Development of Nursing Practice Guidelines for Prevention of Birth Asphyxia Chiang Yuen Hospital Mahasarakham Province

Abstract

This action research aimed to (1) investigate the current situation and problems in preventing neonatal asphyxia at Chiang Yuen Hospital, Maha Sarakham Province, (2) develop a nursing practice guideline to prevent neonatal asphyxia, and (3) evaluate the outcomes of the developed guideline. The study applied the Iowa Model of Evidence-Based Practice to Promote Quality Care as the conceptual framework. Participants included ten registered nurses working in the delivery room and ten newborns delivered at Chiang Yuen Hospital between October 2024 and September 2025. Research instruments comprised a demographic questionnaire, a nursing practice questionnaire, a satisfaction survey, and a neonatal outcome record form. Data were analyzed using descriptive statistics: frequency, percentage, mean, and standard deviation.

The results revealed that (1) the existing nursing practice to prevent neonatal asphyxia lacked standardization and depended largely on individual experience and judgment; (2) the developed guideline consisted of four main components—initial assessment, care during the latent phase, care during delivery, and newborn competency assessment—derived from 15 evidence-based sources; and (3) after implementation, correct nursing practice increased from 70–100% to 90–100%, with nurses reporting high satisfaction (Mean = 2.67, SD = 0.45). The incidence of neonatal asphyxia decreased to 1.28% (12.8 per 1,000 live births), and no neonatal deaths were reported.

The study concluded that the developed nursing practice guideline effectively improved maternal and newborn care quality, reduced complications, disabilities, and mortality, and enhanced nurses’ confidence in clinical practice. This guideline can serve as a prototype for developing standardized nursing practice in other community hospitals.