Quality Improvement of Sepsis Care in Inpatient Department Using NEWS Score and Early Interventions at Kham Muang Hospital, Kalasin Province

Abstract

            This study aimed to evaluate the effectiveness of using the NEWS Score combined with early interventions in developing a care system for patients with bloodstream infections in the inpatient department of Kham Muang Hospital, Kalasin Province. A participatory action research methodology was employed, integrating both quantitative and qualitative approaches. The sample consisted of 120 patients, divided equally into two groups: those before protocol implementation (60 patients) and those after protocol implementation (60 patients). Data collection instruments included patient record forms, satisfaction questionnaires, and in-depth interviews. Data were analyzed using both descriptive and inferential statistics, as well as qualitative content analysis.

            The findings revealed that complete NEWS Score assessments significantly increased from 41.7% to 95.0% (p<0.001), while compliance with the Sepsis Bundle improved from 15.0% to 73.3% (p<0.001). The average time to antibiotic administration decreased significantly from 2.4 ± 1.8 hours to 0.8 ± 0.4 hours (p<0.001), and the average time to lactate measurement declined from 1.8 ± 1.2 hours to 0.6 ± 0.3 hours (p<0.001). Patient mortality decreased significantly from 6.7% to 0% (p=0.041), and the average length of hospital stay was reduced from 8.6 ± 5.2 days to 6.8 ± 4.1 days (p=0.043). Healthcare personnel reported high levels of satisfaction with the protocol (mean score 4.28 ± 0.52 out of 5), with 97.1% recommending its adoption by other community hospitals. In conclusion, the implementation of the NEWS Score combined with early interventions significantly enhanced both the care process and clinical outcomes for patients with bloodstream infections. The results demonstrate the feasibility and potential for scaling up this protocol to other community hospitals with similar contexts, thereby improving care quality and reducing healthcare disparities.