Effectiveness of a Competency Development Program for Nurses in Monitoring Pre-Critical Changes Among Pneumonia Patients at Inpatient Wards, Chiang Khong Crown Prince Hospital

Abstract

Background: Community-acquired pneumonia is a major cause of illness and mortality, particularly among the elderly and individuals with chronic conditions, who face a heightened risk of life-threatening complications. Monitoring for symptom changes before reaching a critical stage is crucial in preventing severe complications. Nonetheless, there remain gaps in nurses' knowledge and practice.

Methods: A quasi-experimental study employing a single group pretest-posttest design sought to evaluate the effectiveness of a capacity-building program for nurses in identifying early signs of deterioration before critical conditions develop in patients with community-acquired pneumonia. The sample comprised 16 professional nurses working in both male and female wards. The research instruments included a capacity-building program for nurses to monitor early signs of critical deterioration in pneumonia patients, a knowledge and skills assessment for professional nurses in detecting early deterioration in pneumonia patients, and a community-acquired pneumonia patient data recording form. Experts verified the content validity, with index of item-objective congruence values of .92 and .96, respectively. The reliability coefficients were 0.80 and 0.98. Data analysis was conducted using descriptive statistics, the Friedman Test, and the Wilcoxon Signed-Rank Test.

Results: The knowledge level of the sample group rose dramatically from 12.5% to 100%, with post-program knowledge scores significantly surpassing pre-program scores at the .01 statistical significance level. Similarly, nursing practices improved from 6.25% to 81.25%, and post-program nursing practice scores were also significantly higher than pre-program scores at the .01 statistical significance level. In terms of clinical outcomes, no adverse clinical events were observed following the program.

Conclusion: The program designed to enhance nurses' ability to detect pre-critical changes in patients with pneumonia can be implemented to bolster patient safety in community hospitals.