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The Role and Direction of Healthcare Facility Design in Infection Control and Prevention

감염예방 및 통제에 있어서 의료시설 디자인의 역할과 방향

  • Received : 2020.05.18
  • Accepted : 2020.08.11
  • Published : 2020.08.30

Abstract

Healthcare-associated infections result in unnecessary illness, death, and costs, impacting a significant number of patients, families, and healthcare professionals. While healthcare facility design can serve as an intervention to prevent and control healthcare-associated infections, its role is not fully evaluated and its implementation is limited in practice. This study illustrates the role of healthcare facility design in infection control and prevention and discusses the need for systematic design guidelines for various types of healthcare facilities and even beyond healthcare settings. Physical environments of the healthcare facility can be reservoirs of pathogens, transmitting the pathogens to visitors and healthcare professionals. This issue indicates that carefully considered design of healthcare facilities can support reducing healthcare-associated infections. There are cases that report significant improvement in terms of infection control and prevention by implementing effective design strategies. This study summarizes these strategies, whose implementations are limited due to the lack of systematic design guidelines that synthesize effective design strategies for infection control and prevention tailored to healthcare systems in South Korea. Thus, for future studies to translate evidence into design of applicable strategies, developing and validating systematic design guidelines for active implementation of design strategies for safer healthcare facilities is needed.

