≈–§√Õ∫§√—«
∑’Ë¡’§«“¡´—∫´âÕπ¬ÿà߬“°„π°“√ªØ‘∫—µ‘°“√欓∫“≈‰¥â
√—∫°“√¥Ÿ·≈∑’˵Õ∫ πÕßµ“¡§«“¡µâÕß°“√/§«“¡§“¥
À«—߉¥â‡À¡“– ¡∑—π ∂“π°“√≥å
1.4 °√–µÿâπæ—≤π“°“√·≈–°“√‡®√‘≠‡µ‘∫‚µ
¢ÕߺŸâªÉ«¬„Àâ‡À¡“– ¡°—∫«—¬ ™à«¬æ—≤π“·≈–‡æ‘Ë¡æ≈—ß
§«“¡ “¡“√∂„π°“√¥Ÿ·≈ ÿ¢¿“æ¢ÕߺŸâªÉ«¬·≈–§√Õ∫
§√—«µ—ßÈ ·µà‡¢â“√—∫°“√√—°…“„πÀÕºŸªâ «É ¬‰Õ´’¬‡Ÿ ¥Á°®π°≈—∫
∫â“π ‚¥¬¡’‡ªÑ“À¡“¬„À⺪Ÿâ «É ¬·≈–§√Õ∫§√—« “¡“√∂¥Ÿ·≈
ÿ¢¿“æ¢Õßµπ‡Õ߉¥âÕ¬à“ß¡’ª√– ‘∑∏‘¿“æ·≈–¬—Ë߬◊π
≈¥°“√°≈—∫‡¢â“¡“√—°…“„πÀÕºŸªâ «É ¬‰Õ´’¬‡Ÿ ¥Á°´È”¿“¬„π
24-48 ™—Ë«‚¡ß
1.5 ‡ªìπµ—«·∑π¢ÕߺŸâªÉ«¬·≈–§√Õ∫§√—«„π
°“√‡®√®“µàÕ√Õ߇æ◊ÕË §ß‰«â´ßË÷ ‘∑∏‘ª√–‚¬™πå¢ÕߺŸªâ «É ¬∑’Ë
æ÷߉¥â√—∫
1.6 ™à«¬„À⺪Ÿâ «É ¬·≈–§√Õ∫§√—«¡’ «à π√à«¡„π
°“√µ—¥ ‘π„®‡æ◊ÕË °“√¥Ÿ·≈√—°…“∑’‡Ë À¡“– ¡°—∫ ¿“æ¢Õß
‚√§ ‡»√…∞“π– ªí®®—¬¿“¬„π-πÕ° ·≈–Õ◊πË Ê∑’‡Ë °’¬Ë «¢âÕß
1.7 Õ∏‘∫“¬/„Àâ¢Õâ ¡Ÿ≈·°àºªŸâ «É ¬·≈–§√Õ∫§√—«
‡°’¬Ë «°—∫欓∏‘ ¿“æ¢Õß‚√§ ·ºπ°“√√—°…“∑’‰Ë ¥â√∫— ‡ªìπ
√–¬–Ê √«¡∑—ßÈ °“√ Õπ·≈–·π–π”‡æ◊ÕË ≈¥°“√‡°‘¥‚√§´È”
1.8 ª√– “π°—∫∑’¡ ÿ¢¿“æ¥â«¬°“√√à«¡ª√–
‡¡‘π «‘‡§√“–Àåªí≠À“∑’ˬ“°≈”∫“°„π°“√¥Ÿ·≈√—°…“À√◊Õ
ªí≠À“∑’Ë´—∫´âÕπ ‡æ◊ËÕ„À⺟âªÉ«¬‰¥â√—∫°“√¥Ÿ·≈Õ¬à“ß¡’
§ÿ≥¿“æ Ÿß ÿ¥·≈–µàÕ‡π◊ËÕß®“°∑’¡ À “¢“
1.9 √‘‡√‘¡Ë À√◊Õ¡’ «à π√à«¡ √â“ß¡“µ√∞“π°“√
欓∫“≈ ®—¥∑”‚§√ß°“√ ◊ËÕ°“√ Õπ
1.10 µ‘¥µ“¡ª√–‡¡‘π¿“«– ÿ¢¿“æ¢ÕߺŸªâ «É ¬
·≈–§√Õ∫§√—«∑’Ë¡’ªí≠À“´—∫´âÕπ¿“¬À≈—߉¥â√—∫°“√¬â“¬
ÕÕ°®“°ÀÕºŸâª«¬‰Õ´’¬Ÿ‡¥Á°®π°√–∑—Ëß°≈—∫∫â“π
1.11 ®—¥√–∫∫ π—∫ πÿ𧫓¡ª≈Õ¥¿—¬‡æ◊ËÕ
ª√–°—π§ÿ≥¿“æ°“√¥Ÿ·≈√—°…“欓∫“≈„À≥⡓µ√∞“π
2. Education
2.1 ·π–π”„À⧫“¡√Ÿâ∑’ˇ©æ“–·°àºŸâªÉ«¬·≈–
§√Õ∫§√—«Õ¬à“ßæՇ撬߷≈–µàÕ‡π◊ËÕß ‡æ◊ËÕ‡ √‘¡ √â“ß/
°√–µÿπâ „À⇰‘¥°“√‡√’¬π√Ÿ·â ≈–¥Ÿ·≈µπ‡Õß ‡¡◊ÕË ¿“«–‚√§§ß
∑’Ëæâπ«‘°ƒµ ·≈–„À⺟⪫¬/§√Õ∫§√—« “¡“√∂‡º™‘≠·≈–
ª√— ∫ µ— « °— ∫ §«“¡‡§√’ ¬ ¥·≈–¿“«–∑ÿ ° ¢å ∑ √¡“π®“°
