Transforming Care at the Bedside: Enhancing Nurses Compliance for Preventing the Transmission of Multidrug-resistant Organisms
Keywords:
Transforming Care at the Bedside, Nurses Compliance, Preventing the Transmission of Multidrug-resistant OrganismsAbstract
Hospital-acquired infections from multidrug-resistant organisms are an increasingly common problem. Nurses play a dominant role in preventing the spread of multidrug-resistant infections.
Objective: This quasi-experimental research aimed to compare the practice of nurses in preventing the spread of multidrug-resistant organisms and the incidence of drug-resistant infections before and after the practice promotion. The sample consisted of 51 nurses in 2 internal medicine wards. The research was conducted from May 2020 to April 2021 using the concept of Transforming Care at the Bedside (TCAB).
Methods: The study's instruments included a demographic data questionnaire, a compliance recording form, and an incidence record form. Data were analyzed using descriptive statistics and a chi-square test.
Result: Results showed that applying the TCAB concept significantly raised nurses' compliance practices from 44.3% to 80% (p<.001). Hospital-acquired infections caused by multidrug-resistant organisms fell from 1.36 to 0.97 per 1,000 hospital days.
Conclusion: Research indicates that using the TCAB concept to increase nurses' compliance can help to reduce the incidence of infections caused by drug-resistant organisms.
References
World Health Organization. Antimicrobial resistance global report on surveillance. [Internet]. 2014. Available from: https://apps.who.int/iris/bitstream/handle/ 10665/112642/9789241564748_eng.pdf?sequence=1&isAllowed=y [cited 2020 Jan 10].
Centers for Disease Control and Prevention. (2019). Antibiotic resistance threats in the United States. [Internet]. 2019. Available from: https://www.cdc.gov/drugresistance/pdf/threats-report/2019-ar-threats-report-508.pdf [cited 2020 Jan 10].
European Centre for Disease for Prevention and Control. Summary of the latest data on antibiotic resistance in the European Union. [Internet]. 2014. Available from: https://www.ecdc.europa.eu/sites/portal/files/media/en/publications/Documents/antibiotic-resistance-in-EU-summary.pdf [cited 2020 Jan 10]
Shenoy ES, Paras ML, Noubary F, Walensky RP, Hooper DC. Natural history of colonization with methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin-resistant Enterococcus (VRE): a systematic review. BMC Infectious Disease, 2014;14(1):177-89.
Morgan DJ, Rogawski E, Thom KA, Johnson JK, Perencevich EN, Shardell M, et al. Transfer of multidrug-resistant bacteria to healthcare workers’ gloves and gowns after patient contact increases with environmental contamination. Crit Care Med, 2012;40(4):1045–51.
Knoester M, De Boer MG, Maarleveld JJ, Claas EC, Bernards AT, de Jonge E, et al. An integrated approach to control a prolonged outbreak of multidrug-resistant Pseudomonas aeruginosa in an intensive care unit. Clin. Microbiol. Infect, 2014;20(4):O207-15.
Centers for Disease Control and Prevention. Management of multidrug-resistant organisms in healthcare setting. [Internet]. 2006. Available from: https://www.cdc.gov/infectioncontrol/pdf/guidelines/mdro-guidelines.pdf [cited 2020 Jan 12].
Dhar S, Marchaim D, Tansek R, Chopra T, Yousuf A, Bhargava A, et al. Contact precautions more is not necessarily better. [Internet]. 2014. Available from: https://www.mc.vanderbilt.edu/documents/infectioncontrol/files/Dhar%20Contact%20Precautions%20ICHE%202014.pdf [cited 2020 Jan 12]
สมฤดี ชัชเวช, รุ่งฤดี เวชวนิชสนอง, กุสุมา บุญรักษ์, ไพจิตร มามาตย์, ไพรัช พิมล, สุพรรษา บุญศรี. ผลของการนำแนวปฏิบัติการป้องกันและควบคุมการแพร่กระจายเชื้อแบคทีเรียดื้อยาไปใช้ ในหอผู้ป่วยหนักอายุรกรรม โรงพยาบาลระดับตติยภูมิ. วารสารวิชาการแพทย์ เขต 11, 2560;31(4):697-708.
