A comparison of the factors which influence infection control in paediatric wards in England and Thailand.

Acquiring an infection during a hospital stay is a hazard for patients throughout the world. Over 1.4 million people worldwide are suffering from infections acquired in hospital. Five to ten per cent of patients admitted to modern hospitals in developed countries acquire one or more infections, whereas patients in developing countries have a higher risk, around two to twenty times this figure. Paediatric patients, especially neonates and infants, have an additional risk of infection because of their compromised immune system.

The purpose of this study was to explore the factors which contribute to the spread of infection among children in paediatric wards in a developed and a developing country: England and Thailand.

Method: An ethnographic approach was utilised to identify practices which promote or prevent the spread of infection in each country. Purposive sampling was employed to recruit ten nurses in England and ten nurses in Thailand. Ethical approval was obtained from De Montfort University (DMU), National Research Ethics Service and the ethical approval committee in Thailand. Nonparticipant observations and semi-structured interviews were the main methods of obtaining data in clinical settings. Data from the observations and interviews were transcribed and coded using thematic content analysis.

Results: Hospitals in Thailand and England faced the same problems regarding attitudes, values and beliefs which contribute to infection control difficulties in children, particularly poor hand hygiene. Good attitudes and beliefs will promote good practice. Moreover, education and training can raise perceptions and promote good practice. However, in terms of different cultures and circumstances, the key factors explaining different implementations between the two countries are resources, lifestyle, and religion.

Conclusion: Even within the same hospital, different backgrounds including education, cultures, policies and support result in different factors which impact on paediatric patients. Individuality and personal responsibility for infection control practice are the most significant factors influencing compliance with best practice.