Basic elements for the control of nosocomial infection in Thai hospitals.

A survey on the basic elements for the control of N.I. was done in 38 hospitals in Thailand in 1991. Manpower shortage was found in one half of them. Service by the microbiological laboratory was under-utilized. Good guidelines on N.I. control needed to be more widely adopted. Capacity of C.S.S.D. lagged behind demands in most hospitals. Water supply was of most concern and needed to be improved in all. Waste-water treatment plants were needed in about one half of the hospitals. Personnel working in catering did not receive adequate screening for communicable diseases in one-half. Workers in the laundry department needed education on infection prevention in about one-third of hospitals. Improper disposal of infectious waste was found in one-quarter. The results of the study indicated that a comprehensive programme is needed for improving the efficacy of N.I. control in Thailand.

Does indication sheet reduce unnecessary urethral catheterization?

The study on the effect of indication sheet on the decision of doctors in ordering urethral catheterization was done in thirteen hospitals randomly selected from all regions of Thailand. 16,959 patients in medical and surgical wards were included between April and May 1989. The rates of urethral catheterization did not change by the influence of indication sheet. However, urethral catheterization without proper indications was reduced from 27.0 per cent in the control group to 14.3 per cent in the experiment group. The indication sheet was accepted in 96.5 per cent of the occasions when doctors prescribed urethral catheterization. The indication sheet changed the doctors' decision and hence reversed the order in 3 events (0.8%). It is concluded that indication sheet was well accepted by doctors and could reduce urethral catheterization without proper indications.