우리나라 병원감염관리의 실태 = A Study on Investigation the Nosocomial Infection Control Program in Korea

다국어 초록 (Multilingual Abstract)

In Korea, the nosocomial infection control program is not well developed. The one of the main reasons of this situation is the medical cost paying system. Under FFS(Fee for service)system, there is no incentives for doctors and hospitals to do active nosocomial infection control. On the contrary, the doctors and hospitals get more profit with nosocomial infections. And the medical ethics is too weak incentives to change the medical personnel attitudes in nosocomial infection control. Funthermore there are many misunderstandings in the nosocomial infection control practices in Korea. For examples, some ineffective nosocomial infection control methods like fogging and air culture are still adapted in many hospitals. To decrease nosocomial infection occurrence and for effective uses of medical cost, active nosocomial infection programs is needed.
This study was planned to investigate the nosocomial infection program in Korea. Mailing questionnaires were sended to all general hospitals(212 hospitals) in Korea.
The result was as follows;
1) 106 general hospitals (75.7%) had infection control committees and only 83 general hospitals(54.4%) had infection control committee meetings since January of 1991.
2) Only one hospital had infection control nurse. In 53 general hospitals(37.9%), infection control personnels were assigned to dual positions.
3) There were some disagreements in infection control guidlines and infection control practices. For example, in 48 general hospitals(36.9%) had 'Hand washing policy' but only 4 general hospitals used 'paper towel' for hand washing.
With those results, an effective nosocomial infection control program was suggested;
1) All general hospitals should have infection control committees and the infection control committee meeting have to be opened at least 4times per year.
2) Hospitals over 300 beds should have at least one infection control nurse.
3) To activate the nosocomial infection program, the changes of the national public health policy in needed, for example, medical cost paying system.