The Effects of Development Activities to Improve Nursing Care Knowledge and Skills for Multiple Trauma Patients at Wang Nam Khiao Hospital

Abstract

Objective: To evaluate the effectiveness of a knowledge and skills development program for professional nurses caring for multi-system trauma patients during inter-hospital referral at Wang Nam Khiao Hospital.

Methods: A quasi-experimental, one-group pretest-posttest design was used. The sample comprised 30 professional nurses responsible for patient care during referral. Participants underwent a structured development program consisting of didactic lectures and individualized simulation-based skill training in caring for multi-system trauma patients during referral. Knowledge and skills were assessed using a purpose-designed instrument before the intervention and again within one month afterward. Descriptive statistics were used to summarize general data. The Wilcoxon signed-rank test was used to compare overall pre- and post-intervention knowledge and skill scores, while the Wilcoxon rank-sum test was used to compare the degree of improvement between nurses from other departments and those from the emergency department. Effect sizes were calculated to evaluate the magnitude of change resulting from the development activities.

Results: Following the intervention, knowledge scores rose significantly from a median of 2.2 (IQR 2.0–2.5) to 3.7 (IQR 3.6–4.4) (mean: 2.4 → 3.9, SD: 0.7 → 0.6; r = 0.620), and skill scores increased significantly from a median of 3.7 (IQR 3.2–4.0) to 4.6 (IQR 4.3–4.8) (mean: 3.7 → 4.5, SD: 0.5 → 0.3; r = 0.609) (both p-value < 0.01, large effect sizes). When comparing the two groups of nurses, those from other departments showed significantly greater improvement than nurses from the emergency department in both knowledge (medium effect size; p-value = 0.02, r = 0.425) and skills (large effect size; p-value < 0.01, r = 0.679). This difference likely reflected a ceiling effect, as nurses from the emergency department already had higher baseline knowledge and skill levels prior to the intervention.

Conclusion: The knowledge and skills development program significantly enhanced the competency of professional nurses in caring for multi-system trauma patients during inter-hospital referral, with large effect sizes for both knowledge and skills, and helped narrow the competency gap between nurses from the emergency department and nurses from other departments. This program should be extended through systematic and continuous training to support standardized care, improve referral practice, and enhance patient safety.

Keywords: Multiple trauma patients, Patient referral, Registered nurses, Knowledge and skills, Development activities