Hospital design is key for infection
control, focusing on separating clean/dirty zones, ensuring good ventilation,
lighting, storage, and facilities like wash basins/single beds. Ward units,
ICU, theatresa, CSSD, Laundry, isolation wards etc. are planned with updated
info on infections. Identifying design risks and engineering controls to reduce
airborne infections are emphasized.
The team of Medpoint infection
prevention and infection control consultants provide nationwide services to the
healthcare sectors and is well known for the expertise and value that clients
receive when utilizing the Expertise services.
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Infection Prevention Solutions
Our team of multi-disciplinary
experts, including Certified Infection Preventionists (CIC) and
epidemiologists, combine decades of frontline experience with the latest
evidence-based practices to help your organization reduce healthcare-associated
infections, address sterilization gaps, enhance infection prevention and
control plans, and effectively manage and control outbreaks. Our onsite
assessments help identify and mitigate infection risks to drive measurable
improvements across organizations.
Scope
of Service
Evidence-based hospital design is a
crucial strategy for preventing healthcare-associated infections (HAIs) and
improving patient outcomes. By considering material choices, spatial layout,
and advanced air management, hospital designers can create environments that
minimize pathogen transmission and promote patient safety. The best hospital designs integrate infection
control principles into every aspect, from architectural layout and airflow to
surface materials and waste management.
Architectural
layout and patient flow
A key strategy in infection control
design is minimizing the risk of cross-contamination by separating high-risk
and low-risk areas.
Segregate high-risk areas: Create clear,
functional segregation between different hospital zones, such as outpatient
departments, intensive care units (ICUs), and operating theatres (OTs) CSSD.
This prevents the intermingling of diverse patient groups and minimizes the
spread of pathogens.
Create clean and dirty corridors:
Design separate pathways for the movement of clean supplies and contaminated
materials, including linen and waste. This separation is crucial for preventing
the transfer of germs from dirty areas to sterile ones.
Strategically place isolation rooms:
Dedicate a specific number of single-patient rooms equipped with hand-washing
facilities and ensuite bathrooms. For contagious diseases, airborne infection
isolation rooms (AIIRs) with negative pressure are essential to contain
airborne pathogens. For immunocompromised patients, protective environment (PE)
rooms with positive pressure protect them from contaminants.
Air
management and ventilation
Proper air handling is one of the
most important engineering controls for preventing airborne infections.
Air pressure differentials: Air
pressure should be carefully managed to prevent the spread of airborne
pathogens. Positive pressure rooms, which maintain higher pressure inside than
in adjacent areas, are used for protecting immunocompromised patients (e.g., in
bone marrow transplant units). Negative pressure rooms, which keep lower
pressure inside, are for isolating patients with highly contagious airborne
illnesses like tuberculosis.
Directional airflow: Design
ventilation systems that direct airflow from clean areas to less-clean areas,
with the air from infectious zones exhausted safely away from public spaces and
air intakes. For isolation rooms, this means air flows from the hallway into
the patient room.
High-efficiency filters: Use
high-efficiency particulate air (HEPA) filters in critical care areas like OTs,
ICUs, and burn units. These filters can capture at least 99.97% of airborne
particles 0.3 microns or larger, including bacteria and viruses.
Appropriate air changes: Ensure HVAC
systems deliver the required number of air changes per hour (ACH) for different
hospital areas. For example, guidelines recommend at least 12 ACH for isolation
rooms and 25 ACH for operating rooms.
Material
and surface selection
The choice of materials can greatly
impact how easily germs can spread and accumulate on surfaces.
Non-porous and seamless surfaces:
Specify non-porous, resilient materials that are resistant to frequent cleaning
and harsh disinfectants. Surfaces should have minimal seams, crevices, or
joints that can harbor pathogens. Examples include solid surfacing materials,
sheet vinyl flooring, and epoxy resin flooring.
Antimicrobial materials: Integrate
naturally antimicrobial materials, such as copper and silver alloys, into
high-touch surfaces like door handles, light switches, and bedrails. These
materials actively reduce the presence of pathogens.
Easy-to-clean design: Implement
design features like rounded drywall corners and wall-mounted equipment to
eliminate difficult-to-clean spaces and minimize dust accumulation.
Robust and resilient finishes:
Materials must be durable enough to withstand frequent, rigorous cleaning with
harsh chemicals without deteriorating, which could create surfaces that harbor
pathogens.
Strategic
placement of facilities
Hand hygiene is arguably the single
most effective method for preventing HAIs. Facility layout plays a crucial role
in promoting compliance.
Convenient hand-washing stations:
Place hand-washing sinks with hands-free operation and alcohol-based hand rub
(ABHR) dispensers at every point of care, including the foot of each patient
bed, outside patient rooms, and in hallways.
Dedicated sinks: Separate clinical
hand-washing sinks from sinks used for cleaning equipment and disposing of
waste to avoid cross-contamination.
Minimize touchpoints: Incorporate
touchless technology, such as automatic doors, motion-activated faucets, and
sensor-activated paper towel dispensers, to reduce physical contact with
frequently touched surfaces.
Zoning
and screening at entry points
Controlling the flow of people and
identifying potential risks at the entrance can contain infectious diseases
before they spread.
Screening areas: Design a separate,
designated area at the hospital entrance for screening patients based on travel
history, fever, and other infectious symptoms, especially during an outbreak.
Febrile patient zones: Create a
separate "fever area" in the Emergency Department with its own
entrance and upgraded ventilation to manage potentially infectious patients
away from the general population.
Wayfinding: Use clear, intuitive
signage and pathways to guide patients and visitors to their destinations
efficiently and prevent them from entering restricted or high-risk areas.
Flexibility
and modularity
Adaptive architecture: Designing
hospitals with flexible and adaptable layouts and modular units allows
facilities to quickly reconfigure spaces in response to changing patient needs
or during an infectious disease outbreak. This resilience is vital for
emergency preparedness.
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