欓∏‘ ¿“æ¢Õß‚√§∑’§Ë °ÿ §“¡™’«µ‘ ‚¥¬æ¬“∫“≈®–µâÕ߉«
µàÕ§«“¡√Ÿ â °÷ §«“¡§‘¥¢ÕߺŸªâ «É ¬·≈–§√Õ∫§√—«·µà≈–√“¬
´÷Ë߇ªìπ∫∑∫“∑ ”§—≠„π°“√™à«¬‡À≈◊ÕºŸâªÉ«¬·≈–§√Õ∫
§√—«„π°“√ª√—∫·ºπ°“√¥”‡π‘π™’«‘µ „Àℙ⻗°¬¿“æ∑’Ë
‡À≈◊ÕÕ¬Ÿ„à À≥â ߟ ÿ¥ „π°“√§ß°‘®°√√¡∑’¡Ë §’ «“¡À¡“¬„π
ºŸâªÉ«¬·µà≈–§π
2.2 Õπ/„À⧫“¡√Ÿâ/®—¥‚ª√·°√¡°“√‡√’¬π
·°à欓∫“≈„Àâ∑π— °—∫§«“¡°â“«Àπâ“∑“ß°“√·æ∑¬å ·≈–
‡∑§‚π‚≈¬’
2.3 ®—¥ conference interesting case
2.4 æ—≤π“·≈–ª√—∫ª√ÿß°“√‡√’¬π°“√ Õπ
°“√Ωñ°ªØ‘∫—µ‘
2.5 ¡’ à«π√à«¡„π°“√‡º¬·æ√৫“¡√Ÿâ∑“ß
¥â“π°“√欓∫“≈ºŸâªÉ«¬¿“«–«‘°ƒµ‡¥Á°
212 Current Concepts in Pediatric Critical Care
3. Consultation
3.1 „À⧔ª√÷°…“·≈–§√Õ∫§√—«‡¡◊ÕË ‡º™‘≠°—∫
ªí≠À“µà“ßÊ æ√âÕ¡∑—ßÈ À“«‘∏°’ “√™à«¬‡À≈◊Õ∑’‡Ë À¡“– ¡„π
°“√ª√—∫µ—«
3.2 ‡ªìπ∑’˪√÷°…“·°à欓∫“≈ª√–®”°“√„π
°“√ª√–‡¡‘πªí≠À“ «“ß·ºπ°“√欓∫“≈ ·≈–°“√ªØ‘∫µ— ‘
°“√欓∫“≈‚¥¬„™â°√–∫«π°“√欓∫“≈‡ªìπ‡§√◊ËÕß¡◊Õ
„π°“√ªØ‘∫—µ‘ß“π
3.3 „À⧔ª√÷°…“·≈–‡ªìπ°”≈—ß„®·°àºŸâªÉ«¬
‡æ◊ËÕ°“√µ—¥ ‘π„®°“√√—°…“Õ’°§√—È߇¡◊ËÕ‚√§°≈—∫‡ªìπ´È”
3.4 ‡ªìπ∑’˪√÷°…“·≈–欓∫“≈æ’ˇ≈’Ȭ߷°àπ—°
»÷°…“欓∫“≈√–¥—∫¡À“∫—≥±‘µ ·≈–欓∫“≈‡©æ“–∑“ß
∑—Èß¿“¬„π·≈–¿“¬πÕ° ∂“∫—π
3.5 √à«¡¡◊Õ·≈–„À⧔ª√÷°…“·°àºŸâ∫√‘À“√„π
‡√◊ËÕß°“√¥Ÿ·≈ºŸâªÉ«¬«‘°ƒµ‡¥Á°
4. Research skills
4.1 ∑”«‘®¬— /ª√–¬ÿ°µå/‡≈◊Õ°º≈ß“π∑’‡Ë °’¬Ë «¢âÕß
°—∫°“√¥Ÿ·≈ºŸªâ «É ¬«‘°ƒµ‡¥Á°¡“„™â„π§≈‘π°‘ Õ¬à“ß¡’«®‘ “√≥≠“≥
4.2 π—∫ πÿπ„Àâ¢âÕ‡ πÕ·π–∑“ߧ≈‘π‘°·°à
π—°»÷°…“√–¥—∫¡À“∫—≥±‘µÀ√◊Õ∫ÿ§≈“°√Õ◊Ëπ∑’Ë π„®®–
∑”«‘®—¬
5. Leadership
5.1 ‡ªìπºŸπâ ”„π°“√ª√—∫ª√ÿߧÿ≥¿“æ°“√¥Ÿ·≈
ºŸâªÉ«¬«‘°ƒµ‡¥Á°·≈–®—¥«“ß√–∫∫°“√¥Ÿ·≈„Àâ§√Õ∫§≈ÿ¡
‚¥¬∑”Àπâ“∑’ˇªìπ facilitator „Àâ°—∫°≈ÿà¡æ¬“∫“≈ª√–®”
°“√®—¥∑”°‘®°√√¡æ—≤π“§ÿ≥¿“æ (quality improvement) ·≈– quality innovation Õ¬à“ßµàÕ‡π◊ËÕß
5.2 “¡“√∂°”Àπ¥¢Õ∫‡¢µ°“√ªÆ‘∫—µ‘°“√
欓∫“≈∑’ Ë –∑âÕπ∂÷ߧÿ≥¿“æ°“√欓∫“≈°“√¥Ÿ·≈ºŸªâ «É ¬
