Management Model for Nursing Service Quality Developing of Palliative Care in Songkhla Hospital

Abstract

This action research aimed to: 1) study problems and needs of management, 2) construct a model in management to improve patients' quality of life and end-of-life care, and 3) study the results from the application of a model of management. Palliative care nurses and patients from 12 wards in Songkhla hospital were involved as the participants. The instruments consisted of a data recording form, a semi-structure focus group discussion, and a nursing service quality assessment form and satisfaction questionnaire. Descriptive statistics were used to analyze quantitative data and content analysis was used for the qualitative data. The results revealed that;

1. 1. The major problems and needs for management were unclear structure and management, insufficient knowledge and skills of the personnel in taking care of end-of- life palliative patients, lack of continuous supervision and nursing care audit according to the standard and career ethics. Moreover, there were also limitation in workloads and coordination in transferring for continuous cares.


2. The model of management to improve the quality of nursing care was called “SK-PCN-CARE Model”.  This model consisted of structure, outcome, nursing standard, guideline and pathway, knowledge and skills, holistic care, learning, audit and review, patient center, communication, network and teamwork, clinical supervision, advance plan and discharge planning, resource and relationship, evaluation and quality improvement.


3. Nurses are satisfied with a model that can integrate management with nursing services by making it easier to perform and gained more knowledge from learning with practice. Moreover, it is able to cover holistic care and add value to oneself and profession. The overall nursing services quality was at a good level. The overall patients and their family’s satisfaction score were at a high level (M = 4.21, SD = .53).