Institute for Healthcare Improvement (IHI). Transforming Care at the Bedside (TCAB) How-to Guide: Spreading Innovations to Improve Care on Medical and Surgical Units. Cambridge. [Internet]. 2008. Available from: http://forces4quality.org/af4q/download-document/3981/Resource-TCABSpreadingInnovationsHowtoGuideSep09.pdf [cited 2020 Jan 12].
Attachit K, Jaidee U, Tuandoung P, Kamswang, N. Results of Transforming Care at Bedside (TCAB) nursing program on the occurrence of unplanned extubation. Buddhachinaraj Med J, 2020;37(2):128-35.
John ME, Samson-Akpan PE, Nsemo AD. Transforming nursing care at patients' bedside in low resource settings: A Study of four hospitals in southern Nigeria. Nur Primary Care, 2021;5(3)02:1-6.
โรงพยาบาลชัยภูมิ. สรุปผลการดำเนินงานประจำปีการควบคุมและป้องกันการติดเชื้อ 2562. ชัยภูมิ: งานควบคุมและป้องกันการติดเชื้อในโรงพยาบาล โรงพยาบาลชัยภูมิ, 2562.
Livshiz-Riven I, Borer A, Nativ R, Eskira S, Larson E. Relationship between shared patient care items and healthcare-associated infections: a systematic review. Int J Nurs Stud, 2015;52(1):380-92.
McDonald EG, Dendukuri N, Frenette C, Lee TC. Time-series analysis of health care–associated infections in a new hospital with all private rooms. JAMA internal medicine, 2019;179(11):1501-6.
Stiller A, Salm F, Bischoff P, Gastmeier P. Relationship between hospital ward design and healthcare-associated infection rates: a systematic review and meta-analysis. Antimicrob Resist Infect Control, 2016;5(1):1-10.
พรพิมล อรรถพรกุศล, พรนภา เอี่ยมลออ, จิราภรณ์ คุ้มศรี, สินจัย เขื่อนเพชร, นิภาพร ช่างเสนา, นัยนา วัฒนากูล. ผลลัพธ์ของการใช้แนวปฏิบัติการพยาบาลในการป้องกันและควบคุมการติดเชื้อดื้อยาต้านจุลชีพโรงพยาบาลนพรัตนราชธานี. APHEIT Journal of Nursing and Health, 2021;3(3):e2685.
Burston S, Chaboyer W, Gillespie B, Carroll R. The effect of a transforming care initiative on patient outcomes in acute surgical units: a time series study. Journal of Advanced Nursing, 2015;71(2):417-29.
O'Hara LM, Nguyen MH, Calfee DP, Miller LG, Pineles L, Magder LS, et al. CDC Prevention Epicenters Program. Risk factors for transmission of carbapenem-resistant Enterobacterales to healthcare personnel gloves and gowns in the USA. Journal of Hospital Infection, 2021;109:58-64.
Sreshtaa VS, Geetha RV. Role of Hand washing and Hand Sanitising in Preventing Infection. Annals of the Romanian Society for Cell Biology, 2021;724-37.
Needleman J, Pearson ML, Upenieks VV, Yee T, Wolstein J, Parkerton M. Engaging frontline staff in performance improvement: the american organization of nurse executives implementation of transforming care at the bedside collaborative. Jt Comm J Qual Patient Saf, 2016;42(2):61-9.
Kasatpibal N, Chittawatanarat K, Nunngam N, Kampeerapanya D, Duangsoy N, Rachakom C, et al. Impact of multimodal strategies to reduce multidrug‐resistant organisms in surgical intensive care units: Knowledge, practices and transmission: A quasi‐experimental study. Nursing open, 2021;8(4): 937-46.
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