«‘°ƒµ‡¥Á°·≈–§√Õ∫§√—« ‚¥¬¡’¥™— π’™«’È ¥— ‡ªìπ‡°≥±å„π°“√
ª√–‡¡‘πº≈≈—æ∏å
5.3 ‡ªìπºŸâπ”„π°“√‡ª≈’ˬπ·ª≈ß∑“ߧ≈‘π‘°
·≈–·∫∫Õ¬à“ß∑’Ë¥’„π°“√ªÆ‘∫—µ‘°“√欓∫“≈
6. Collaboration
6.1 ‡ªìπ∑’ˬա√—∫„π°“√ªÆ‘∫—µ‘ß“π√à«¡°—∫
Interdisciplinary team ‡æ◊ËÕ enhance environment
„π°“√¥Ÿ·≈ºŸâªÉ«¬/§√Õ∫§√—«
6.2 √à«¡¡◊Õ°—∫ ∂“∫—π°“√»÷°…“„π°“√∑”
Àπâ“∑’ˇªìπ欓∫“≈æ’ˇ≈’Ȭ߄Àâ°—∫π—°»÷°…“欓∫“≈
6.3 ª√– “πß“π·≈–√à«¡¡◊Õ°—∫ “¢“«‘™“™’æ
Õ◊Ëπ„π°“√‡√’¬π°“√ Õπ °“√‡ªìπ∑’˪√÷°…“ °“√∫√‘À“√
®—¥°“√·≈–°“√«‘®—¬‡æ◊ËÕ„Àâº≈≈—æ∏å°“√¥Ÿ·≈ºŸâªÉ«¬«‘°ƒµ
‡¥Á°¥’¢÷Èπ
7. Communication
°“√ ◊Ë Õ “√‡ªì π ®ÿ ¥ ª√– ߧå æ◊È π ∞“π„π°“√
ªØ‘∫—µ‘°“√欓∫“≈11 ·≈–‡ªìπ∫∑∫“∑ ”§—≠∑’Ë欓∫“≈
„πÀÕºŸªâ «É ¬«‘°ƒµµâÕßµ√–Àπ—°§◊Õ °“√ ◊ÕË “√‚¥¬°“√„Àâ
¢âÕ¡Ÿ≈∑’Ë ¡Ë”‡ ¡Õ ¡’§«“¡ ¡¥ÿ≈„π°“√ ◊ËÕ “√ ·≈–¡’
°≈¬ÿ∑∏å„π°“√‡®√®“µàÕ√Õß12 ´÷Ëß°“√ ◊ËÕ “√√–À«à“ß
欓∫“≈ ºŸâªÉ«¬·≈–§√Õ∫§√—«¡’«—µ∂ÿª√– ߧå∑’Ë ”§—≠ 4
ª√–°“√13 §◊Õ
ë ‡ªì π °“√ √â “ ß — ¡ æ— π ∏å ¿ “æ°— ∫ ‡¥Á ° ·≈–
§√Õ∫§√—«„π‡™‘ß∫«°
ë ‡ªìπ°“√„Àâ¢Õâ ¡Ÿ≈°“√‡®Á∫ªÉ«¬·≈– ‘ßË ∑’‡Ë °‘¥
¢÷Èπ°—∫ºŸâªÉ«¬∫πæ◊Èπ∞“𧫓¡‡ªìπ®√‘ß
ë ‡ªìπ°“√°”Àπ¥¢âÕ √ÿª§«“¡µâÕß°“√¢Õß
ºŸâªÉ«¬
ë ‡ªìπ°“√„™â·À≈àߪ√–‚¬™πå„Àâ¡’ª√– ‘∑∏‘¿“æ Ÿß ÿ¥„π°“√‡Õ◊ÕÈ „Àâ°∫— ºŸªâ «É ¬«‘°ƒµ‡¥Á°·≈–§√Õ∫§√—«
8. Spiritual Care14-15
°“√‡®Á∫ªÉ«¬√ÿπ·√ß∑’ˇ°‘¥„πºŸâªÉ«¬‡¥Á°‡ªìπ
‡Àµÿ°“√≥å∑’˧√Õ∫§√—«‰¡à‰¥â§“¥°“√≥å¡“°àÕπ °“√¥Ÿ·≈
∑“ߥâ“𮑵«‘≠≠“≥‡ªìπ°“√¥Ÿ·≈∑’µË Õ∫ πÕߧ«“¡µâÕß
°“√¢ÕߺŸâªÉ«¬«‘°ƒµ‡¥Á°·≈–§√Õ∫§√—« ‰¥â¡’°“√»÷°…“
«‘®—¬¡“µ—Èß·µà§.».1970s ‡ªìπµâπ¡“ ·≈–®“°√“¬ß“π‰¥â
¢âÕ √ÿª«à“ §«“¡µâÕß°“√¢ÕߺŸªâ «É ¬«‘°ƒµ‡¥Á°·≈–§√Õ∫
§√—«¡’¥—ßπ’È ¡’À≈—°ª√–°—π§ÿ≥¿“æ°“√¥Ÿ·≈∑’Ë¥’ °“√„Àâ
Role of Nurses in Pediatric Critical Care: Clinical Career Ladder, ÿ¿“√—µπå ‰«¬´’µ“ 213
¢âÕ¡Ÿ≈∑’µË √ߧ«“¡‡ªìπ®√‘ß §«“¡ ÿ¢ ∫“¬¢ÕߺŸªâ «É ¬·≈–
