Nursing, Health, and Education Journal

Quality Improvement of Incident Reporting of Female Inpatient Ward, Namsom Hospital, Udon Thani Province

ชนพิชา แผ่นทอง, Apiradee Nantsupawat, Petsunee Thungjaroenkul — Fri, 29 Aug 2025 00:00:00 +0700

Introduction: Incident reporting represents a critical component of risk management strategies aimed at reducing adverse events to enhance healthcare service quality and patient safety. Previous operational assessments revealed that incident reporting occurred less frequently than actual incidents, with reports often containing inaccuracies and failing to meet established timelines.

Research objectives: To develop the quality of incident reporting in the female medical ward at Namsom Hospital, Udon Thani Province.

Research methodology: This developmental study employed the FOCUS-PDCA (Find, Organize, Clarify, Understand, Select - Plan, Do, Check, Act) continuous quality improvement framework, comprising nine sequential steps: 1) identifying processes requiring improvement, 2) establishing a knowledgeable team with process understanding, 3) comprehending the target improvement process, 4) understanding causes of process variation, 5) selecting the specific process for improvement, 6) planning the improvement strategy, 7) implementing the improvement plan, 8) monitoring outcomes, and 9) executing actions to achieve favorable results with continuous improvement. The purposive sample consisted of 16 healthcare personnel working in the female medical ward at Namsom Hospital. Research instruments included focus group discussion guidelines, incident reporting protocols, and an incident reporting checklist with documented records, achieving an assessment reliability of 0.9. Data analysis utilized descriptive statistics.

Results: Following implementation of the FOCUS-PDCA continuous quality improvement process, the healthcare team demonstrated the ability to report incidents accurately and comprehensively at rates exceeding 80%, while achieving timely reporting at rates above 80%. However, findings indicated that some personnel incompletely assessed severity levels and identified risks in occurring incidents, attributed to insufficient skills and experience in incident risk analysis.

Conclusion: Implementation of the FOCUS-PDCA continuous quality improvement process resulted in comprehensive, accurate, and timely incident reporting.

Implications: Nursing administrators should provide ongoing support for practice implementation, continuous monitoring and evaluation, skill development and experience enhancement for personnel risk analysis capabilities, and extension of incident reporting quality improvement to other organizational units.

The Effect of SOS Score Assessment Tool Utilization on Patient Care Outcomes in Sepsis at Pra Arjanfan Arjaro Hospital

Thasswan Khamla , Chanyawee Chaiwong — Fri, 29 Aug 2025 00:00:00 +0700

Introduction: The utilization of SOS Score in the care of patients with sepsis by professional nurses has resulted in a reduction in the incidence of septic shock and mortality.

Research objective: This study aimed to examine the effect of using the SOS Score assessment on patient care outcomes in individuals with bloodstream infections, by comparing results between the experimental and control groups at Phra Arjanfan Arjaro Hospital.

Research Methodology: A quasi-experimental two-group pre-post test design was employed. The study sample consisted of 42 patients diagnosed with bloodstream infection, divided equally into an experimental group (n = 21) and a control group (n = 21). In addition, 14 registered nurses responsible for the care of these patients were purposively selected. The research instruments included: 1) A multidisciplinary clinical practice guideline for sepsis care, 2) The SOS Score assessment tool, 3) A record form for patient demographics and clinical outcomes, and 4) A questionnaire measuring nurses’ satisfaction with the SOS Score. Data were analyzed using descriptive statistics, Chi-square test, Fisher’s Exact test, and independent t-test.

Results: The experimental group that used the SOS Score for caring for patients with sepsis at Phra Ajarnfan Arjaro Hospital had a significantly lower mortality rate from sepsis compared to the control group that received standard nursing care at the .05 significance level (t = 1.45, p < .05). The overall satisfaction of professional nurses regarding the implementation of the SOS Score practice was at a high level ( = 4.25, SD = 0.48).

Conclusion: The implementation of the SOS Score assessment tool contributes to reducing mortality rates and has been accepted by nurses.

Implication: Professional nurses should be encouraged to use the SOS Score continuously by enhancing knowledge regarding SOS Score utilization and providing supervision, monitoring, and regular evaluation of its implementation.

Effect of Flipped Classroom Learning on Pediatric Nasogastric Tube Feeding Insertion Skills of Nursing Students

Patcharee Watthanachai, warangkana udomsapaya, Sopah Raksatham — Sat, 30 Aug 2025 00:00:00 +0700

Intoduction: Flipped Classroom Learning is an instructional method that promotes self-directed learning.

