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J Hosp Infect. 2017 Jan;95(1):71-75. doi: 10.1016/j.jhin.2016.10.011. Epub 2016 Oct 20.

ICU ward design and nosocomial infection rates: a cross-sectional study in Germany.

Author information

1
Institute of Hygiene and Environmental Medicine, Charité University Medicine Berlin, German National Reference Centre for the Surveillance of Nosocomial infections, Berlin, Germany. Electronic address: andrea.stiller@charite.de.
2
Institute of Hygiene and Environmental Medicine, Charité University Medicine Berlin, German National Reference Centre for the Surveillance of Nosocomial infections, Berlin, Germany.
3
Institute of Industrial Building and Construction Design, Technical University Carolo Wilhelmina Braunschweig, Germany.

Abstract

BACKGROUND:

There is increasing interest in the effects of hospital and ward design on multi-faceted infection control. Definitive evidence is rare and the state of knowledge about current ward design is lacking.

OBJECTIVE:

To collect data on the current status of ward design for intensive care units (ICUs) and to analyse associations between particular design factors and nosocomial infection rates.

METHODS:

In 2015, operational infrastructure data were collected via an online questionnaire from ICUs participating voluntarily in the German nosocomial infection surveillance system (KISS). A multi-variate analysis was subsequently undertaken with nosocomial infection rates from the KISS database from 2014 to 2015.

FINDINGS:

In total, 534 ICUs submitted data about their operational infrastructure. Of these, 27.1% of beds were hosted in single-bed rooms with a median size of 18m2 (interquartile range 15-21m2), and 73.5% of all ICU beds had a hand rub dispenser nearby. The authors were able to match 266 ICUs in the multi-variate analysis. ICUs with openable windows in patient rooms were associated with lower device-associated lower respiratory tract infections [odds ratio (OR) 0.73, 95% confidence interval (CI) 0.58-0.90]. ICUs with >40% two-bed rooms were associated with lower primary bloodstream infection rates (OR 0.66, 95% CI 0.51-0.86).

CONCLUSION:

Only minor associations were found between design factors and ICU infection rates. Most were surrogates for other risk factors.

KEYWORDS:

Infection control; Intensive care unit; Nosocomial infection; Ward design

PMID:
27884473
DOI:
10.1016/j.jhin.2016.10.011
[Indexed for MEDLINE]

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