Effects of the Use of Guidelines for Prevention of Hospital-Acquired Pneumonia for Orthopedic Patients, Buriram Hospital

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Nittaya Teeraviroj Sujitra Sukphadung Kraiwut Sooksanit

Abstract

Background: Pneumonia in the hospital (Hospital-Acquired Pneumonia: HAP) is the most commonly infection that can found in the hospital and make the longer length of stay and high costs. Some people get into the crisis from being infected in the bloodstream and may be dead. The incidence found 0.9 : 1,000 patient days in non-ventilated patients.
Objective: To study the incidence of HAP and to compare HAP before and after use HAP prevention guidelines.
Methods: Action research is divided into 4 phases: Phase 1 : brainstorm by multidisciplinary approach use morbidity & mortality and root cause analysis in HAP cases and dead case from HAP. Review guideline, empirical training 20 professional nurses about prevention of HAP. Summary and establishes HAP prevention guidelines. Phase 2 : Implementation. Phase 3: Evaluate. Phase 4 To improve by learning, evaluate and summary the guidelines for prevention HAP. The samples are 20 nurses with multidisciplinary and 30 Orthopedics patients at Buriram Hospital age 60 years and over, both male and female with hip fracture were purposive selected. This study conducted between July - December 2016. Data were analyzed using frequency, percentage, mean and standard deviation.
Results: The finding showed that the samples were use HAP prevention guidelines 93.7%. No HAP was found. Compared with pre-study in hip fracture patients from the year 2013-2015, HAP were found 0.4, 0.9 and 0.6 per 1,000 patient days in non-ventilated patients respectively.
Conclusion: The results of this study suggest that professional nurses include multidisciplinary should focus on HAP prevention by use HAP prevention guidelines especially in the elderly patient. Evaluate the result continuously and review by multidisciplinary if found the incidence of HAP case.
Key words: Hospital-Acquired Pneumonia, HAP, Guidelines

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1. วิศิษฎ์ อุดมพาณิชย์. ปอดบวมที่เกิดในโรงพยาบาล. ใน: วิทยา ศรีดามา, บรรณาธิการ. การดูแลรักษาผู้ป่วยในที่เป็นปัญหา. กรุงเทพฯ: โรงพิมพ์แห่งจุฬาลงกรณ์มหาวิทยาลัย; 2537:180-9.

2. Bergogne-Bérézin E. Current guidelines for the treatment and prevention of nosocomial infections. Drugs 1999;58(1):51-67.

3. Strausbaugh LJ. Nosocomial respiratory infection. In: Mandell GL, Bennett JE, Dolin R. editors. Principle and practice of infectious disease. 5th. ed. Philadelphia: Churchill-Livingstone;2000:3020-8.

4. อนุชา อภิสารธนรักษ์. โรคปอดอักเสบที่เกิดขึ้นในโรงพยาบาล. ใน: พรรณทิพย์ ฉายากุล, ชิษณุ พันธุ์เจริญ, ชุษณา สวนกระต่าย, สุรภี เทียนกริม, ยุพิน ศุพุทธมงคล, ศศิธร ลิขิตนุกูล และคณะ. ตำราโรคติดเชื้อ 2. พิมพ์ครั้งที่ 1. กรุงเทพมหานคร: โฮลิสติก พับลิชชิ่ง จำกัด; 2548:1369-82.

5. Kashuba AD, Nafziger AN, Drusano GL, Bertino JS Jr. Optimizing aminoglycoside therapy for nosocomial pneumonia caused by gram-negative bacteria. Antimicrob Agents Chemother 1999;43(3):623-9.

6. The American Thoracic Society and the Infectious Diseases Society of Ameri ca. Gui deli nes f or the management of adults with hospitalacquired, ventilator-associated, and healthcare-associated pneumonia. Am J Respir Crit Care Med 2005;171:388-416.

7. Chao-Hsien Lee, Chien-Liang Wu. An Update on the Management of Hospital-Acquired Pneumonia in the Elderly. Int J Gerontol 2008;2(4):183-95.

8. วีระยุทธ์ ชาตะกาญจน์. การวิจัยเชิงปฏิบัติการ Action research. วารสารราชภัฏสุราษฎร์ธานี 2558;2(1):29-49.

9. Cochran W.G. Sampling technique. New York: John Wiley & Son. Inc.; 1953.

10. Tablan OC, Anderson LJ, Besser R, Bridges C, Hajjeh R; CDC, et al. Guidelines for preventing health-care--associated pneumonia, 2003: recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee. MMWR Recomm Rep 2004;53(RR-3):1-36.

11. วิรชัช สนั่นศิลป์. “โรคกระดูกพรุน: ถาม-ตรวจ-รักษา-ป้องกันได้”. สถานการณ์โรคกระดูกพรุน ปี 2555: หักครั้งเดียวก็เกินพอ. [ออนไลน์]. [ ค้นเมื่อวันที่ 21 มี.ค. 2560]. ; เข้าถึงได้จาก:URL:https://www.bangkokhealth.com/index.php/health/health-system/bone/2218-2555.html

12. Med Thai. โรคกระดูกพรุน. (ออนไลน์). [ค้นเมื่อ 21 มี.ค.2560].; เข้าถึงได้จาก:URL: https://medthai.com/%E0%B9%82%E0%B8%A3%E0%B8%84%E0%B8%81%E0%B8%A3%E0%B8%B0%E0%B8%94%E0%B8%B9%E0%B8%81%E0%B8%9E%E0%B8%A3%E0%B8%B8%E0%B8%99/.

13. Burton LA, Price R, Barr KE, McAuley SM, Allen JB, Clinton AM, et al. S13 Incidence And Risk Factors For The Development Of Hospital Acquired Pneumonia In Older Hospitalised Patients. Thorax 2014;69(suppl 2):A9-A10.

14. Masterton RG, Galloway A, French G, Street M, Armstrong J, Brown E, et al. Guidelines for the management of hospital-acquired pneumonia in the UK: report of the working party on hospital-acquired pneumonia of the British Society for Antimicrobial Chemotherapy. J Antimicrob Chemother 2008;62(1):5-34.

15. Segers P, Speekenbrink RG, Ubbink DT, van Ogtrop ML, de Mol BA. Prevention of nosocomial infection in cardiac surgery by decontamination of the nasopharynx and oropharynx with chlorhexidine gluconate: a randomized controlled trial.JAMA 2006;296(20):2460-6.

16. ปิยะภัทร เดชพระธรรม. ปัญหาการกลืนในผู้สูงอายุ (Dysphagia in Elderly). เวชศาสตร์ฟื้นฟูสาร 2556;23(3):73-80.
17. Bergin C, Speroni KG, Travis T, Bergin J, Sheridan MJ, Kelly K, et al. Effect of preoperative incentive spirometry patient education on patient outcomes in the knee and hip joint replacement population. J Perianesth Nurs 2014;29(1):20-7.

18. Wren SM, Martin M, Yoon JK, Bech F. Postoperative pneumonia-prevention program for the inpatient surgical ward. J Am Coll Surg 2010;210(4):491-5.

19. Ramkumar Venkateswaran, Prasad KN. Management of postoperative pain. Indian J. Anesth 2006;50(5):345-54.

20. Stolbrink M, McGowan L, Saman H, Nguyen T, Knightly R, Sharpe J, et al. The Early Mobility Bundle: a simple enhancement of therapy which may reduce incidence of hospital-acquired pneumonia and length of hospital stay. J Hosp Infect 2014;88(1):34-9.