Development of Nursing Guideline for Prevention and Control of Carbapenem Resistant Enterobacteriaceae (CRE) in Pediatric Patients Care
Keywords:Carbapenem resistant Enterobacteriaceae (CRE), Guideline for Prevent and Control drug resistance, The promotion of knowledge and practical support
Objectives: The purposes of this study were to develop and study the effect of using nursing guideline for prevention and control of Carbapenem Resistant Enterobacteriaceae (CRE) in pediatric patients care. This research consisted of 2 study cycles: Cycle 1: Development and study the effect of using nursing guideline. Cycle 2: Study the effect of using nursing guidelines after promoting knowledge and supporting according to the PRECEDE - PROCEED model. Methods: This study is an action research. The sample group of professional nurses in CRE Infection Ward at Queen Sirikit National Institute of Child Health was divided into 2 groups, 40 persons in each cycle. The data were analyzed by percentage, mean and standard deviation and test the statistically significant difference of the arithmetic mean to compare the results of cycle 1 and cycle 2 with independent t-test. Results: Nursing guideline for prevention and control of CRE in pediatric patients care includes hand hygiene, contact precautions, educating for personnel patients and relatives, cohorting patients and staff, communication, environmental cleaning, CRE screening and active surveillance testing. Problems and obstacles of the implementation are the lack of knowledge and confidence in practice, complexity of the procedures, inadequate personal protective equipment, insufficient disinfectants, being blamed or punished. After the development of guidelines with the promotion of knowledge and practical support according to the PRECEDE - PROCEED model, the professional nurses were knowledgeable, satisfied, and able to follow the guidelines more accurately, at 0.01 and 0.05 significant level. The incidence of CRE after the development of guidelines with the promotion of knowledge and practice, was lower than in the first cycle, at 0.01 significant level. Conclusion: Strengthening knowledge and supporting compliance with problems and obstacles helping nurses to follow better guidelines
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