The Development of the Care Model for Children with Pneumonia in Yasothon Hospital

Abstract

            Background: This research aims to develop and study the results of developing a care model for children with pneumonia at Yasothon Hospital.

            Objective: This study was conducted between 6 January 2022 and 31 October 2022, and was conducted in 4 phases: Phase 1: situation study; Phase 2: model development; Phase 3: trial use; and Phase 4: evaluation. The sample was selected based on the inclusion criteria: (1) 56 pediatric pneumonia patients and 56 caregivers, and (2) 10 professional nurses. The research instruments were: (1) Nursing practice guidelines for pediatric pneumonia patients and assessment of warning signs of a crisis (PEWS), (2) Nursing capacity development program, validity checked by 5 experts. The instruments used for data collection were: (1) Indicator recording form, (2) Personnel satisfaction questionnaire, reliability tested, Cronbach's alpha coefficient of the entire version was 0.81, (3) Personnel knowledge measurement form, total difficulty value was 0.77, (4) Patient satisfaction questionnaire, reliability tested, Cronbach's alpha coefficient of the entire version was 0.98, data were analyzed using descriptive statistics, and differences were compared using Paired t-test.

            Results: The study found that 1) The nursing model for pediatric pneumonia patients consisted of (1) a care plan for pediatric pneumonia patients, (2) a program to promote knowledge about pneumonia for caregivers, and (3) screening using a symptom change warning system (PEWS). 4) Discharge planning program using a 5-step discharge planning model consisting of (4.1) assessment of problems and post-discharge care needs, (4.2) diagnosis of problems following post-discharge care, (4.3) determination of discharge plan according to D-Method, (4.4) compliance with the discharge plan, and (4.5) evaluation.

            2) The results of the model include service provider results, with overall staff satisfaction being at a very high level ( = 4.73, S.D. = 0.15), and the compliance with the care guidelines was at 91.07 percent. The results of the service users were as follows: The number of unplanned ICU transfers, respiratory failure, and readmissions within 28 days was significantly reduced at the .05 level, and overall caregiver satisfaction was very high ( = 4.84, S.D. = 0.14). Caregivers' knowledge after the development was higher than before the development. ( before = 8.83,  after = 16.38) significantly at the .05 level.

            Conclusion: The development of a care model for children with pneumonia produces good results and should be the development guidelines applied to other groups of patients with chronic diseases.