‰¥â√—∫°“√ π—∫ πÿπ™à«¬‡À≈◊Õ ∂÷ß·¡â«à“∑’¡ ÿ¢¿“æ®–
µ√–Àπ—°∂÷ß·≈– πÕßµÕ∫§«“¡µâÕß°“√¥—ß°≈à“« ·µà¬ß—
‰¡à “¡“√∂µÕ∫ πÕ߉¥â ‡ ∑à “ ∑’Ë ºŸâ ªÉ « ¬·≈–§√Õ∫§√— «
µâÕß°“√ ‡π◊ÕË ß®“°ºŸªâ «É ¬‰¡à‰¥â‡º™‘≠°—∫°“√‡®Á∫ªÉ«¬¥â“π
√à“ß°“¬‡∑à“π—Èπ ·µà¥â“πÕ“√¡≥å ®‘µ —ߧ¡ ®‘µ«‘≠≠“≥°Á
ªÉ«¬¥â«¬ °“√π” Conceptual model of spiritual care15
¥—ß¿“æ∑’Ë 1 ¡“‡ªìπ°√Õ∫·π«§‘¥„π°“√ √â“ß ‘ßË ·«¥≈âÕ¡
√Õ∫µ—«ºŸâªÉ«¬«‘°ƒµ‡¥Á°·≈–§√Õ∫§√—«„Àâ¡’∫√√¬“°“»∑’Ë
Õ∫Õÿπà ¡’‡¡µµ“ ·≈– πÕßµÕ∫µ√ß°—∫§«“¡µâÕß°“√∑“ß
¥â“𮑵«‘≠≠“≥ ®–∑”„À⺟âªÉ«¬‡¥Á°·≈–§√Õ∫§√—«æ∫
°—∫À—«„®¢Õß°“√欓∫“≈·∫∫Õߧå√«¡∑’Ë ¡∫Ÿ√≥å
9. Ethics
ªØ‘ ∫— µ‘ ° “√欓∫“≈‚¥¬¬÷ ¥ À≈— ° §ÿ ≥ ∏√√¡
®√‘¬∏√√¡ ®√√¬“∫√√≥«‘™“™’æ ·≈–°ÆÀ¡“¬∑’‡Ë °’¬Ë «¢âÕß
√«¡∑—ßÈ °“√µ—¥ ‘π„®·°â‰¢„πªí≠À“∑’´Ë ∫— ´âÕπ∑“ß®√‘¬∏√√¡
·≈–°“√æ‘∑—°…å ‘∑∏‘Ï¢ÕߺŸâªÉ«¬·≈–§√Õ∫§√—«
Other Roles
Case management16 ‡ªìπµ”·Àπàß„À¡à¢Õß°“√
ªØ‘∫µ— °‘ “√欓∫“≈¢—πÈ Ÿß∑’‡Ë °‘¥¢÷πÈ „πµÕπµâπ §.».1980s
∑’ Ë À√—∞Õ‡¡√‘°“ ¡’°“√π”√Ÿª·∫∫°“√ªØ‘∫µ— °‘ “√欓∫“≈
°“√®—¥°“√ºŸâªÉ«¬√“¬°√≥’ ‚¥¬„Àâ°“√¥Ÿ·≈ºŸâªÉ«¬µ—Èß·µà
·√°√—∫‡¢â“¡“„πÀπ૬ߓπ·≈–µ‘¥µ“¡®π°≈—∫∫â“π ·≈–
Social Needs
ë Availabiity/adequacy of support system (eg.family friends, neighbors; support groups)
ë Resources after discharge (eg.Meals on Wheels, transportation)
ë Financial concerns
Physical Needs
ë Symptoms
diagnosis, and treatment
ë Pain and discomfort
ë Disability lifestyle changes
Religious Needs
ë Belief God or higher power
ë Search for meaning
ë Unresolved life issues
ë End-of-life-issues
Emotional Needs
ë Fear, anger
ë Sadness and loss, hope
PATIENT
AND
FAMILY
Cognitive Needs
ë Language barriers, difficulty hearing ë Difficulty with medical jargon
ë Lack of sufficient time to communicate
