The Patient Room: what is the ideal solution? - Cornell University

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Airborne Infection: Patient Room and Infection Control Sources of some airborne pathogens can be construction and renovation activities or ventilation system contamination and malfunction. This could mean dust and moisture accumulating in the heating, ventilation, and air conditioning systems or the failure of these systems. In one study, there was an outbreak of invasive pulmonary aspergillosis (IPA) in a ward housing acute leukemia patients. This ward had natural ventilation and the hospital was doing extensive construction and renovation. The infection rate climbed to 50%. Some of the patients were moved to another ward with HEPA filters and for the following three years none of them developed IPA. However, those kept in the regular ward had a 29% rate of infection during the same time (Joseph 2006). Contamination and malfunction of HVAC systems can pose a threat of its own. A specific MRSA study where six patients and one nurse were infected found that ventilation grills in two patient bays were harboring MRSA. When this happened , the ventilation system would shut down daily during its cycle, which created negative pressure so air from the patient ward got sucked into the ventilation system. When the system came back on, the infected air came out to infect patients and staff (Joseph 2006). These previously discussed cases seem preventable now that we know what caused them. Indeed there are processes and steps to take in order to improve air quality. Using HEPA filtration is one way to control air pollutants. Some believe the most effective way to combat these pollutants is to control them at the source (Joseph 2006). Joseph’s “Steps involved in providing clean filtered air in the hospital,” are demonstrated in the graphic. 16
Contact Transmission: Patient Room and Infection Control The easiest way to deter contact transmission of infection and disease is to clean often and thoroughly. This sounds simple enough as every hospital is staffed with housekeeping workers who are trained in cleaning and disinfecting rooms. Different rooms that may have housed patients with different diseases or infections may be treated differently. The issue comes when a patient is discharged but was in a dual-bed room so the other patient is still there. Even if the vacant half of the room is cleaned immaculately there is still the threat of pathogens that can settle on all surfaces throughout the room. A further threat is that the hospital is full so people normally getting single rooms are now in doubles. If the Emergency Department has people waiting for rooms the housekeeping staff is rushed to clean as quickly as possible so that the room or bed is available. This type of process does not necessarily encourage best practice and diligence . According to the staff at the Mayo Clinic, “Clostridium difficile, often called C. difficile or "C. diff," is a bacterium that can cause symptoms ranging from diarrhea to life-threatening inflammation of the colon. Illness from C. difficile most commonly affects older adults in hospitals or in long term care facilities and typically occurs after use of antibiotic medications.” This is a serious problem in many hospitals across the country. Two cases in the UK with especially severe outbreaks found that there were predominantly multibed rooms with shared toilets. There were very few single rooms with private toilets. These factors together were seen as major contributors to the outbreak (HERD Journal 2008). It is not realistic to expect someone to completely disinfect the entire bathroom every time someone uses it if there are multiple people in the same room. This type of practice simply would not be feasible. Having single-bed rooms as the norm would help to contain this sort of outbreak. While we wouldn’t want anyone to come down with this sort of illness it would be very desirable to limit it to as few patients as possible. 17
Page 1 and 2: Design Dilemma DEA 4350 November 8t
Page 3 and 4: Executive Summary DEA 4530/6530 Pla
Page 6 and 7: The Patient Room: a complicated web
Page 8 and 9: History of Patient Rooms Historical
Page 10 and 11: History of Patient Rooms What happe
Page 12 and 13: HOT TOPIC1: INFECTION CONTROL 12
Page 14 and 15: Patient Room and Infection Control
Page 18 and 19: How do these issues impact the admi
Page 20 and 21: Patient Room and Infection Control
Page 22 and 23: HOT TOPIC 2: SINGLE VS. MULTI-PATIE
Page 24 and 25: Why so much building Activity? •
Page 26 and 27: "With what we are learning about th
Page 28 and 29: New York City Construction Costs: i
Page 30 and 31: Single Patient Room and Safety What
Page 32 and 33: Single Patient Rooms and Safety: In
Page 34 and 35: Single Patient Room and Increased P
Page 36 and 37: Single Patient Room and Communicati
Page 38 and 39: Single Patient Room and Patient Sat
Page 40 and 41: Single Patient Room and Layout Comp
Page 42 and 43: Single Patient Room and Social Isol
Page 44 and 45: HOT TOPIC 3: EVIDENCE BASED DESIGN
Page 46 and 47: A closer look at Evidence-Based Des
Page 48 and 49: (Healthcare Design, 2006) Evidence-
Page 50 and 51: Evidence-Based Design: A Homelike A
Page 52 and 53: The Ideal Patient Room: proposed so
Page 54 and 55: To compensate for insufficient fund
Page 56: Safety, efficiency, and ease on sta
Page 59 and 60: esonance/ Resources continued: Inst

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