Research Objectives: To study the effects of flipped classroom learning on the pediatric nasogastric tube feeding insertion skills of nursing students; and the students' satisfaction towards learning through flipped classroom learning management.

Research methodology: This quasi-experimental study involved second-year nursing students at Boromarajonani College of Nursing, Bangkok. Purposive sampling yielded 168 participants, divided into an experimental group (n = 88) and a control group (n = 80). Data collection instruments included: 1) a flipped classroom teaching plan for pediatric nasogastric tube feeding insertion, 2) a validated instructional video (CVI = .93), 3) an objective structured clinical examination (OSCE) with interrater reliability of .93, and 4) a student satisfaction questionnaire with a Cronbach’s alpha of .95. Data were analyzed using descriptive statistics and independent t-tests.

Results: The results revealed that the pediatric nasogastric tube feeding insertion skills score of nursing students after learning with the use of the flipped classroom learning approach was significantly higher than conventional learning methods (t=7.29, p > .01). Overall student satisfaction toward learning through the flipped classroom approach was the highest of the methods ( =4.69, SD=.50).

Conclusions: Flipped Classroom enhances both learning outcomes and student satisfaction in teaching pediatric nasogastric tube feeding skills, especially when supported by systematically developed educational media. It is well-suited for promoting self-directed learning in nursing education.

Implications: It is recommended that further studies be conducted to extend the

application of flipped classroom learning in other nursing topics or courses to enhance

students’ learning outcomes.

การประเมินพัฒนาการและผลกระทบในระยะยาวของทารกที่เกิดจากมารดาที่ตรวจพบการใช้สารแอมเฟตามีนระหว่างการตั้งครรภ์: การศึกษาทิศทางคู่

Rapeepan Chanouan — Sat, 30 Aug 2025 00:00:00 +0700

Background: Amphetamine use among pregnant women has increased in the Thai-Lao border area of Loei Province, with rates twice the national average. Amphetamines cross the placental barrier and affect fetal neurological growth and development.

Objective: To evaluate the developmental outcomes and long-term effects in infants born to mothers who tested positive for amphetamine use during pregnancy in the Thai-Lao border area of Loei Province.

Methods: A two-phase bidirectional analytical study was conducted. Phase 1 involved a retrospective review of maternal and infant medical records from public hospitals in Loei Province (2020-2023), comparing 32 mothers who tested positive for amphetamine use with 32 matched controls based on maternal age, gestational age, and socioeconomic status. Phase 2 involved developmental follow-up starting at 12 months of age, with assessments every 6 months using DENVER II and Bayley-III scales. Data were analyzed using t-test, Chi-square test, and multiple logistic regression.

Results: Mothers who used amphetamines during pregnancy had a significantly higher rate of low birth weight infants (<2,500 grams) at 46.9% compared to 21.9% in the control group (OR=3.21, p=0.029). The mean birth weight was 237.1 grams lower (p=0.018). Developmental follow-up at 18.3±6.8 months revealed delayed development in all domains among the study group, particularly in language development (OR=7.22, p=0.007) and emotional-social development. Additionally, 42.9% had a 9-fold higher risk of multi-domain developmental delays (p=0.024). The study group showed significantly more attention deficit problems (OR=5.20, p=0.044) and sleep disturbances (OR=3.45, p=0.040) compared to controls.

Conclusion: Amphetamine use during pregnancy adversely affects birth weight and child development. Enhanced prevention measures, improved screening and monitoring systems for at-risk children, and promotion of breastfeeding are recommended to mitigate these effects in border areas.

Implications: Implement enhanced prevention measures for substance use in pregnant women, develop screening and developmental monitoring systems for at-risk children, promote breastfeeding, and establish multidisciplinary care guidelines specifically for border areas.

The Development of Clinical Nursing Practice Guidelines for Pregnant Women Preterm Labor at Nong Khai Hospital

Tatsanawan Doungdee , Nuttagritta Wonglakorn — Sat, 30 Aug 2025 00:00:00 +0700

Introduction: Preterm birth is high risk of neonatal mortality. Clinical Nursing Practice Guidelines for pregnant women with preterm labor is quality to delayed preterm deliveries until full term deliveries.

