The Development of Nursing System for Pediatric Patients with Epilepsy

Abstract

This action research sought to develop a nursing care system for pediatric epilepsy patients and assess its effectiveness at Sunpasitthiprasong Hospital. Swanson’s Theory of Caring and clinical practice guidelines from the Neurological Institute served as the conceptual framework, while systems theory guided the implementation process. The study involved a purposive sample of 45 pediatric epilepsy patients, 45 primary caregivers, and 55 nurses. Data collection spanned from July 1, 2024, to June 20, 2025. Research instruments included nursing practice guidelines, caring-based nursing care plans, and a telehealth follow-up system. Data analysis was conducted using descriptive statistics and paired t-tests.

Results: The findings indicated that the developed nursing system consisted of four essential components: (1) the competency development of nurse case managers, (2) the implementation of a five-step caring-based nursing practice, (3) a seamless information transfer system, and (4) home follow-up through telehealth services. In terms of effectiveness outcomes, nurses' adherence to nursing practice guidelines significantly improved from a moderate level to the highest level (p < .001). Additionally, caregivers' knowledge and caregiving behaviors increased significantly (p < .001), and their satisfaction with the system was rated at the highest level. Notably, the unplanned readmission rate within 28 days and the ICU  re-admission rate both dropped to zero (0%) following implementation. The findings indicate that the newly developed nursing care system significantly improved continuity of care, patient safety, and quality of life for pediatric epilepsy patients. This system can also serve as a practical model for enhancing nursing services in similar healthcare environments.