Effects of Nursing Practice Guidelines of Early Warning System on Nurses’ Knowledge, Practice and Abnormal Signs Detection in At-risk Neonates

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Panudda Bubphamalo
Apawan Nookong
Somsiri Rungamornrat


Purpose: To study the effects of nursing practice guidelines of early warning system on nurses’ knowledge, practice and abnormal signs detection in at-risk neonates.

Design: Quasi-experimental research, the two-group pretest-posttest design.

Methods: The sample comprised of 35 registered nurses operating in two neonatal wards, at a tertiary hospital in Bangkok. The nurses were divided into experimental (n = 23), and control (n = 12) groups. Two hundred and ten at-risk newborns’ charts were also recruited. Nurses in the control group provided routine nursing care while those in the experimental group provided nursing care in accordance with the early warning system nursing practice guidelines. Data were collected using the general information questionnaire for nurses, knowledge test of early warning system, practice record form, and form for identifying abnormal conditions in at-risk neonates which was combined with the Whitt Neonatal Trigger Score. Chi-square test, Fisher’s exact test and Mann-Whitney U test were utilized for data analysis.

Main findings: Data analysis revealed that knowledge scores of the experimental group were significantly higher than that of the control group (U = 55.5, p = .004). The difference of practice scores before and after the program in the experimental group was significantly higher than that in the control group (U = 851, p = .008). The detection rate of abnormalities in at-risk neonates reported by the experimental group was significantly higher than that by the control group (gif.latex?\chi2 = 32.50, p < .001); that is, 87% and 66.7%, respectively.

Conclusion and recommendations: Nursing practice guidelines of the early warning system could improve nurses’ knowledge of the warning system, performance in practicing the warning system, and detection of abnormal signs in at-risk neonates. As a result, nurses should implement guidelines when caring for at-risk neonates. Novice nurses should receive trainings for the early warning system before starting their practices in neonatal wards.

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How to Cite
Bubphamalo, P., Nookong, A., & Rungamornrat, S. . (2023). Effects of Nursing Practice Guidelines of Early Warning System on Nurses’ Knowledge, Practice and Abnormal Signs Detection in At-risk Neonates. Nursing Science Journal of Thailand, 41(3), 79–93. Retrieved from https://he02.tci-thaijo.org/index.php/ns/article/view/261203
Research Papers


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