การพัฒนารูปแบบการพยาบาลเพื่อป้องกันการแพร่กระจายเชื้อดื้อยาต้านจุลชีพในหอผู้ป่วยใน โรงพยาบาลโพนทอง จังหวัดร้อยเอ็ด

Ranjuan  Krueawan

Authors

Ranjuan Krueawan Phonthong Hospital

Keywords:

Development of nursing model, Antimicrobial Resistance, Infection Control

Abstract

Purposes: To develop and evaluate a nursing model for preventing the spread of antimicrobial-resistant (AMR) infections at Phon Thong Hospital, Roi Et Province.

Study design: This study employed a Research and Development (R&D) design.

Materials and Methods: The sample consisted of 45 professional nurses working at Phon Thong Hospital. The research was divided into three phases: situational analysis and identification of related factors; development of the nursing model; and implementation and evaluation. Data were collected using knowledge tests, practice assessment forms, and satisfaction questionnaires. Statistical analysis included frequency, percentage, mean, standard deviation, and paired t-test, with a significance level set at .05.

Main findings: The developed nursing model comprised the enhancement of nursing knowledge and competency, standardized nursing practice guidelines, surveillance and supervision systems, and continuous evaluation and improvement. This model was clear and well-suited to the community hospital context. Following implementation, the results showed that: Professional nurses had significantly higher knowledge scores regarding AMR prevention compared to the pre-implementation phase (p < .05).Correct practices in preventing and controlling the spread of AMR infections significantly increased, particularly in hand hygiene (5 Moments), use of personal protective equipment (PPE), and patient or equipment isolation. Overall satisfaction with the nursing model among professional nurses was at the highest level.

Conclusion and recommendations: The developed nursing model effectively improved nursing knowledge and practice and achieved high satisfaction levels. It is recommended that this model be implemented as a standard practice guideline in inpatient wards. Furthermore, future studies should examine long-term outcomes or apply the model in other hospital contexts to confirm systemic effectiveness.

References

World Health Organization. Global antimicrobial resistance and use surveillance system (GLASS) report 2023. Geneva: World Health Organization; 2023.

Antimicrobial Resistance Collaborators. Global burden of bacterial antimicrobial resistance in 2019: a systematic analysis. Lancet. 2022;399(10325):629-55.

O’Neill J. Tackling drug-resistant infections globally: final report and recommendations. London: Review on Antimicrobial Resistance; 2016.

World Health Organization. Antimicrobial resistance country profile: Thailand. Geneva: World Health Organization; 2018.

Phumart P, Phodha T, Thamlikitkul V, Riewpaiboon A. Health and economic impacts of antimicrobial resistance in Thailand. J Health Serv Res Policy. 2019;24(2):109-16.

โรงพยาบาลโพนทอง. รายงานสถานการณ์การติดเชื้อดื้อยาต้านจุลชีพในโรงพยาบาลโพนทอง จังหวัดร้อยเอ็ด. ร้อยเอ็ด: โรงพยาบาลโพนทอง; 2566.

Huttner B, Harbarth S, Carlet J, Cosgrove S, Goossens H, Holmes A, et al. Antimicrobial resistance: a global view from the 2013 World Healthcare-Associated Infections Forum. Antimicrobial Resistance and Infection Control. 2013;2(1):31.

Zingg W, Holmes A, Dettenkofer M, Goetting T, Secci F, Clack L, et al. Hospital organisation, management, and structure for prevention of health-care-associated infection: a systematic review and expert consensus. Lancet Infect Dis. 2015;15(2):212-24.

World Health Organization. Guidelines on core components of infection prevention and control programmes at the national and acute health care facility level. Geneva: World Health Organization; 2021.

Courtenay M, Castro-Sánchez E, Gallagher R, Gould D, Hawker C, Nurse N, et al. Delivery of antimicrobial stewardship competencies in UK pre-registration nurse education programmes: a national cross-sectional survey. J Hosp Infect. 2019;101(4):431-7.

Ivers N, Jamtvedt G, Flottorp S, Young J M, Odgaard-Jensen J, French SD, et al. Audit and feedback: effects on professional practice and healthcare outcomes. Cochrane Database Syst Rev. 2012;(6):CD000259.

อารยา ทิพย์วงศ์, สมใจ ศิริอุดมภาส, พิมพรรณ นามสมมติ. ผลของการนิเทศทางคลินิกแบบมีส่วนร่วมต่อพฤติกรรมการป้องกันและควบคุมการติดเชื้อของพยาบาลวิชาชีพในโรงพยาบาลระดับตติยภูมิ. วารสารสภาการพยาบาล. 2563;35(2):45-58.

Damschroder L J, Aron D C, Keith R E, Kirsh S R, Alexander J A, Lowery J C. Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implement Sci. 2009;4:50.