Problems and obstacles in implementation of nosocomial infection control in Thailand.
OBJECTIVE
To study the problems in implementation of nosocomial infection (NI) control in Thailand and strategies to overcome the obstacles.


METHODS
Interviewing administrators, chair-persons of infection control committee and doctors.


RESULTS
During June 2002 and August 2003, 255 persons were interviewed by infection control nurses using a set of questionnaires. Administrators, chair-persons of infection control committee, doctors in 32 hospitals across the country were enrolled by stratified random sampling. Policy on NI control was known to 95.3% and implementation to 81.2% of subjects. The main obstacles of NI control was the lack of incentive (66.7%) and support from administrators (30.2%). Hospital administrators set NI control at high priority, in only 40.9%, they could be motivated by regular presentation of NI data. Infection control nurses (ICN) should ideally work full-time (88.6%) but in reality, only 20.8% did so. The main problem for NI control was the shortage of ICN posts in most hospitals. This resulted in no career ladder and incentive for ICN. To overcome these problems, support from administrators, more education programs in NI control and provision of posts for ICN, are needed.


CONCLUSIONS
The main problems and obstacles an implementation of NI control were the lack of support from administrators and the lack of the ICN post.
Danchaivijitr
Somwang
S
Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok. sisdc@mahidol.ac.th
Assanasen
Susan
S
Trakuldis
Montakanti
M
Waitayapiches
Sribenja
S
Santiprasitkul
Somporn
S
D003428:Cross Infection / Q000517:prevention & control*; D006739:Hospital Administration; D006801:Humans; D017053:Infection Control / Q000379:methods* / Q000458:organization & administration; D007407:Interviews as Topic; D016134:Organizational Policy; D016730:Program Development; D015397:Program Evaluation; D011795:Surveys and Questionnaires; D013785:Thailand