The development of guidelines for preventing the spread of drug-resistant infections in the inpatient department of Phromphiram Hospital, Phitsanulok Province

Abstract

This action research aimed to develop practice guidelines for preventing the spread of drug-resistant infections in the inpatient department, Phrom Phiram Hospital, Phitsanulok Province. The sample consisted of 14 registered nurses. The study employed a four-step action research process: planning, action, observation, and reflection. Research instruments included in-depth interview guides, focus group discussion guides, the practice adherence evaluation form, the guideline appropriateness assessment tool, the satisfaction questionnaire, and the drug-resistant infection surveillance record. Data were collected through questionnaires, observations, and interviews. Qualitative data were analyzed using content analysis, while quantitative data were analyzed using frequency, percentage, mean, and standard deviation.

The findings revealed that the infection prevention practice guidelines comprised 12 components:1)patient isolation and zoning, 2) hand hygiene, 3) use of personal protective equipment (PPE), 4) separation of medical equipment and supplies, 5) disinfection of medical equipment, 6) management of patient-used linens, 7) patient transport, 8) environmental control, 9) specimen collection, 10)Patient admission and transfer, 11) patient and family education, and 12) discontinuation of contact precautions for specific resistant organisms. Nurses were able to comply with the developed guidelines at a high level. The guidelines were rated as most appropriate for implementation, and registered nurses expressed the highest level of satisfaction with the guidelines. Regarding patient outcomes, the hospital’s rate of drug-resistant infections was reduced to 0.00 per 1,000 patient-days, and no patient deaths from drug-resistant infections were reported. Therefore, the developed guidelines should be expanded and implemented in other community hospitals.