ผลของโปรแกรมการพัฒนาการใช้ National Early Warning Score สำหรับพยาบาลในการประเมินผู้ป่วยในกลุ่มโรคสำคัญ งานผู้ป่วยในโรงพยาบาลห้างฉัตร จังหวัดลำปาง

Buntai Sithipaisal

Authors

Buntai Sithipaisal Hangchat Hospital

Keywords:

Complications, National Early Warning Score Development Program, Patients with major diseases, Unexpected death, Unplanned referral

Abstract

This quasi-experimental study aimed to examine the effects of a program to develop nurses' use of the National Early Warning Score (NEWS) to assess patients with major diseases. The study population included registered nurses in the inpatient department and patients with major diseases admitted to the unit. Patient outcomes were compared with those of patients admitted during the same period in the preceding year. Research instruments comprised a NEWS utilization program and a knowledge and skills assessment questionnaire for nurses. Expert validation of the instruments yielded content validity indices ranging from 0.67 to 1.00 and a KR-20 reliability coefficient of 0.82. Data analysis employed descriptive statistics, the Wilcoxon Signed-Rank Test, and Fisher’s Exact Test.
Three months post-intervention, the experimental group exhibited significantly higher mean knowledge and practical skill scores for NEWS utilization than during the pre-intervention period (p < .05). The incidence of adverse events also decreased. In the experimental group, sepsis occurred in 2.44% of patients, with no cases of septic shock, unplanned referral, or unexpected death,and a recovery rate of 100.00%. In contrast, the control group (patients from the previous year) had a sepsis rate of 21.95%, septic shock rate of 2.44%, recovery rate of 97.56%, unplanned referral rate of 2.44%, and unexpected death rate of 2.44%. Despite these differences, complications and clinical outcomes did not differ significantly between groups (p = 0.293). In summary, the program significantly enhanced nurses’ knowledge and skills in patient assessment using the NEWS score. Although clinical outcomes did not reach statistical significance, likely due to sample size limitations, the results indicate meaningful improvements in patient safety.

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