The Effects of Nursing Guideline for Monitoring Critical Risk Early Warning Score Among Pneumonia Pediatric Patients at Srisangwornsukhothai Hospital.

Abstract

Pneumonia is a major public health problem in children, particularly among those under five years of age who are at high risk of hypoxemia, respiratory failure, and potential progression to critical conditions if timely monitoring is not provided. Although the Pediatric Early Warning Score (PEWS) system effectively screens disease severity, it has limitations in its application in community hospitals. Therefore, a nursing guideline for monitoring early warning signs of critical illness, namely the SSW-PEWS, was developed for pediatric patients with pneumonia at Srisangworn Sukhothai Hospital. The objectives of this study were: (1) to examine the effects of using the SSW-PEWS guideline for monitoring early warning signs of critical illness in pediatric patients with pneumonia; (2) to compare the mean knowledge scores and satisfaction levels of nurses before and after implementing the guideline; and (3) to descriptively compare the incidence of unplanned admission to the intensive care unit, unplanned endotracheal intubation, unplanned cardiopulmonary resuscitation, and emergency patient referral after the implementation of the guideline. The study sample consisted of 15 registered nurses and 42 pediatric patients with pneumonia aged 1 month to 15 years. Research instruments included the SSW-PEWS guideline, a knowledge test, a nurse satisfaction questionnaire, and an incidence record form. Data were analyzed using the paired- samples t-test and descriptive statistics. The results revealed that nurses’ knowledge scores after using the guideline were significantly higher than before implementation (p < .05). Nurses’ satisfaction with the guideline was at a high level. After implementation, no incidences of unplanned endotracheal intubation or unplanned cardiopulmonary resuscitation were found in the experimental group (0%), whereas the control group showed an incidence rate of 3.12%. These findings indicate that the SSW-PEWS guideline enables nurses to effectively monitor changes in patients’ conditions, reduce disease severity, and enhance patient safety among pediatric patients at Srisangworn Sukhothai Hospital.