Nursing and nursing education in Thailand: the past, the present, and the future.
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Biomedical subjects
Publications and source records attributed to Wipada Kunaviktikul.
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An intensive care unit (ICU) is valuable but consumes a disproportionately high amount of health-care resources. Accordingly, cost containment has been deemed a mandatory task. A review of the literature from many countries was completed to determine the strategies for reducing the cost of care in the ICU. The results of this review show that cost reduction can be achieved by using a variety of the following strategies: (i) instituting a closed ICU, where all the patient care is directed by intensivists or full-time critical care trained physicians; (ii) the utilization of interdisciplinary approaches to the care of patients in the ICU; (iii) developing and implementing a program of television-guided remote intensivists; (iv) the use of an alerting and reminding system; and (v) increasing the number of intermediate care beds for patients who require only monitoring and intensive nursing. The conclusion reached is that many of these strategies provide evidence for hospital manager decisions regarding cost containment strategies for the delivery of health care in the ICU.
In Thailand, quality of nursing care has been defined. The next step is to determine how to measure quality. Given the limited resources to provide health care and the demands to justify the use of registered nurses, there is an urgent need to demonstrate how professional nursing care makes a difference to outcomes of care. The purpose of this study was to further refine nursing indicators of quality by developing operational definitions, validating them and then determining their applicability in a variety of clinical settings. The process included three phases. The first phase used focus groups to identify and define indicators of quality nursing care and the second phase included testing these indicators in four settings to determine if data could be collected. Manuals were developed that defined the quality indicators and the scoring system to be used in the assessment. In the third phase, the findings were presented to a group of experts and minor changes were made to the indicators. Then, the indicators were categorized into three groups: structure, process, and outcome. The validated outcomes and manual for their assessment and monitoring were sent to all hospitals in Thailand. The study relied upon the findings from the four different hospitals. If the indicators were implemented in a wider variety of settings, other differences might have emerged. There is also a possibility that 'best practice' might not be reflective of the scientific basis of nursing practice. The findings generally support the initial work carried out in the USA. There is a need to continue to study how these indicators can improve patient outcomes.
This article presents the derivation of moral competence in nursing practice by identifying its attributes founded on Thai culture. In this process moral competence is formed and based on the Thai nursing value system, including personal, social and professional values. It is then defined and its three dimensions (moral perception, judgment and behavior) are also identified. Additionally, eight attributes as indicators of moral competence are identified and selected from three basic values. The eight attributes are loving kindness, compassion, sympathetic joy, equanimity, responsibility, discipline, honesty, and respect for human values, dignity and rights. All attributes are discussed by addressing the three moral dimensions in order to present how to deal with ethical issues in nursing practice. As a summary, a model of moral competence is presented to demonstrate moral competence in nursing practice in Thailand.
Only within the last 3 decades have a select number of countries addressed issues surrounding the all-inclusive health and well-being of women. This factor has had a major influence on nursing education within these countries and the subsequent development of curricula. Because the preparation of nurses is pivotal in shaping a society's health care agenda, this article compares and contrasts demographic characteristics, curricular frameworks, the role of the nurse, quality control of nursing curricula, and the focus of nursing courses related to women's health care among the countries of Australia, Japan, South Korea, and Thailand. Recommendations based on infant mortality rates, life expectancy, leading causes of death, and country-based health care issues are provided to inform and guide the future focus of nursing education courses on women's health care within these countries.