The Development of a Competency Enhancement Program for Professional Nurses for Discharge Planning and Continuing Care for Ischemic Stroke Patients, Maharat Nakhonratchasima Hospital

Abstract

This action research aimed to 1) develop a competency-building program for nurses in discharge planning and continuing care for stroke patients at Maharat Nakhon Ratchasima Hospital, and 2) evaluate the program's effectiveness by comparing the nurses' competency scores, knowledge, and practical skills before and after the program, as well as assessing their satisfaction with the program. The sample consisted of 21 nurses who received the competency development program and three experienced nurses who served as competency assessors. A four-phase action research design was employed: 1) planning, problem analysis, and program design;                       2) implementation, including program delivery and mentorship; 3) observation and performance evaluation; and 4) reflection. Research instruments included the competency development program, which underwent content validity assessment by five experts and achieved a content validity index of 1. Data collection tools were competency assessment forms, knowledge tests, skill assessment forms, and satisfaction surveys, which demonstrated content validity indices of 1, 0.97, 1, and 0.97, respectively, and reliability coefficients of 0.81, 0.72, 0.84, and 0.87, respectively. Quantitative data was analyzed using descriptive statistics and Wilcoxon Signed-Rank Tests, while qualitative data was analyzed through content analysis.

Results: The findings revealed that the program developed, which was grounded in stroke nursing competency and discharge planning principles, significantly enhanced the nurses' discharge planning and ongoing care competencies. The two-day training, combined with mentorship, resulted in a statistically significant improvement in nurses' competency scores at the .01 level post-intervention. Knowledge scores also showed a significant increase at the .05 level. However, no significant differences were found in practical skills. Despite this, overall satisfaction with the program was high. Given these outcomes, it is recommended that this competency enhancement program be implemented in other medical wards with similar contexts to Maharat Nakhon Ratchasima Hospital to improve patient quality of life.