¿“æ∑’Ë 1 Conceptual model of spiritual care
214 Current Concepts in Pediatric Critical Care
„™â clinical pathway ‡ªìπ·π«∑“ß„Àâ°“√¥Ÿ·≈·≈–®—¥°“√
µ“¡§«“¡µâÕß°“√¢ÕߺŸªâ «É ¬/§√Õ∫§√—«„™â·À≈àߪ√–‚¬™πå
∑√—欓°√ ÿ¢¿“æÕ¬à“ߧÿ¡â §à“·≈–¡’ª√– ‘∑∏‘¿“æ American Nurse Association (ANA) ‰¥â„À⧫“¡À¡“¬ case
management ‡ªìπ°√–∫«π°“√®—¥°“√∫√‘°“√¥â“π
ÿ¢¿“æ∑’Ë¡’§ÿ≥¿“æ ≈¥°“√∑”ß“π·∫∫·¬° à«π ‡æ‘Ë¡
§ÿ≥¿“æ™’«‘µºŸâªÉ«¬·≈–≈¥§à“„™â®à“¬ ·≈– Zander ‰¥â
°≈à“««à“ ‡ªìπ°“√®—¥√–∫∫°“√¥Ÿ·≈ºŸªâ «É ¬∑’®Ë –𔉪 Ÿ°à “√
¥Ÿ·≈ºŸâªÉ«¬∑’ˇπâπº≈≈—æ∏å¿“¬„π√–¬–‡«≈“∑’Ë°”Àπ¥·≈–
¡’°“√∫√‘À“√®—¥°“√∑√—欓°√∑’‡Ë À¡“– ¡ „π §.». 1994
Case Management Society of America (CMSA)
„À⧫“¡À¡“¬«à“ ‡ªìπ°√–∫«π°“√§«“¡√à«¡¡◊Õ„π°“√
ª√–‡¡‘π «“ß·ºπ ¥”‡π‘π°“√ªØ‘∫µ— ‘ ª√– “πß“πµ‘¥µ“¡
·≈–ª√–‡¡‘π∑“߇≈◊Õ°„π°“√„Àâ∫√‘°“√ ‡æ◊ÕË µÕ∫ πÕßµàÕ
§«“¡µâÕß°“√¢ÕߺŸâªÉ«¬·µà≈–√“¬¥â«¬°“√ ◊ËÕ “√ ·≈–
°“√„™â∑√—欓°“√∑’Ë¡’Õ¬Ÿà𔉪 Ÿàº≈≈—æ∏å∑’Ë¡’§ÿ≥¿“æ·≈–
§ÿ¡â §à“ ´÷ßË µ—«™’«È ¥— ”§—≠∑’ Ë –∑âÕ𧫓¡ ”‡√Á®¢Õß∫∑∫“∑
π’ȧ◊Õ °“√ª√–‡¡‘π·≈–«—¥º≈≈—æ∏å°“√∫√‘À“√ ®—¥°“√
·ºπ°“√√—°…“欓∫“≈∑’‡Ë æ‘¡Ë §ÿ≥¿“æ¿“¬„µâ§“à „™â®“à ¬∑’Ë
‡À¡“– ¡
∫∑∫“∑·≈–Àπâ“∑’§Ë «“¡√—∫º‘¥™Õ∫¢Õß Case Manager
1. ‡≈◊Õ°ºŸâªÉ«¬/µ“¡‡°≥±å∑’Ë°”Àπ¥/‡À¡“– ¡
”À√—∫°“√‡¢â“√–∫∫ Case Management
2. ª√–‡¡‘πªí≠À“ºŸâªÉ«¬·≈–§√Õ∫§√—«·∫∫Õߧå
√«¡ √–∫∫°“√ π—∫ πÿπ¢ÕߺŸâªÉ«¬ ·≈– ∂“π¿“æ∑“ß
°“√‡ß‘π ·≈–«‘‡§√“–Àåªí≠À“®“°¢âÕ¡Ÿ≈∑’ˉ¥â√«∫√«¡‰«â
∑—ÈßÀ¡¥
3. °”Àπ¥·≈–«“ß·ºπ°“√欓∫“≈„Àâ Õ¥§≈âÕß
µ“¡·ºπ°“√¥Ÿ·≈ºŸªâ «É ¬·∫∫ À “¢“ µ—¥ ‘π„® —ßË °“√„Àâ
‡√‘Ë¡ªØ‘∫—µ‘ ·≈–‡ªìπºŸâµ√«® Õ∫§«“¡∂Ÿ°µâÕߢÕß°“√
ªØ‘∫—µ‘µ“¡·ºπ°“√¥Ÿ·≈ √«¡∑—Èߪ√–‡¡‘𧫓¡°â“«Àπâ“
¢ÕߺŸâªÉ«¬‡ª√’¬∫‡∑’¬∫°—∫‡ªÑ“À¡“¬ ·≈–º≈≈—æ∏å∑“ß
§≈‘π‘°„π·µà≈–«—π
4. ‡ πÕ§«“¡§‘¥‡ÀÁπ·°à∑’¡ ÿ¢¿“æ„π°“√ª√—∫
