Development of nursing practice guidelines for the care of premature infants with respiratory distress syndrome at Mahasarakham Hospital

Abstract

This study employed action research with the objectives of developing and evaluating the effectiveness of nursing practice guidelines for the care of preterm infants with respiratory distress at Mahasarakham Hospital. The study was conducted from December 2024 to June 2025 using the Evidence-Based Practice Model by Soukup (2000), which consists of four phases: (1) identifying clinical problems, (2) searching for empirical evidence, (3) developing and piloting the guidelines, and (4) implementing the guidelines in practice.The sample consisted of 30 registered nurses, 30 preterm infants, and 30 primary caregivers selected through purposive sampling. Data collection instruments included focus group discussions, a competency assessment form, a satisfaction questionnaire, and a caregiver knowledge test. Research tools included the developed nursing practice guidelines and the Respiratory Distress Score (RD Score) assessment tool. Data were analyzed using descriptive statistics, percentage, and Paired Sample T-Test.

The findings showed that the developed nursing practice guidelines encompassed four key components 1) guidelines for preterm infant care 2) nurse competencies 3) caregiver knowledge and skills, and (4) clinical supervision. After implementation, the accurate use of the RD Score by nurses increased to 90%, and the incidence of unanticipated clinical deterioration and unplanned admissions to the neonatal intensive care unit decreased by 6.66. Nurse competencies in all domains significantly improved (P < .05), as did caregiver knowledge (P < .001). Adherence to the guidelines increased to 98.28%, and satisfaction with the guidelines was high (95.28%).