Objective To explore the prevention and control effect of carbapenem resistant Gram-negative bacillus (CRO) in geriatric ward based on transparent supervision model. Methods Patients admitted to the geriatric ward in the First People’s Hospital of Lianyungang between January 2018 and December 2022 were selected. A transparent regulatory model for CRO was established and implemented in 2019, including the establishment of a regulatory group, the development of cluster prevention and control measures, the implementation of transparent reminder, publicity, supervision and assessment and other management measures. We evaluated the effectiveness by comparing the detection rate and infection rate of CRO before and after the intervention. Results A total of 15015 patients were monitored, and a total of 418 strains of CRO were detected. The incidence rate of noso-comial infection was decreasing year by year（χ2=26.666, P<0.001), and the etiological submission rate of hospitalized patients before antimicrobial treatment had been increasing year by year（χ2=280.320, P<0.001). The detection rate of CRO infection had been decreasing year by year, but the difference was not statistically significant (P>0.05), and there was statistical significance in the detection rate of carbapenem-resistant Klebsiella pneumonia infection (P=0.030). The detection rate of CRO had been decreasing year by year (χ2=33.593, P<0.001), and there was statistical significance in the detection rate of carbapenem-resistant Klebsiella pneumonia (χ2=23.663, P<0.001) and carbapenem resistant Pseudomonas aeruginosa (χ2=14.527, P=0.006).Conclusions By establishing and promoting transparent supervision mode in the geriatric ward, the detection rate and infection rate of drug-resistant bacteria can be significantly reduced, and the prevention and control effect of CRO in the elderly patients in the ward can be effectively improved to ensure the safety of elderly patients.