‡ª≈’¬Ë π·ºπ°“√¥Ÿ·≈„Àâ Õ¥§≈âÕß°—∫ªí≠À“·≈–§«“¡µâÕß
°“√¢ÕߺŸâªÉ«¬·µà≈–√“¬
5. „À⧔ª√÷°…“·≈–™à«¬‡À≈◊Õ∑’¡æ¬“∫“≈„π
°“√·°â‰¢ªí≠À“∑’Ë´—∫´âÕπ¢ÕߺŸâªÉ«¬/§√Õ∫§√—«
6. ‡ªìπºŸâ√‘‡√‘Ë¡«“ß·ºπ®”Àπ૬ºŸâªÉ«¬·≈–ª√–
“πß“π°—∫Àπ૬ߓπÕ◊Ëπ∑’ˇ°’ˬ«¢âÕß¿“¬À≈—ß®”Àπà“¬
ºŸâªÉ«¬
7. ª√– “πß“π°—∫∑’¡ ÿ¢¿“æÕ◊ËπÊ ‡æ◊ËÕ„À⇰‘¥
°“√¥Ÿ·≈ºŸâªÉ«¬/§√Õ∫§√—«Õ¬à“ßµàÕ‡π◊ËÕß
8. µ√«®‡¬’¬Ë ¡ºŸªâ «É ¬/§√Õ∫§√—«√à«¡°—∫·æ∑¬å·≈–
∑’¡æ¬“∫“≈
9. ®—¥ª√–™ÿ¡ ª√÷°…“À“√◊Õ ·°â‰¢ªí≠À“¢Õß
ºŸâªÉ«¬/§√Õ∫§√—«®“°¢âÕ¡Ÿ≈∑’˪√–‡¡‘π‰¥â
10.查§ÿ¬°—∫ºŸªâ «É ¬·≈–§√Õ∫§√—«∂÷ß·ºπ°“√¥Ÿ·≈
µ“¡ clinical pathway ·≈–º≈≈—æ∏å∑§’Ë “¥«à“Õ“®®–‡°‘¥¢÷πÈ
11.‡ªìπºŸ„â À⧫“¡√Ÿ‡â °’¬Ë «°—∫°“√¥Ÿ·≈ ÿ¢¿“æµπ‡Õß
¢ÕߺŸâªÉ«¬·≈–§√Õ∫§√—«
Competency Model of Pediatric Critical care
Nurses17-18
°“√∑’æË ¬“∫“≈®–ªÆ‘∫µ— ‰‘ ¥âµ“¡∫∑∫“∑·≈–§«“¡
√—∫º‘¥™Õ∫„À⇰‘¥º≈ —¡ƒ∑∏‘∑Ï ßÈ— À¡¥∑’°Ë ≈à“«¡“·≈â«π—πÈ ¡’
§«“¡®”‡ªìπµâÕß¡’ ¡√√∂π– (competency) §«“¡√Ÿâ
§«“¡ “¡“√∂ ·≈–∑—°…–¥â“π°“√ªÆ‘∫—µ‘°“√欓∫“≈
‡À¡“– ¡°—∫≈—°…≥–ß“π„πÀÕºŸâªÉ«¬ ‰Õ´’¬Ÿ ¥—ßπ’È
1. ¡√√∂π–¥â“𧫓¡√Ÿâ
ë ¡’§«“¡√Ÿ¥â “â π欓∏‘ √’√«‘∑¬“ Õ“°“√ ·ºπ
°“√√—°…“‡°’ˬ«°—∫‚√§·≈–°≈ÿà¡Õ“°“√∑’Ë∑”„À⇰‘¥«‘°ƒµ
¡’§«“¡‡¢â“„®„π°√Õ∫§«“¡√Ÿ∑â ßÈ— ¥â“π biomedical, clinical √–∫“¥«‘∑¬“¢Õß‚√§ §«“¡√Ÿâ‡√◊ËÕß惵‘°√√¡∑“ß
—ߧ¡∑’®Ë ”‡ªìπ √«¡∂÷ß¡’§«“¡ “¡“√∂„π°“√·ª≈ ∂“π
°“√≥å∑’Ë«‘°ƒµ‘·≈–π”¡“ª√–¬ÿ°µå‡¢â“°—∫°“√¥Ÿ·≈ºŸâªÉ«¬
‚¥¬‡©æ“–∑’Ëæ∫∫àÕ¬Õ¬à“ßπâÕ¬„π 5 ‚√§·√° (Top 5
diseases): √–∫∫∑“߇¥‘πÀ“¬„® √–∫∫À—«„®·≈–À≈Õ¥
Role of Nurses in Pediatric Critical Care: Clinical Career Ladder, ÿ¿“√—µπå ‰«¬´’µ“ 215
‡≈◊Õ¥ √–∫∫ ¡Õß·≈–ª√– “∑«‘∑¬“ ·≈–‚≈À‘µ«‘∑¬“
‡ªìπµâπ
ë ¡’§«“¡√Ÿâ¥â“π°“√‡®√‘≠‡µ‘∫‚µ·≈–æ—≤π“
°“√‡¥Á°µ“¡«—¬
ë ¡’§«“¡√Ÿâ¥â“π°“√ªÆ‘∫—µ‘°“√欓∫“≈µ“¡
protocol/guidline„πÀ—µ∂°“√∑’ˇªìπ Top 5 ‡™àπ
- °“√ªÑÕß°—π°“√‡≈◊ËÕπÀ≈ÿ¥¢Õß endotrachial tube
