การพัฒนาแนวทางการดูแลรักษาภาวะติดเชื้อระยะแรกของทารกแรกเกิด  โรงพยาบาลโพนพิสัย จังหวัดหนองคาย

Pakaporn Toojinda; Thirarat Poonpussorn; Porakot Soofon; Penjan Homehong

Authors

Pakaporn Toojinda Phonphisai hospital
Thirarat Poonpussorn Phon Phi Sai Hospital
Porakot Soofon Phon Phi Sai Hospital
Penjan Homehong Phon Phi Sai Hospital

Keywords:

early onset sepsis, newborns, early onset sepsis guideline

Abstract

Introduction: Neonatal sepsis is a significant cause of mortality and morbidity in newborns.

Research objectives: To develop the neonatal early onset sepsis guideline and evaluate the effectiveness of the guideline in Phonphisai Hospital.

Research methodology: This study was action research by applying concept of Kemmis & Mc Taggart. The sample group consisted of 1) 31 healthcare professionals, including: pediatricians, obstetrician gynecologists, general practitioners, and registered nurses; and 2) 55 newborns suspected of being infected. The research tools included the neonatal early onset sepsis guideline, knowledge assessment, in-depth interviews questions, satisfaction questionaries, and medical records form. Data were analyzed using descriptive statistics, paired t-test, and content analysis.

Results: The development of the neonatal early onset sepsis guideline included: the neonatal early onset sepsis guideline for nurses and for physicians. After the implementation of the new guidelines, it was found that nurses and physicians involved in neonatal care had significantly higher knowledge in assessing and caring for newborns compared to before the development of the guidelines (p < 0.001). The overall satisfaction was rated as very high (M = 4.84, SD = .37). For newborn, the infection rate decreased from 31.30 % to 20 %, the average number of bed days from 7.90 days to 6.80 days, and the medical expenses fer case from 25,989.43 baht to 22,901 baht.

Conclusion: The newly developed care guidelines can be used for monitoring and caring for newborns with early-onset sepsis.

Implication: The research can be utilized to develop the competencies of rotating nurses and physicians, as well as to establish practical guidelines in the neonatal intensive care unit.

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References

Palatnik A, Liu LY, Lee A, Yee LM. Predictors of early-onset neonatal sepsis or death among newborns born at <32 weeks of gestation. Journal of Perinatology 2019;39(7):949-55.

Berardi A, Sforza F, Baroni L, Spada C, Ambretti S, Biasucci G, et al. Epidemiology and complications of late-onset sepsis: an Italian area-based study. PLOS ONE 2019;14(11):1-15.

Paliwoda M, New K, Bogossian F. Neonatal early warning tools for recognizing and responding to clinical deterioration in neonates cared for in the maternity setting: A retrospective case–control study. International Journal of Nursing Studies 2016;61:125-35

Nursing Division Office of the Permanent Secretary, Ministry of Public Health. Nursing standards in hospitals. Bangkok: Thammasat University Pres Nursing; 1999.

Husada D, Chanthavanich P, Chotigeat U, Sunttarattiwong P, Sirivichayakul C, Pengsaa K, et al. Predictive model for bacterial late-onset neonatal sepsis in a tertiary care hospital in Thailand. BMC Infectious Diseases 2020;20(1):1-11.

Phon Pisai Hospital. Phonphisai outpatient medical record in 2023. (in Thai)

Kemmis S., Mc Taggart, R. The action research planer (3rded). Victoria: Deakin University; 1988.

Faul F, Erdfelder E, Lang AG, Buchner, A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior research methods 2007;39(2):175-91.

Cohen J. Statistical power analysis for the behavioral sciences (Revised Ed.); 1997.

Early onset: sepsis and pneumonia (24-48 hr). Late onset: meningitis. Intra-partum antibiotic prophylaxis (IPA): prevent GBS dis. Group B streptococcus [Internet]. 2018 [cited 2022 Mar 4] Available from: http://www.phukieo.net/hospital/wp-content/uploads/2017/09/7.Neonatal.pdf

Bloom, B.S Mastery learning. UCLA – CSEIP evaluation comment. Los Angeles: University of California at Los Angeles. 1971.

Kuharattanachai C. Introduction to statistics. Bangkok: The Department of applied statistics, Mahanakorn University of Technology; 1999. (in Thai)

Kuprasit M, Panprasert S. The caring model development of neonatal sepsis at Somdet. Phra Phutthaloetla Hospital in Samutsongkhram: Journal of Public Health Nursing 2021; 35(1): 1-20. (in Thai)

Korrianchai T, Rodparn I, Soonyanon S, Bootcheewan S, Suksalee U. The Development of effective nursing system to prevent drug-resistant infections in newborns. Phra Nakhon Si Ayutthaya Hospital 2019;9(2):113-31. (in Thai)

Benner, P. Form novice to expert: Excellence and power in clinical nursing practice. Menlo Park, CA: Addison-Wesley; 1984.

RItveeradej C. Outcome of the newly developed standardized treatment guideline on Neonatal sepsis. Mahassarakham Hospital Journal 2019;16(3):23-32. (in Thai)

Chompoolong S, Sriruksa S. The development nursing service system of preterm infant in Mahasarakham Hospital and Network. Journal of Nurses’ Association of Thailand, North- Eastern Division 2013;31(2):151-64. (in Thai)