The Caring Model development of Neonatal Sepsis at Somdet Phra Phutthaloetla Hospital in Samutsongkhram Province

Abstract

               Sepsis is life-threatening for neonates. Their care needs an appropriate model and clear nursing guidelines. This action research aims to develop a care model for neonatal sepsis at Somdet Phra Phutthaloetla Hospital, and examine care outcomes based on both Donabedian’s model and the Iowa model of evidence-based practice. Subjects were 71 nurses, 86 live births and 11 neonates who were diagnosed with neonatal sepsis. The research progressed sequentially through the following four steps: 1) Situation analysis 2) Model development for clinical nursing 3) Implementation of the Model in Actual Cases, and 4) Evaluation of the Model Outcomes. Research tools included: A review of medical record forms for neonatal sepsis, a questionnaire of care situations for neonatal sepsis, a knowledge test for those who treat neonatal sepsis, a satisfaction assessment form to evaluate the care model, data collection assessment through neonate data forms and evaluation results during and after implementation. Data were analyzed using content analysis, descriptive statistics, and paired t–test.

             The results showed a care model for neonatal sepsis with 3 components: The first component was a structure that included set policies and goals, development of registered nurses’ knowledge, and management of medical equipment. The second component was a process including identification of neonatal sepsis with neonates at high risk, identification of the pathogen, the source of infection and infection control, resuscitation of the circulatory system, organ support with intensive monitoring, and multidisciplinary care for neonatal sepsis with follow-up practice. The third component was the outcome for patients and nurse practitioners after using the care model. Outcomes of the development indicated that the patient’s incidence of severe sepsis and septic shock was 9.09; the mortality rate was 0. Nurses had increased mean scores of knowledges (p < 0.05); good levels in practice. Nurse satisfaction with the care model was very good. The neonatal sepsis care model’s development was appropriate to its specific context, increased knowledge of nurses, and applicable in the work process to reduce mortality rate from neonatal sepsis. This model is recommended for further application for high- quality nursing development.