Development of Nursing Administration Model in the COVID-19 Outbreak Situation of Hospitals under the Ministry of Public Health

Abstract

The objectives of study were to explore the situation, develop a nursing administration model, and evaluate the use of the model in the COVID-19 outbreak situation of the hospitals under the Ministry of Public Health. It was conducted in the tertiary hospitals, covering 13 health regions nationwide and consisted of 3 phases: (1) studying the situation, (2) developing and testing the model, and (3) evaluating the model. The samples in phases 1 and 2 consisted of 59 chief nurses in the 13 tertiary hospitals. The samples in phase 3 included 13 head nurses, 316 nurse administrators, 545 staff nurses, and 616 suspected/confirmed COVID-19 cases recieving medical service during 1-28 February 2021. Data were collected using mixed method, both quantitative and qualitative approaches. The research instruments were: (1) nursing administrative manual in the COVID-19 situation, assessed for content validity by 5 experts with CVI 0.80, and (2) data collecting tools which included a survey and a brainstorming guides on the management of situation, guidelines to monitor the model implementation, group discussion guidelines to evaluate the model, administrative readiness assessment form, the suspected/confirmed case’s perception on administrative readiness inquiry, opinion towards the model, and the nurse’s self-efficacy questionnaire. The quantitative data were analyzed using descriptive statistics; and the qualitative data using content analysis. The findings showed that the 13 tertiary hospitals did manage the administrative nursingcare accordingtothe situation. There wasneither well-definednursing management model employed nor continued the administrative nursing care to cover the after-COVID-19 outbreak phrase. The model development identified 3 components of the nursing care: (1) the emergency nursing response operations center, (2) the assessment of nursing management readiness, and (3) the COVID-19 outbreaknursing management guidelines, that covered the 3 phases (before, during, and after) of the outbreak. The findings on the model evaluation found that the chief nurses and the nurse-administrators towards the model were at a high level and this model was quite practical and could apply to other hospitals as well as other infectious diseases (Mean=4.58, SD=0.58; Mean=4.54, SD=0.60, Mean=4.61, SD=0.58 respectively). The suspected/confirmed COVID-19 cases rated the nursing administrative readiness at a high level (Mean=4.35, SD=0.41) and they were satisfied with the nursing service provision at a high level (Mean=4.30, SD=0.45). The nurses also perceived their competencies towards COVID-19 practices at a high level (Mean=4.55, SD=0.44) and they feel confident on the measures launched by their organizations at a high level (Mean=4.40, SD=0.53). There was no infection among nurses during practice; and also no spreading among infected or suspected cases before and after implementation of the model in 13 tertiary hospitals.