Development of a Carbapenem Resistance Enterobacteriaceae Spread Prevention Model in Hematology and Oncology Medicine Ward, Suratthani Hospital

Abstract

The rate of CRE-resistant infection in the ward, blood disease and cancer tends to increase, affecting the patient's risk of death. However, there is no clear pattern of prevention for the spread of drug-resistant infection appropriate to the ward's context. This action research aimed to develop and evaluate the outcome of a targeted CRE-resistant spread prevention model divided into two groups: 1) newly-admitted patients of the wards, blood disease and cancer. 270 persons 2) Care workers involved in 2 groups: management And a group of 32 practitioners implementing action research concepts Between December 2018 - July 2019, the tool for collecting data was the drug-resistant infection assessment form of Surat Thani Hospital. Semi-structured interview form And observation form to monitor practice Check the validity of the content. The reliability was determined by the Intra-rater reliability method of 1. The qualitative data were analyzed by content analysis. And quantitative data were analyzed by frequency and percentage values.

The results showed that (1) the anti-transmission model of CRE group was composed as follows: 1) screening for risk groups 2) knowledgeable staff 3) hand washing 4) isolation of patients and communicating information 4 ) Wearing body protection, 5) taking a shower with 4% CHG, and 5) cleaning the environment And (2) The outcome of CRE spread Prevention Model was followed by 89.66% in Screening,  83.98%  in Isolation and Information, 84.70% in Hand Hygiene & PPE, 81.50% in Isolation equipment, 84.50% in Daily cleaning environment and  91.50% in Post Discharge cleaning environment.  CRE infection rate  decrease from 0.52%  to 0.24%  in June 2019.

The results of this research could be applied to prevent the spread of CRE-resistant bacteria in other wards with similar contexts.