Great efforts are in place to minimize the spread of infection in healthcare environments and the world of healthcare design can help improve these efforts even more.
While the healthcare system has made great strides in improving many patient and staff issues over the last 15 years or so, one issue that still hasn’t been solved is that of healthcare associated infections (HAIs). According to the Centers for Disease Control and Prevention Prevalence Report, based on a large sample of U.S. Acute care hospitals, an estimated 1 in 25 hospital patients have at least one HAI. Even worse, approximately 75,000 hospital patients with HAIs have died during their hospitalizations. According to the European Centre for Disease Prevention and Control, more than 4 million patients acquire an HAI every year, with an estimated 37,000 deaths as a direct consequence.
Many changes in healthcare design, such as the evolution towards private patient rooms and the use of antimicrobial surfaces, were made partially to help combat the infection control issue. An increase in the number of hand-washing sinks have helped, as well as the careful placement of them within the patient room; the same applies to dispensers that are frequently used such as, gloves, masks, and other disposable items. In addition, this article by Buie, et al in Contract Magazine, includes further strategies the designer should focus on during the design phase to aid in the reduction of infectious diseases.
Design Areas to Improve Infection Control
- Proper design of the patient head-wall and placement of medical equipment to minimize clutter and efficiency can reduce cross contamination
- Provide adequate and properly sized writing surfaces within the patient room to reduce or eliminate the possibility of placing or charting other paper work on known contaminated surfaces
- Provision of adequate equipment storage minimizes clutter and optimizes cleaning effectiveness
- Minimize reveals, pendants, suspended surfaces, corners, edges, etc., where ever possible to avoid potential infectious transmission. Med surge, ICUs, PACUs, etc., need to be thoroughly cleaned. Areas that are difficult to reach tend not to be cleaned or not cleaned as frequently as other more easily reached surfaces
- Selection of materials that are non-microbial are preferred. Monolithic surfaces minimize or eliminate joints that can harbor mold and bacteria
By designing a healthcare facility with a large portion dedicated to infection control, facilities may not have to use as many resources to prevent HAIs as well as decrease the amount of dollars spent on strict cleaning measures. General cleanliness helps, however so many surfaces in healthcare environments are either difficult to clean or not give proper attention during routine cleanings. In addition, items like privacy curtains or blinds present challenges to the cleaning crews that are already taxed with keeping a large number of high-touch surfaces in the hospital room, clean.
Limiting patient contact with medical personnel, as well as exposure to other patients, can dramatically aid in the decrease of HAIs. Specifying different solutions in the design phase of a large hospital project or renovation, such as privacy glass, allow medical staff members to observe patients from behind closed doors. For instance, privacy glass minimizes unnecessary patient contact thereby reducing the chances of a healthcare associated infection being spread to the patient and vise verse. Privacy glass can also help reduce dollars and time spent on strict cleaning measures that may prove to be ineffective.
In any case, it should be clear that we need to implement some more effective steps to battle infection in healthcare settings. The design solution mentioned above are being implemented in more and more new buildings; they also need to be worked into existing facilities that were not designed with infection control issues in mind. Architects and designers need to keep these steps in mind when working on any healthcare facility, be it new construction or a renovation.
