Vol. 2, Issue 1, Part A (2025)

Hospital-acquired infections (HAIs) remain a major threat to patient safety in acute medical wards, contributing substantially to morbidity, mortality, antimicrobial resistance, and excess healthcare costs. Although comprehensive infection prevention and control (IPC) programmes and evidence-based bundles are recommended at national and international levels, translating these strategies into consistent bedside practices in general medical wards is challenging. Bedside checklists offer a low-cost, practical tool to standardize critical infection-prevention behaviours at the point of care, yet most existing evidence focuses on intensive care units and operating theatres rather than routine medical wards.
This research evaluates the role of a structured bedside infection-prevention checklist in reducing HAIs in adult medical wards of a tertiary-care hospital. We adopted a quasi-experimental before-after design with a six-month baseline period followed by a six-month intervention period. The intervention comprised a daily bedside checklist covering hand hygiene, personal protective equipment uses, catheter and line care, urinary catheter necessity and maintenance, respiratory hygiene, environmental cleaning cues, and isolation precautions. Nurses completed the checklist once per shift for all admitted patients, supported by focused training and weekly audit-and-feedback sessions. The primary outcome was the overall HAI incidence density per 1, 000 patient-days; secondary outcomes included device-associated infection rates, antibiotic days of therapy, length of stay, in-hospital mortality, and nursing compliance with checklist items.
We observed a clinically meaningful reduction in overall HAI rates between the baseline and intervention periods, accompanied by declines in catheter-associated urinary tract infections and suspected line-associated bloodstream infections. Checklist implementation was associated with improved documented adherence to hand hygiene opportunities, appropriate use of personal protective equipment, and timely removal of invasive devices. Nursing staff reported that the bedside checklist was feasible to use, improved situational awareness around infection risks, and facilitated communication with physicians about device necessity.
These findings suggest that a structured bedside infection-prevention checklist is a promising, pragmatic approach to strengthening IPC practices in medical wards and may help bridge the implementation gap between high-level IPC guidelines and routine bedside care. Larger multicentre studies are warranted to confirm effectiveness, assess sustainability, and evaluate cost-effectiveness across diverse healthcare settings.