Development of Nursing Practice Guideline to Prevent and Control the Spread of Drug-Resistant Infections in Male Medicine Ward, Nong Bua Lamphu Hospital

Abstract

The objective of this intervention research with historical control design was to study results of the developed nursing practices guideline to prevent and control the spread of drug-resistant infections among patients with all diseases as compared to regular practices in a male medical ward, Nong Bua Lamphu hospital. The study used a retrospective data collected in July 2023 for the group using the regular practices. The group that used the newly developed nursing practice guidelines were collected prospectively from October to November 2023. The data from both groups were analyzed using frequencies, means, standard deviations and percentages. The primary outcome was drug-resistant hospital-acquired infection from both groups were compared using multivariable risk difference and multivariable mean difference regressions.

The total 195 patients’ age ranged from 18-95 years old with an average age of 58.0 (±16.6) years. After adjusting for variables including age, BMI, diagnosis, comorbidities, history of alcohol use, antibiotics used and community acquired drug-resistant infections, the developed nursing practices guideline could significantly reduce drug-resistant infections in hospitals by 17% (95%CI: 0.26, -0.08) (p<0.001); reduce respiratory infection with drug-resistant bacteria by 10% (95%CI: -0.17, -0.03) (p=0.005), and reduce urinary tract infection by 4% (95%CI:-0.09, -0.00) (p=0.038). No significant decrease was found in the circulatory system (4%; 95%CI: -0.11, 0.01; p=0.087) and length of hospital stay (2 days; 95%CI:-5.09, 0.57; p=0.097). The developed nursing practices can reduce drug-resistant infections in hospitals and can be applied in other settings.