The Nursing service model for quality and safety in consulting work at Roi Et Hospital

Abstract

Purposes: To examine problems and needs, develop, and evaluate the effectiveness, appropriateness, and feasibility of a nursing service model for improving quality and safety in counseling services at Roi Et Hospital.

Study design: A mixed-methods research and development study conducted in three phases: situation and needs assessment; model development and quality validation; and model implementation and evaluation.

Materials and Methods: Participants in the situation and needs assessment phase included 10 healthcare providers and 12 service recipients selected by purposive sampling according to the specified criteria. In the model development phase, content validity was assessed by three experts. The implementation phase included 30 healthcare providers and 30 service recipients selected according to the specified eligibility criteria. Research instruments included interview forms, assessment forms, and questionnaires. Quantitative data were analyzed using frequency, percentage, mean, and standard deviation. Pre–post differences were analyzed using a paired-sample t-test after checking the normality of the difference scores, with the statistical significance level set at .05. Qualitative data were analyzed using content analysis.

Main Findings: Six major problems in service provision were identified. The developed model consisted of six components: (1) nursing practice guidelines; (2) an eight-step counseling process; (3) a standardized documentation and instrument system; (4) a personnel competency development system; (5) a monitoring and evaluation system; and (6) quality indicators. The model and research instruments were evaluated for content validity by three experts. The reliability coefficients of the service recipient and healthcare provider assessment instruments were 0.97 and 0.99, respectively. Following implementation of the model, healthcare providers' competency scores increased from 3.42 ± 0.38 to 4.58 ± 0.29, with a mean difference of 1.16 points (95%CI 1.01–1.31, p < .001). The rate of pre-counseling assessment increased from 73.3% to 100.0%, complete documentation increased from 70.0% to 96.7%, and service recipient follow-up increased from 66.7% to 93.3%. Service recipient satisfaction increased from 3.76 ± 0.41 to 4.71 ± 0.25, with a mean difference of 0.95 points (95%CI 0.81–1.09, p < .001).

Conclusion and recommendations: The developed nursing service model effectively improved service quality and safety, healthcare provider competency, and service recipient satisfaction. The model should be adapted for similar healthcare settings, with continuous competency development and monitoring of quality indicators to promote sustainable service improvement.