Guidelines for potential development of nursing and midwifery clinic operators to comply with the laws of Sanatorium Act B.E. 2541 and amendments, Phetchabun Provincial Public Health Office

Abstract

Abstract

This study is designed to: 1) assess problems concerning with nursing and midwifery clinic operators’ compliance with the Nursing and Midwifery Act B.E. 2541 (1998) and its amendments 2) explore potential development approaches and guidelines for nursing and midwifery clinic operators to adhere to the Act before and after participating in the project. This research employs a Participatory Action Research (PAR) with a sample of 102 licensed nursing and midwifery clinic operators in Phetchabun province. These operators had been authorized before 2024 and registered as innovative service units by the National Health Security Office (NHSO) before October 2024. The research tools include structured interviews and a record form used for assessing compliance with the legal standards set for outpatient clinics (non-inpatient facilities) and evaluated by the subject themselves. Data collection followed the PDCA cycle: Planning, Do, Check and Action. Data are analyzed using frequency and percentage. Statistical analysis uses a Paired t-test with a significance level of p-value less than 0.05.

Results: (1) The problem conditions identified among clinic operators regarding legal compliance include limited and unclear legal knowledge, lack of updates on new regulations, absence of additional educational or information media, light punishment, outdated regulations, lack of promotion and reminders for compliance, and legal enforcement that is not widespread and timely enough to punish legal offenders. (2) To enhance operators’ compliance, three key activities were implemented: Activity 1: Providing accurate knowledge about standards and regulations. Activity 2: Developing electronic information media concerned with Nursing and Midwifery laws. Activity 3: Follow-up and consultation activities. After the subject’s participation in these activities and follow-up by the researcher, all the subjects’ scores improved significantly. The average score before the intervention was 19.92, and after the intervention, it increased to 28.82. The results showed a notable improvement in the operators’ capacity to comply with the Nursing and Midwifery Act and its amendments which indicated by the p-value score of 0.001 (p < 0.05)