The Effects of Using a Neonatal Early Warning Assessment Tool on Nurses’ Knowledge, Satisfaction, and the Incidence of Critical Conditions in Newborns in the Neonatal Unit of Surin Hospital

Abstract

Assessing critical conditions in newborns demands both expertise and effective evaluation tools. This study aimed to explore the development and outcomes of implementing a neonatal critical warning signs assessment tool in the neonatal ward at Surin Hospital. The action research was conducted in four phases: planning, implementation, observation and follow-up, and reflection. The sample consisted of two groups: 15 professional nurses in the neonatal ward and 70 newborn patients, which included preterm infants (less than 37 weeks gestation, treated for no more than 60 days) and term infants (37 weeks gestation or older, no more than 28 days old). These were equally divided into control and experimental groups, with 35 in each. The research instruments comprised a personal data record form, the NEWS assessment tool, a knowledge questionnaire on using the NEWS tool, a nurse satisfaction questionnaire, and a critical event recording form. Content validity was confirmed with IOC values of 0.86, 0.99, 0.92, 1.00, and 0.99, respectively. Reliability was evaluated using KR-20 for the knowledge questionnaire (0.95) and Cronbach's alpha for the satisfaction questionnaire (0.92). Data analysis included frequency, percentage, mean, standard deviation, the Wilcoxon signed ranks test, and Fisher's Exact test.

Results: The NEWS version 2 assessment comprises eight components: 1) temperature; 2) respiration; 3) heart rate; 4) respiratory symptoms; 5) blood pressure; 6) oxygen saturation; 7) nervous system; and 8) other clinical symptoms, including breathing patterns, abdominal distension, mottled skin, regurgitation, and bloody stools. After implementing this assessment, nurses exhibited significantly higher knowledge scores compared to their baseline, with a statistical significance level of p < .01. Satisfaction with the assessment tool was reported at the highest level (Mean = 4.70, S.D. = 0.48). There were no recorded incidents of unplanned transfers of critically ill newborns to the ICU, resuscitation, or mortality. It is recommended that nurses be encouraged to use this assessment to enhance the efficiency of patient monitoring.