Keywords

References

  1. Amended by Ordiance of Ministry of Health and Welfare No.477, Encorcement Rule of The Medical Service Act. Retrieved from http://www.law.go.kr/LSW/nwRvsLsInfoR.do?lsiSeq=191545
  2. Baloh, J., Reisinger, H. S., Dukes, K., da Silva, J. P., Salehi, H. P., Ward, M.,..., & Herwaldt, L. (2019). Healthcare Workers' Strategies for Doffing Personal Protective Equipment. Clinical Infectious Diseases, 69(Supplement_3), S192-S198. doi:10.1093/cid/ciz613
  3. Birnbach, D. J., Nevo, I., Scheinman, S. R., Fitzpatrick, M., Shekhter, I., & Lombard, J. L. (2010). Patient safety begins with proper planning: a quantitative method to improve hospital design. Quality and Safety in Health Care, 19(5), 462. doi:10.1136/qshc.2008.031013
  4. Boyce, J. M., Havill, N. L., & Moore, B. A. (2015). Terminal Decontamination of Patient Rooms Using an Automated Mobile UV Light Unit. Infection Control & Hospital Epidemiology, 32(8), 737-742. doi:10.1086/661222
  5. Chen, Y. S., Lin, Y. E., Liu, Y. C., Huang, W. K., Shih, H. Y., Wann, S. R.,..., & Chang, C. L. (2008). Efficacy of point-of-entry copper-silver ionisation system in eradicating Legionella pneumophila in a tropical tertiary care hospital: implications for hospitals contaminated with Legionella in both hot and cold water. Journal of Hospital Infection, 68(2), 152-158. doi:https://doi.org/10.1016/j.jhin.2007.10.020
  6. Choi, K., Jeong, D., & Kwon, S. J. (2019). A Study on the Architectural Planning of Spatial Composition and Circulation in Private Regional Infectious Disease Hospital. Journal of The Korea Institute of Healthcare Architecture, 25(4), 81-91.
  7. Denham, M. E., Bushehri, Y., & Lim, L. (2018). Through the Eyes of the User: Evaluating Neonatal Intensive Care Unit Design. HERD: Health Environments Research & Design Journal, 11(3), 49-65. doi:10.1177/1937586718761017
  8. Denham, M. E., Kasali, A., Steinberg, J. P., Cowan, D. Z., Zimring, C., & Jacob, J. T. (2013). The Role of Water in the Transmission of Healthcare-Associated Infections: Opportunities for Intervention through the Environment. HERD: Health Environments Research & Design Journal, 7(1_suppl), 99-126. doi:10.1177/193758671300701s08
  9. DuBose, J. R., Matic, Z., Sala, M. F. W., Mumma, J. M., Kraft, C. S., Casanova, L. M.,..., & Jacob, J. T. (2018). Design strategies to improve healthcare worker safety in biocontainment units: learning from ebola preparedness. Infection Control & Hospital Epidemiology, 39(8), 961-967. doi:10.1017/ice.2018.125
  10. Enk, R. A. V. (2006). Modern hospital design for infection control Retrieved from https://www.healthcaredesignmagazine.com/architecture/modern-hospital-design-infection-control/
  11. Eom, J. S. (2018). Facilities and construction in hospitals for infection control. J Korean Med Assoc, 61(1), 36-42. https://doi.org/10.5124/jkma.2018.61.1.36
  12. Facility Guidelines Institute. (2018). Guidelines. Retrieved from https://fgiguidelines.org/guidelines/2018-fgi-guidelines/
  13. Grass, G., Rensing, C., & Solioz, M. (2011). Metallic Copper as an Antimicrobial Surface. Applied and Environmental Microbiology, 77(5), 1541. doi:10.1128/AEM.02766-10
  14. Herwaldt, L. A., Smith, S. D., & Carter, C. D. (1998). Infection Control in the Outpatient Setting. Infection Control and Hospital Epidemiology, 19(1), 41-74. doi:10.2307/30141356
  15. Hota, S., Hirji, Z., Stockton, K., Lemieux, C., Dedier, H., Wolfaardt, G., & Gardam, M. A. (2009). Outbreak of Multidrug-Resistant Pseudomonas aeruginosa Colonization and Infection Secondary to Imperfect Intensive Care Unit Room Design. Infection Control & Hospital Epidemiology, 30(1), 25-33. doi:10.1086/592700
  16. Jacob, J. T., Kasali, A., Steinberg, J. P., Zimring, C., & Denham, M. E. (2013). The Role of the Hospital Environment in Preventing Healthcare-Associated Infections Caused by Pathogens Transmitted through the Air. HERD: Health Environments Research & Design Journal, 7(1_suppl), 74-98. doi:10.1177/193758671300701s07
  17. Kang, J. M., (2020. April. 26). High-risk facilities including nursing homes tested for COVID-19 and reported 322 confirmed cases. Newsis. https://newsis.com/view/?id=NISX20200427_0001007039&cID=10201&pID=10200
  18. Kang, J., & Kwon, S. (2019). A Study on the Guideline of Spatial Composition and Circulation in Triages and Entrances Area in Emergency Departments for Efficient Infection Control. Journal of The Korea Institute of Healthcare Architecture, 25(1), 41-49. https://doi.org/10.15682/JKIHA.2019.25.1.41
  19. Karpanen, T. J., Casey, A. L., Lambert, P. A., Cookson, B. D., Nightingale, P., Miruszenko, L., & Elliott, T. S. J. (2015). The Antimicrobial Efficacy of Copper Alloy Furnishing in the Clinical Environment: A Crossover Study. Infection Control & Hospital Epidemiology, 33(1), 3-9. doi:10.1086/663644
  20. Kim, J. G., & Seo, H. B. (2016). Infection Control in Triage Space of Emergency Room: Based on Analysis of Healthcare Facility Standards. Journal of The Korea Institute of Healthcare Architecture, 22(4), 97-104. https://doi.org/10.15682/jkiha.2016.22.4.97
  21. Kim, Y. S., (2020. April. 26). A patient transfer agent at Eunpyeong St. Mary's Hospital confirmed positive for COVID-19, the agent transferred 207 patients YTN News. https://www.yna.co.kr/view/AKR20200426018552060?input=1195m
  22. Kim, Y. S., (2020. April. 27). Myongji Hospital where healthcare professionals confirmed positive conducted tests on 44 other healthcare professionals and reported negative. Yonhap News. https://www.yna.co.kr/view/AKR20200427107000017?input=1195m
  23. Ko, S. M., (2020, Faberary. 21). A patient transfer agent at Eunpyeong St. Mary's Hospital confirmed positive for COVID-19, the agent transferred 207 patients Chosun Ilbo. http://news.chosun.com/site/data/html_dir/2020/02/21/2020022103364.html
  24. Kwon, S. J., & Yoon, H. (2016). A Development of Design Guidelines for the Negative Pressured Isolation Units Controlling Severe Respiratory Infectious Disease. Journal of The Korea Institute of Healthcare Architecture, 22(3), 45-56. https://doi.org/10.15682/jkiha.2016.22.3.45