Research objective: This research was to :1) Develop Nursing Practice Guidelines (CNPGs) for pregnant women with preterm labor 2) Delayed preterm deliveries until full term deliveries and decrease readmitted within 28 days

Research Methodology: The framework was applied by the Australian National Health and Medical Research Council. The development was divided R&D (Research and Development). The sample by purposive sampling are 48 pregnant women with preterm labor by included criteria. Research Instrument is 1) Clinical Nursing Practice Guidelines for pregnant women with preterm labor 2) The evaluation form for care pregnant women with preterm labor. Data were collected using record form and observation. Data were analyzed by using descriptive statistics and Chi-square tests

Results: The results were that after used CNPGs. had good outcomes such as increased percent of delayed preterm deliveries until full term deliveries but readmitted within 28 days in two groups were not different

Conclusion: CNPGs. had good outcomes such as increased percent of delayed preterm deliveries, increased full-term deliveries

Implication: Should be used CNPGs continuing for development CNPGs in line withmedical advancement.

Development of Clinical Practice Guidelines (CPGs) For Discharge Planning In Antimicrobial Resistance Patient At Pra Arjanfan Arjaro Hospital

มาริสา หมื่นจูม, Jaruporn Chaiwongsa — Sat, 30 Aug 2025 00:00:00 +0700

Introduction: Antimicrobial resistance infection resulting in severe illness, Higher mortality rate and treatment requires new medication more expensive. Discharge planning in antimicrobial resistance patient is important to reduce the spread of infection and re-infection rate.

Research objective: 1) Development of Clinical Practice Guidelines (CPGs) for discharge planning in antimicrobial resistance patient 2) For evaluation compliance Clinical Practice Guidelines (CPGs) 3) For evaluation knowledge of antimicrobial resistance and prevention community spread in patient and care giver.

Research Methodology: The framework was applied by the Australian National Health and Medical Research Council. The development was divided Research and Development. The sample by purposive sampling are 16 nurse and 42 antimicrobial resistance patient. Research Instrument is 1) Clinical Practice Guidelines (CPGs) for discharge planning in antimicrobial resistance patient 2) Data were collected by questionnaire for evaluation Clinical Practice Guidelines (CPGs), For evaluation knowledge, and questionnaire for satisfaction of patient and nurse. Data were analyzed by using descriptive statistics and Independent t-test.

Results: 1) development of Clinical Practice Guidelines (CPGs) for discharge planning in antimicrobial resistance patient used 16 evidence base practice 2) The register nurse can used CPGs is high level 3) The knowledge of antimicrobial resistance and prevention community spread in patient and care giver are high lever 4) the satisfaction of patient and care giver are high lever 5) The satisfaction of register nurse is high level 6) Re-admit rate in 28 day before used CPGs is more than after use in significant 0.05.

Conclusion: CNPGs. can be practiced and had good outcomes such as decreased re-admit rate of antimicrobial resistance infection.

Implication: Should be used CNPGs continuing for encouragement patient and care giver to be confident in taking care of yourself.

Key words: 1. Clinical Practice Guidelines (CPGs) 2. Discharge Planning 3. Antimicrobial Resistance

The Strategies for Development the Quality of Telemedicine Services in Cancer Patients in Udon Thani Cancer Hospital

Chanyanis Chamnanchan, Thanakrit Thurisut — Sat, 30 Aug 2025 00:00:00 +0700

Introduction: Telemedicine has been widely implemented in cancer care. Enhancing service quality is essential to ensure high-quality and sustainable healthcare delivery

Research objectives: To develop strategies for improving the quality of telemedicine services for cancer patients.

Research methodology: This developmental research employed a mixed-methods approach and was conducted in three phases. Phase 1 involved assessing current issues in two steps: (1) a quantitative study using questionnaires with 193 cancer patients to analyze problem levels using frequency, percentage, mean, and standard deviation; and (2) a qualitative study using in-depth interviews with 15 key informants, analyzed through content analysis. Phase 2 focused on strategy formulation. Phase 3 evaluated the proposed strategies using assessments by 30 experts, with data analyzed using frequency, percentage, mean, and standard deviation. The participants included cancer patients and telemedicine providers at Udon Thani Cancer Hospital, selected through purposive sampling.

Results: System quality issues were found to be at a moderate level ( x^-= 2.58, SD = 0.98), with issues in reliability, ease of use, and response time. Problems included unstable systems, poor internet, and complexity for elderly patients, and the need for caregiver or provider support. Service quality issues were at a low level ( x^-= 2.29, SD = 1.02), especially in responsiveness, tangibility, and assurance. Challenges involved coordination, service areas, procedures, technology, and communication tools. A total of 6 strategies comprising 11 projects were developed to enhance telemedicine service quality. Evaluation results indicated that the strategies were appropriate and feasible for implementation.

Conclusion: The developed strategies are suitable for improving telemedicine services for cancer patients.

Implications: These strategies should be applied in practice to enhance the quality and efficiency of telemedicine services for cancer patients.

Keywords: strategies, service quality, telemedicine, cancer