ผลของการตรวจสอบและให้ข้อมูลย้อนกลับต่อการปฏิบัติการป้องกันการติดเชื้อของพยาบาลวิชาชีพและการติดเชื้อของผู้ป่วยจากการ ฟอกเลือดด้วยเครื่องไตเทียม

Abstract

Vascular access infection can severely impact hemodialysis patients and may result in death. This complication can be prevented by adhering to clinical practice guidelines for prevention of vascular access infection. The purpose of this study were to determine the effects of audit and feedback on infection prevention practices among registered nurses and infection among hemodialysis patients in a hemodialysis unit at a tertiary hospital during September 2013 to January 2014. A quasi-experimental research one group pretest-posttest design was used. The study sample consisted of 5 registered nurses and 30 hemodialysis patients. The research instruments consisted of the demographic data questionnaire, the infection surveillance form for hemodialysis patients, the observation recording form, the audit and feedback plan, and practice guidelines for prevention of vascular infection. Data were analyzed using descriptive statistics, Chi-square test, Fisher’s exact probability test and calculation of the infection rate expressed as number of episodes per 100 patient-months.

Audit and feedback strategies used were daily audit from the investigator and weekly verbal feedback from a head nurse. Staff nurses provided verbally feedback and individual written feedback in a sealed envelope. Group data on the board was also included in the study. Results of the study revealed that after implementation of the audit and feedback, the proportion of correct infection prevention practices among registered nurses increased significantly for hand hygiene, exit-site care, access catheter care, and permanent access care from 48.45%, 86.19%, 62.89%, and 67.35% respectively to 77.49%, 95.16%, 92.08%, and 97.22% (p <.01). In addition, incidence of vascular access infection among hemodialysis patients was not different between before and after the intervention.

The findings reveal that audit and feedback can be used to improve the practices among registered nurses on prevention of vascular access infection.