RESUMEN
BACKGROUND: The influence of the hospital's infrastructure on healthcare-associated colonization and infection rates has thus far infrequently been examined. In this review we examine whether healthcare facility design is a contributing factor to multifaceted infection control strategies. METHODS: We searched PubMed/MEDLINE, EMBASE and Cochrane Central Register of Controlled Trials (CENTRAL) from 1990 to December 31st, 2015, with language restriction to English, Spanish, German and French. RESULTS: We identified three studies investigating accessibility of the location of the antiseptic hand rub dispenser. Each of them showed a significant improvement of hand hygiene compliance or agent consumption with the implementation of accessible dispensers near the patient bed. Nine eligible studies evaluated the impact of single-patient rooms on the acquisition of healthcare-associated colonization and infections in comparison to multi-bedrooms or an open ward design. Six of these studies showed a significant benefit of single-patient bedrooms in reducing the healthcare-associated colonization and infection rate, whereas three studies found that single-patient rooms are neither a protective nor risk factor. In meta-analyses, the overall risk ratio for acquisition of healthcare-associated colonization and infection was 0.55 (95% CI: 0.41 to 0.74), for healthcare-associated colonization 0.52 (95% CI: 0.32 to 0.85) and for bacteremia 0.64 (95% CI: 0.53 to 0.76), all in favor of patient care in single-patient bedrooms. CONCLUSION: Implementation of single-patient rooms and easily accessible hand rub dispensers located near the patient's bed are beneficial for infection control and are useful parts of a multifaceted strategy for reducing healthcare-associated colonization and infections.
RESUMEN
BACKGROUND: A high percentage of single-bed rooms and antiseptic hand rub dispensers in hospitals are required for infection prevention OBJECTIVE: Data acquisition of the hospitals' current status of infrastructure pertaining to infection prevention MATERIALS AND METHODS: A electronic questionnaire was sent in March 2015 to all hospitals participating in the nosocomial infection surveillance system (KISS) to collect operational infrastructure data. RESULTS: Completed questionnaires were received from 621 hospitals (response rate 46 %) and provided data about the building infrastructure of 534 intensive care units and 621 representative medical wards. While most beds in the intensive care unit are equipped with an antiseptic hand rub dispenser at the bedside, only 31.5 % of the medical ward beds are so equipped. Moreover, only 27.1 % of intensive care beds and 6.4 % of medical ward beds are in single-bed rooms. The intensive care room size showed a median of 18 m² for single-bed rooms and 28 m² for two-bed rooms. In the medical wards, 28.2 % of the patient rooms are not equipped with an ensuite toilet. CONCLUSIONS: The paucity of bedside antiseptic hand rub dispensers in medical wards should be rectified at once to optimize hand hygiene compliance of health care workers. Likewise, the lack of single-bed rooms on medical wards and intensive care units should be considered when renovating old or planning new buildings in the near future.
