Problems and Obstacles in Implementation of Nosocomial Infection Control in Thailand
Somwang Danchaivijitr MD*, Susan Assanasen MD*, Montakanti Trakuldis RN**, Sribenja Waitayapiches RN***, Somporn Santiprasitkul RN***
Affiliation : *Department of Medicine, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, **Department of Nursing, Ministry of Public Health, Nonthaburi, ***Center for Nosocomial Infection Control, Faculty of Medicine Siriraj Hospital
Objectives : To study the problems in implementation of nosocomial infection (NI) control in Thailand and
strategies to overcome the obstacles.
Materials and Methods : Interviewing administrators, chair-persons of infection control committee and doc-
tors.
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.
Conclusion : The main problems and obstacles an implementation of NI control were the lack of support from
administrators and the lack of the ICN post.
Keywords : Problems, Obstacles, Nosocomial infection, Control
