Developing Quality Assurance (QA) Nursing Service Models for Hospitals under the Sisaket Provincial Public Health Office

Abstract

This action research aimed to study the situation, development process, and outcomes of nursing service quality development to ensure nursing quality assurance (QA) certification at hospitals under the Sisaket Provincial Public Health Office. The study was conducted using one cycle of four steps: plan, act, observe, and reflect, from May 2024 to February 2025. Participants were purposively selected, comprising 45 nursing group leaders and department heads from seven community hospitals. Data were collected through questionnaires, focus group discussions, and document analysis. Quantitative data were analyzed using descriptive statistics including frequency distribution and percentages, while qualitative data were analyzed through categorization and thematic summary.

                 The research results revealed that before development in all seven community hospitals, there were four main challenges: lack of personnel knowledge and understanding, complex self-assessment report writing, resource constraints, and limitations in external evaluation processes. Development was implemented through five main plans: personnel capacity building, supervision and empowerment, knowledge sharing, networking, and monitoring and evaluation. Post-development findings showed that high-level knowledge of nursing quality assurance increased from 95.56% to 100%, high-level knowledge of self-assessment increased from 33.33% to 84.44%, high-level positive attitudes increased from 82.22% to 91.11%, and all seven hospitals were able to submit applications for nursing quality assurance certification, with two hospitals already certified. This study developed the "QA 5 Steps Sisaket Model" comprising five key components: 1) policy and leadership support, 2) personnel capacity development, 3) supervision and empowerment system, 4) networking and knowledge sharing, and 5) monitoring and evaluation system.

                 The developed model effectively enhanced knowledge, attitudes, and readiness of community hospitals for nursing quality assurance certification. The study recommends scaling up this model to neighboring provinces.