- °“√欓∫“≈ºŸâªÉ«¬∑’˵âÕßæ÷Ëß擇§√◊ËÕß
™à«¬À“¬„®·≈–°“√ªÑÕß°—π°“√‡°‘¥ Ventilator Associated Pneumonia (VAP)
- °“√¥Ÿ·≈ºŸâªÉ«¬∑’ˉ¥â√—∫°“√∑” CVVH
- °“√欓∫“≈ºŸâªÉ«¬∑’ˉ¥â√—∫°“√§“ “¬
«πÀ≈Õ¥‡≈◊Õ¥¥” à«π°≈“ß
- °“√欓∫“≈ºŸâªÉ«¬¿“¬À≈—߉¥â√—∫°“√
ª≈Ÿ°∂à“¬‰¢°√–¥Ÿ°
ë ¡’§«“¡√Ÿâ¥â“π°“√¥Ÿ·≈§√Õ∫§√—«§◊Õ»Ÿπ¬å
°≈“ß°“√¥Ÿ·≈ (Family Centered-Care)
ë ¡’§«“¡√Ÿâ¥â“π°“√ª√–‡¡‘π¿“«– ÿ¢¿“æ
¢ÕߺŸâªÉ«¬‰¥â§√Õ∫§≈ÿ¡∑—Èß√à“ß°“¬ ®‘µ„® Õ“√¡≥å ·≈–
—ߧ¡
ë ¡’§«“¡√Ÿ¥â “â π°“√«“ß·ºπ°“√欓∫“≈‰¥â
§√Õ∫§≈ÿ¡∑—Èß√à“ß°“¬ ®‘µ„® Õ“√¡≥å ·≈– —ߧ¡ Õ¥
§≈âÕß°—∫¿“«– ÿ¢¿“æ·≈–·ºπ°“√√—°…“
ë ¡’ § «“¡√Ÿâ „ π°“√∫— π ∑÷ ° ¢â Õ ¡Ÿ ≈ ∑“ß°“√
欓∫“≈‰¥â∂Ÿ°µâÕß §√Õ∫§≈ÿ¡ ·≈–§√∫∂â«π
ë ¡’§«“¡√Ÿ¥â “â π°“√ ◊ÕË “√ “¡“√∂∂à“¬∑Õ¥
§«“¡√Ÿâ ·≈–«‘∏’°“√ªÆ‘∫—µ‘„Àâ°—∫ºŸâªÉ«¬·≈–§√Õ∫§√—«‰¥â
‡À¡“– ¡°—∫ ¿“æ°“√√—∫√Ÿâ„π·µà≈–∫ÿ§§≈
ë ¡’§«“¡√Ÿ¥â “â π°“√∫√‘À“√¬“‰¥â∂°Ÿ µâÕßµ“¡
¡“µ√“∞“π/¢âÕ°”Àπ¥¢ÕßÀπ૬ߓπ
ë ¡’§«“¡√Ÿâ‡°’ˬ«°—∫π‚¬∫“¬ ·≈–√–‡∫’¬∫
ªÆ‘∫—µ‘¢ÕßÀπ૬ߓπ ·≈–Õߧå°√
ë ¡’§«“¡√Ÿâ‡°’ˬ«°—∫°“√æ—≤π“§ÿ≥¿“æ°“√
∫√‘°“√
- Quality Improvement
- Risk Management
- Quality Assurance
- Continuous Quality Improvement
2. ¡√√∂π–¥â“π∑—°…–
ë Patient Care ¡’∑—°…–°“√®—¥√–∫∫°“√
¥Ÿ·≈∑’„Ë Àâ§√Õ∫§√—«‡ªìπ»Ÿπ¬å°≈“ߢÕß°“√¥Ÿ·≈ ¥â«¬°“√
æ—≤π“À√◊Õª√—∫°“√¥Ÿ·≈∑’ˇÀ¡“– ¡À√◊Õ Õ¥§≈âÕß°—∫
ªí≠À“ ÿ¢¿“æ·≈– √â“߇ √‘¡ ÿ¢¿“æ¢ÕߺŸâªÉ«¬‚¥¬¡’
∑—°…–„π°“√„™â°√–∫«π°“√欓∫“≈µ—Èß·µà√—∫ºŸâªÉ«¬®π
°√–∑—ßË ®”Àπà“¬/¬â“¬ÕÕ°‡ªìπ‡§√◊ÕË ß¡◊Õ„π°“√ªÆ‘∫µ— ß‘ “π
ë Interpersonal Skills and Communication Skills · ¥ß∂÷ß∑—°…–„π°“√ √â“ß —¡æ—π∏¿“æ·≈–
°“√ ◊ËÕ “√∑’˙૬„À⇰‘¥°“√·≈°‡ª≈’ˬπ¢âÕ¡Ÿ≈ ·≈–§«√
¡’ à«π√à«¡„π°“√¥Ÿ·≈ºŸâªÉ«¬ ·≈–§√Õ∫§√—« √«¡∂÷ß∑’¡
ºŸâ¥Ÿ·≈
ë Practice-based Learning and Improvement ¡’∑—°…–°“√ªØ‘∫—µ‘∫πæ◊Èπ∞“π¢Õߧ«“¡√Ÿâ ·≈–¡’