  25. Lee, D. R. N., Kwon, S. J., Sung, M. K., Yoon, H. J., & Hong, J. K. (2017). A Study on the Facility Eligibility Inspection & Effect of Environment Improvement for National Inpatient Isolation Units. Journal of The Korea Institute of Healthcare Architecture, 23(4), 67-75. https://doi.org/10.15682/jkiha.2017.23.4.67
  26. Lee, H., & Kwon, S. (2019). A Study of the Spatial Composition and the Facility Criteria of In-patient Rooms in General Hospitals after MERS 2015. Journal of The Korea Institute of Healthcare Architecture, 25(2), 27-35. https://doi.org/10.15682/JKIHA.2019.25.2.27
  27. Lee, H., Kim, K., & Oh, Y. H. (2016). A Study on the Space Design for Nosocomial Infection Control in Intensive Care Unit. Journal of The Korea Institute of Healthcare Architecture, 22(4), 87-95. https://doi.org/10.15682/jkiha.2016.22.4.87
  28. Leoni, E., De Luca, G., Legnani, P. P., Sacchetti, R., Stampi, S., & Zanetti, F. (2005). Legionella waterline colonization: detection of Legionella species in domestic, hotel and hospital hot water systems. Journal of Applied Microbiology, 98(2), 373-379. doi:10.1111/j.1365-2672.2004.02458.x
  29. Rutala, W. A., Gergen, M. F., Tande, B. M., & Weber, D. J. (2015). Rapid Hospital Room Decontamination Using Ultraviolet (UV) Light with a Nanostructured UV-Reflective Wall Coating. Infection Control & Hospital Epidemiology, 34(5), 527-529. doi:10.1086/670211
  30. Sehulster, L., Chinn, R., Arduino, M., Carpenter, J., Donlan, R., Ashford, D.,..., & Cleveland, J. (2003). Guidelines for environmental infection control in health-care facilities; recommendations of CDC and Healthcare Infection Control Practices Advisory Committee (HICPAC).
  31. Siegel, J. D., Rhinehart, E., Jackson, M., Chiarello, L., & Health Care Infection Control Practices Advisory Committee. (2007). 2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Health Care Settings. American Journal of Infection Control, 35(10 Suppl 2), S65-S164. doi:10.1016/j.ajic.2007.10.007
  32. Squier, C., Yu, V. L., & Stout, J. E. (2000). Waterborne nosocomial infections. Current Infectious Disease Reports, 2(6), 490-496. doi:10.1007/s11908-000-0049-1
  33. Steinberg, J. P., Denham, M. E., Zimring, C., Kasali, A., Hall, K. K., & Jacob, J. T. (2013). The Role of the Hospital Environment in the Prevention of Healthcare-Associated Infections by Contact Transmission. HERD: Health Environments Research & Design Journal, 7(1_suppl), 46-73. doi:10.1177/193758671300701s06
  34. The Center for Health Design. (2015). Infection Control Strategies Provide Foundation for New Hospital Building Retrieved from https://www.healthdesign.org/insights-solutions/infection-control-strategies-provide-foundation-new-hospital-building
  35. Thomas, B. W., Berg-Copas, G. M., Vasquez, D. G., Jackson, B. L., & Wetta-Hall, R. (2009). Conspicuous vs customary location of hand hygiene agent dispensers on alcohol-based hand hygiene product usage in an intensive care unit. The Journal of the American Osteopathic Association, 109(5), 263-267.
  36. Tomas, M. E., Kundrapu, S., Thota, P., Sunkesula, V. C. K., Cadnum, J. L., Mana, T. S. C.,..., & Donskey, C. J. (2015). Contamination of Health Care Personnel During Removal of Personal Protective Equipment. JAMA Internal Medicine, 175(12), 1904-1910. doi:10.1001/jamainternmed.2015.4535
  37. Trautmann, M., Halder, S., Hoegel, J., Royer, H., & Haller, M. (2008). Point-of-use water filtration reduces endemic Pseudomonas aeruginosa infections on a surgical intensive care unit. American Journal of Infection Control, 36(6), 421-429. doi:https://doi.org/10.1016/j.ajic.2007.09.012
  38. Trillis, F., Eckstein, E. C., Budavich, R., Pultz, M. J., & Donskey, C. J. (2015). Contamination of Hospital Curtains With Healthcare-Associated Pathogens. Infection Control & Hospital Epidemiology, 29(11), 1074-1076. doi:10.1086/591863
  39. U.S. Department of Health and Human Services Centers for Disease Control and Prevention (CDC). (2003). Guidelines for Environmental Infection Control in Health-Care Facilities: Recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee (HICPAC). Retrieved from https://www.cdc.gov/infectioncontrol/pdf/guidelines/environmental-guidelines-P.pdf
  40. Ulrich, R. S., Zimring, C., Zhu, X., DuBose, J., Seo, H. B., Choi, Y. S.,..., & Joseph, A. (2008). A Review of the Research Literature on Evidence-Based Healthcare Design. HERD: Health Environments Research & Design Journal, 1(3), 61-125. doi:10.1177/193758670800100306
  41. White, R. D., Smith, J. A., & Shepley, M. M. (2013). Recommended standards for newborn ICU design, eighth edition. Journal Of Perinatology: Official Journal Of The California Perinatal Association, 33 Suppl 1, S2-S16. doi:10.1038/jp.2013.10
  42. Wong, M. F., Matic, Z., Campiglia, G. C., Zimring, C. M., Mumma, J. M., Kraft, C. S.,..., & Program, f. t. C. P. E. (2019). Design Strategies for Biocontainment Units to Reduce Risk During Doffing of High-level Personal Protective Equipment. Clinical Infectious Diseases, 69(Supplement_3), S241-S247. doi:10.1093/cid/ciz617
  43. World Health Organization. (2016). Guidelines on Core Components of Infection Prevention and Control Programmes at the National and Acute Health Care Facility Level. Retrieved from https://www.who.int/gpsc/core-components.pdf
  44. World Health Organization. (2018). IMPROVING INFECTION PREVENTION AND CONTROL AT THE HEALTH FACILITY. Retrieved from https://www.who.int/infection-prevention/tools/core-components/facility-manual.pdf
  45. World Health Organization. (n.d.). Prevent Infections Save Lives in Health Care. Retrieved from https://www.who.int/infection-prevention/tools/core-components/HAI-Infographic.pdf?ua=1,
  46. Zimring, C., Denham, M. E., Jacob, J. T., Lenfestey, N. F., Kamerow, D. B., Hall, K. K.,..., & Steinberg, J. P. (2013). Understanding the Role of Health Care Facility Design in the Acquisition and Prevention of HAIs. Retrieved from https://www.ahrq.gov/research/findings/final-reports/haidesign/haidesign-summary.html