Date of Award

11-4-2024

Degree Type

Thesis

Degree Name

Master of Science in Nursing (MScN)

First Advisor

Dr. Naghma Rizvi

Second Advisor

Dr. Fizza Farroqui

Third Advisor

Ms. Syeda Aleena Fazal

Department

School of Nursing and Midwifery, Pakistan

Abstract

Background: The emergence of multidrug resistance organisms (MDROs) in the whole world poses big challenges to patient care, especially among ventilated patients who are at high risk due to their lengthened stay in the hospital, weak immunity, and various invasive procedures that might have been carried out. Reduction of such infections requires good prevention using VAP bundles, early diagnosis, and treatment. Together, these approaches can significantly reduce the MDRO rates, decrease the morbidity of patients, and optimise the allocation of healthcare resources in critical care areas.
Purpose: This study aimed to provide critical insights into the prevalence and underlying factors contributing to MDRO infections among ventilated patients within the Sindh Infectious Disease Hospital and Research Centre, Karachi.
Method: This investigation used a retrospective quantitative analysis of patient records and medical data from the hospital database. A quantitative approach was applied to examine ventilator-associated pneumonia (VAP) variables in the selected patient cohort. Over a year, data from 200 patients clinically diagnosed with VAP were collected for this study. The records were sourced from the Sindh Infectious Disease Hospital and Research Centre, Karachi. Standard diagnostic examinations were performed at this hospital for VAP patients admitted to the critical care unit.
Findings: The findings were divided into three major areas: demographics of ventilated patients, patient characteristics based on comorbidities, and duration of hospital stay. Most patients did not have significant comorbidities; however, the hospital stays were significantly longer in those with VAP p-value of 0.007. In this regard, MDRO infections contribute to prolonged durations of mechanical ventilation. However, the research also revealed that there were more common MDROs like MRSA and Pseudomonas aeruginosa, but age and gender had minimal relation to VAP rates. Insights into treatment effectiveness analysis that some precautions appeared more beneficial, particularly in lessening the duration of hospital stays for infected patients.
Conclusion: The study concluded that extended hospitalization lengths and mechanical ventilation durations were significantly associated with the emergence of MDRO infections. It also implies that healthcare facilities may need to implement proactive interventions such as personalized care plans or enhanced infection control measures to reduce the risk of MDROs. The government collaborates with the WHO to develop timely intervention strategies and implement measures to monitor pre-hospital antibiotic exposure and community-based factors that contribute to the emergence of multidrug-resistant organisms (MDROs).

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1

Last Page

71

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