การพัฒนาแนวปฏิบัติการพยาบาลในการบริหารยาที่มีความเสี่ยงสูงในหอผู้ป่วยทารกแรกเกิดวิกฤต

Abstract

This developmental research aimed to develop and evaluate nursing practice guidelines for high-alert drug administration in the Neonatal Intensive Care Unit (NICU) at Khon Kaen Hospital. The study followed the eight-step framework of the National Health and Medical Research Council (NHMRC). Purposive sampling was used to select 20 registered nurses and 100 neonatal patients who received high-alert drugs between January and February 2025. Research instruments included the nursing practice guidelines for high-alert drug administration, a knowledge test, a compliance assessment form, and a monitoring-surveillance form. Content validity of the instruments was confirmed by three experts, with a validity index of 1.0. The developed guidelines consisted of three phases: (1) nursing practice before administering high-alert drugs, (2) during administration, and (3) after administration. Implementation of the guidelines resulted in significantly improved nurse knowledge post-intervention compared to pre-intervention (p < 0.1). Compliance with the guidelines was rated at the highest level, and overall nursing performance was also at the highest level. Furthermore, the incidence of medication errors classified as Level E showed a decreasing trend from 2021 to 2023, with rates of 3.80, 1.98, and 1.13 per 1,000 bed days, respectively. No patients experienced harm or adverse reactions from high-alert drugs.