Development of a Nursing Model for Critically ill Neonate and Pediatric Patients Receiving Heated Humidified High Flow Nasal Cannula (HHHFNC), Nakornping Hospital

  • Yaowapa Janma Nakornping hospital
  • Suphan Wongtan Nakornping Hospital, Chiang Mai Province
  • Wanna Suthamma Nakornping Hospital, Chiang Mai Province
  • Amporn Korree Nakornping Hospital, Chiang Mai
Keywords: High flow oxygen therapy, Neonate and Pediatric Intensive Care, Nursing model


This developmental research aims to study the outcomes of a nursing model for critically ill neonate and pediatric patients receiving Heated Humidified High Flow Nasal Cannula (HHHFNC) at Nakornping Hospital during August 2020 to April 2021. The purposive sampling consisted of a developing team of 10 members, 45 professional nurses, 77 critically ill neonate and pediatric patients, 1day-15 year. The research was conducted in 4 phases: 1) situation analysis, 2) nursing model development, 3) application of the developed model, and 4) outcome evaluation. The research instruments consisted of group discussion questionnaires and a nursing model for critically ill neonate and pediatric patients receiving HHHFNC. The data collection tools consisted of: 1) a personal data questionnaire for nurses and patients, 2) a nursing practice observation form, 3) an outcome record form, 4) a nursing satisfaction questionnaire, and 5) a knowledge assessment form. All passed content validity = 1. The nursing satisfaction questionnaire and the nursing practice observation form, with reliability by Cronbach’s alpha coefficient, were 1 and 0.86, respectively. The knowledge assessment form, with reliability by Kuder-Richardson (KR-20), was 0.75, and the average power of all items was 0.49. Data analysis, descriptive statistics and inferential, paired t-test, independent t-test, chi-square test, exact probability test. Qualitative data using content analysis.

          The results revealed that the nursing model for critically ill neonate and pediatric patients receiving HHHFNC consisted of: 1) nursing before HHHFNC, 2) nursing during HHHFNC, and 3) nursing after HHHFNC. The mean scores of nurse knowledge after development were statistically significantly higher than before (p < 0.001). The overall nurses’ satisfaction was at the highest level (95.55 %). The success of HHHFNC before development was 82.50., 94.59 after development, nasal cannula slippage, pleural air leaks, hospital-acquired pneumonia. The decrease was not statistically significant. The nose lesion was significantly different (p < .05), and the mean length of stay in the intensive care unit decreased from 15.25 days to 6.83 days with statistical significance (p < .05).

The developed nursing model is appropriate for increasing the quality of nursing care. Nursing administrators should use the model to improve the quality of nursing care for patients receiving HHHFNC.


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Research Article