Role of nurses in prevention of antimicrobial resistance

Antimicrobial resistance (AMR) is an important issue in many countries especially at tertiary health care facilities. Improvements in quality in the area of AMR are urgently needed in many countries including Thailand to provide effective and efficient services with the ultimate goal of improving quality of care and patients’ quality of life. Nurses play a major role in controlling AMR problems because patients are in their “hands” and infections with resistant organisms are primarily transmitted through direct contact. Thailand has initiated several steps to build capacity of nurses in this area. These include a Master’s degree programme and short training courses in the area of infection control with the focus on AMR. The nursing and midwifery workforce can play an important role in prevention of nasocomial infestion (NI) including AMR prevention and control if they have been properly educated and trained. This paper focuses on the situation of AMR in Thailand and the initiatives of the Faculty of Nursing, Chiang Mai University in building capacity of nurse-midwives in general and infection control nurses in NI and AMR prevention and control and in other areas. Antimicrobial resistance in Thailand The primary mission of the health care facility is to respond to the needs of the client or patient, family and community by providing effective and efficient services with equal access to quality of care. Inadequate quality of care could cause nosocomial infection (NI), an infection that can be acquired during hospitalization, and antimicrobial resistance (AMR). AMR has become one of the serious health problems in many countries including Thailand. Its consequences have impacts on the patient and on the family, health personnel and hospitals. In most hospitals, infection prevention and control activities have been integrated into the system of care. NI is one of the key indicators for hospital accreditation in Thailand. For the hospital to be certified as an accredited hospital, the hospital must incorporate the following components of mission: (a) has a written policy, strategy and protocol of NI prevention and control; (b) has effective and efficient NI prevention and control programme; (c) has assigned a person responsible for NI prevention and control programme; (d) provides opportunities for personnel to gain knowledge and skills in the NI prevention and control programme with updated information; (e) focuses on the process of NI prevention and control programme activities; and (f) has continuous quality improvements and activities on NI prevention and control. Incidence of antimicrobial resistant