Quality Improvement of Pre-Crisis Care in Pediatric 2 Unit, Uttaradit Hospital

Abstract

         Pediatric patients in hospitals are at risk of swift deterioration, perhaps resulting in a critical state at any moment. Consequently, delivering pre-crisis care for this demographic is paramount. This developmental study sought to enhance the quality of pre-crisis treatment in the pediatric ward 2 of Uttaradit Hospital, employing Deming's PDCA cycle as the methodological framework. The framework comprises four stages: plan, do, check, and act. The study cohort comprised nine professional nurses. The research used three primary instruments: 1) a revised pre-crisis care guideline based on the Pediatric Early Warning Signs (PEWS); 2) an assessment form to assess the efficacy of pre-crisis care; and 3) the internal incident report from the pediatric unit. Five independent experts validated the quality of all devices. The content validity index (CVI) of the evaluation form was 0.99, and the intraclass correlation value (ICC) was 0.94. We performed data analyses employing descriptive statistics. The study results showed that nurses accurately provided pre-crisis care in accordance with guidelines at 84.75%, and during the data-gathering period, there were no incidents involving respiratory failure, unplanned NICU admission, or deaths among newborn patients in the setting.
        The study demonstrates that the PDCA process is an effective method for addressing pre-crisis care issues for newborn patients in a pediatric ward as it provides an appropriate guideline for newborn patients pre-crisis care. In addition, administrators should encourage nurses to adhere to guidelines to prevent adverse events during pre-crisis care for newborn patients