Development of Nursing Service System in Chaloem Phrakiat 60th Birthday Anniversary Nawaminthachini Health Centers and Sub-district Health Promoting Hospitals under the Provincial Administrative Organizations.

Abstract

This research and development project aimed to develop, evaluate the effectiveness of, and provide policy recommendations for the nursing service system in the Chalerm Phrakiat 60th Anniversary Nawamintharachini Health Stations (CHC) and the Sub-district Health Promoting Hospitals (HPH) under the Provincial Administrative Organization (PAO). The study was conducted between March 2023 and September 2024 and was divided into three phases: Phase 1: Investigated the current situation of the nursing service system. The sample included (1) two PAO administrators and (2) 147 nurses. Phase 2: Developed and tested the nursing service system. The sample consisted of five experts and 71 nurses. Phase 3: Studied the effectiveness of the nursing service system. The sample included 71 nurses and three administrators from the PAO, CHC, and HPH.
The study results showed that the developed nursing service system consisted of four components: (1) Guidelines for organizing the nursing service system, (2) A capacity-building program for nurses, (3) Guidelines for nursing supervision, and (4) Guidelines for collecting nursing indicators. The effectiveness study revealed that the knowledge scores of professional nurses significantly increased after using the nursing service system and the capacity-building program, with statistical significance at the 0.05 level. The professional nurses demonstrated a better understanding of their roles and had a high level of agreement regarding their ability to follow the nursing service system guidelines. They were also highly satisfied with the nursing service system. Service recipients reported a high level of overall satisfaction with the nursing service system. Nursing outcomes significantly improved compared to before the implementation of the nursing service system, with statistical significance at the 0.05 level. The developed nursing service system was found to be appropriate, flexible, adaptable, and applicable in real-world scenarios. Policy recommendations for the PAO included establishing a Memorandum of Understanding (MOU) with the Provincial Public Health Office in each province, prioritizing the capacity-building of professional nurses, and aligning nursing workforce planning with the designated staffing framework. For the Ministry of Public Health, the recommendations included assigning clear responsibility for nursing supervision, monitoring, and quality control, as well as providing technical support. The Ministry should also focus on preparing personnel for the transfer to the PAO.