°“√æ—≤π“°“√ªØ‘∫—µ‘ · ¥ß∑—°…–·≈–∑—»π§µ‘∑’Ë®”‡ªìπ
µàÕ°“√ª√–‡¡‘πµπ‡ÕßÕ¬à“ßµàÕ‡π◊ÕË ß ‚¥¬°“√„™â«∏‘ ª’ Ø‘∫µ— ‘
∑“ß«‘∑¬“»“ µ√å ·≈–Õâ“ßÕ‘ß∂÷ß°“√«‘®—¬ °“√ª√–‡¡‘π
·≈–ª√—∫ª√ÿß°“√ªØ‘∫—µ‘°“√¥Ÿ·≈ºŸâªÉ«¬
ë Professionalism ¡’∑—°…–∑’Ë· ¥ß∂÷ß°“√
¡’§«“¡√—∫º‘¥™Õ∫µàÕ°“√ªØ‘∫µ— µ‘ “¡À≈—°®√‘¬∏√√¡ ·≈–¡’
§«“¡‡¢â“„®/µ√–Àπ—°/‰«µàÕªí≠À“∑’¡Ë §’ «“¡‡ÀÁπ·µ°µà“ß
°—π
ë Systems-based practice ¡’∑—°…–°“√
ªØ‘∫—µ‘°“√¥Ÿ·≈∑’˧”π÷ß∂÷ߧÿ≥¿“æ°“√∫√‘°“√ ¿“¬„µâ
∫√‘∫∑¢Õß√–∫∫°“√¥Ÿ·≈ ÿ¢¿“æ
ë ∑—°…–„π°“√ª√–‡¡‘π·≈–°“√™à«¬™’«µ‘ ‚¥¬
㪉 Pediatric Advanced Life Support
ë ∑— ° …–„π°“√™à « ¬∑”/°“√ªØ‘ ∫— µ‘ ° “√
欓∫“≈„πÀ—µ∂°“√∑’ˇªìπ Top 5 ¢ÕßÀπ૬ߓπ
ë ∑—°…–„π°“√„™âÕªÿ °√≥å/‡§√◊ÕË ß¡◊Õ∑“ß°“√
·æ∑¬å‰¥â‡À¡“– ¡
216 Current Concepts in Pediatric Critical Care
√ÿª
∫∑∫“∑¢Õß欓∫“≈„πÀÕºŸªâ «É ¬«‘°ƒµ∑’ªË Ø‘∫µ— „‘ π
acute ·≈– tertiary care setting ¡’§«“¡®”‡ªìπµâÕß
ª√—∫∫∑∫“∑·≈–æ—≤π“µπ‡ÕßÕ¬à“ßµàÕ‡π◊ËÕß „Àâ∑—π°—∫
§«“¡°â“«Àπâ“∑“ß°“√·æ∑¬å·≈–°“√π”‡∑§‚π‚≈¬’√–¥—∫
Ÿß¡“„™â„π°“√√—°…“欓∫“≈ºŸâªÉ«¬ Õ’°∑—È߬—ßµâÕß¡’°“√
ªØ‘∫µ— ß‘ “π„π‡™‘ß«‘™“™’æ∑’∑Ë ”ß“π√à«¡°—π‡ªìπ∑’¡ ¡’§«“¡
√à«¡¡◊Õ°—∫∫ÿ§≈“°√®“°»“ µ√åÀ≈“¬ “¢“ À√◊Õ°“√
∑”ß“π„π√Ÿª·∫∫¢Õß∑’¡ À “¢“ ‡π◊ËÕß®“°ªí≠À“
ÿ¢¿“æ¢ÕߺŸâªÉ«¬/§√Õ∫§√—«¡’§«“¡´—∫´âÕπ¡“°¢÷Èπ
∫ÿ§≈“°√®“°∑ÿ° “¢“®÷ßµâÕß¡’§«“¡√à«¡¡◊Õ°—π‚¥¬„™â
§«“¡√Ÿâ®“°«‘™“™’æ¢Õßµπ‡Õ߇æ◊ËÕª√–‚¬™πå¢ÕߺŸâªÉ«¬
πÕ°®“°π’È欓∫“≈¬—ßµâÕ߇¢â“„®∂÷ßªí®®—¬∑“ß —ߧ¡
‡»√…∞°‘®∑’Ë àߺ≈°√–∑∫¥â“πÕ“√¡≥å ®‘µ —ߧ¡ ®‘µ
«‘≠≠“≥¢Õߧ√Õ∫§√—« ‘ßË ‡À≈à“π’¡È Õ’ ∑‘ ∏‘æ≈µàÕ°“√ªØ‘∫µ— ‘
°“√欓∫“≈∑’˵âÕߪ√—∫ª√ÿ߇ª≈’ˬπ·ª≈ß°“√ªØ‘∫—µ‘
ß“π„Àâ Õ¥§≈âÕß°—∫§«“¡µâÕß°“√¢Õß —ߧ¡ ‚¥¬‡©æ“–
„π‡√◊ÕË ß¢Õß°“√ ◊ÕË “√·≈–°“√¥Ÿ·≈∑“ߥâ“𮑵«‘≠≠“≥
‡æ◊ËÕ‡æ‘Ë¡§ÿ≥¿“æ°“√¥Ÿ·≈
‡Õ° “√Õâ“ßÕ‘ß
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