Development of a Nursing Care Model for Pregnant Women with Preterm Labor at Nakornping Hospital

Abstract

A nursing care model for pregnant women with preterm labor can respond to their needs and enhance the effectiveness of an extended duration of pregnancy. This research and developmental study (R&D) aimed to develop and evaluate a nursing care model for use among women with preterm labor in the labor room at Nakornping Hospital. The study process was categorized into five main stages: 1) situation analysis, 2) care model development, 3) trial care model, 4) implementation and evaluation, and 5) analysis and conclusion. The participants were recruited purposively and consisted of 16 registered nurses and case managers at Nakornping Hospital, and 62 pregnant women with preterm labor who had been admitted to the labor room at Nakornping Hospital. The women were divided into two groups. One group, before implementation of the nursing care model, included 32 pregnant women. The study group included 30 pregnant women who were cared for using the nursing care model for pregnant women with preterm labor. The data were collected using in-depth interviews, focus groups, participatory observation, and medical records study. Quantitative data was analyzed using descriptive statistics, independent t-test, and chi square test.

The results of this study showed that the nursing care model for pregnant women with preterm labor at Nakornping Hospital was handled using case management, as follows:
1. Nursing case managers’ use of the model consisted of 1) assessment and screening, 2) planning of care, from the admission stage until discharge planning, 3) holistic nursing interventions, 4) a monitoring/visiting system, communicated through the use of telephone and Line application, and 5) evaluation.
2. Nursing practice guidelines for pregnant women with preterm labor consisted of 1) nursing care during the ante-partum period, 2) nursing care for the intra-partum period, and 3) nursing care for the post-partum period: two hours after birth. The consequence outcomes of this study showed that registered nurses practiced by following this nursing care model completely, and their opinions on the model were at a high level. Pregnant women’s satisfaction was high with the nursing care model. The model implemented was able to help extend the duration of pregnancy by over 48 The average gestational age of delivery increased from 32.12 weeks to 37.04 weeks and average total expenditure in the hospital decreased from 105,638.05 THB to 38439.93 THB, which was statistically significant (p = 0.001). Additionally, complications from tocolytic drugs decreased from 9.4% to 0%.

It can be concluded that the nursing care model for pregnant women with preterm labor could extend the pregnancy duration, increase the average gestational age of delivery, decrease average total expenditure in the hospital, and decrease complications from use of tocolytic drugs.