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

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How do these issues impact the administrator? Patient Room and Infection Control Administrators have people coming to them constantly wanting things. Whether it is a surgeon wanting a new robotic surgical device, a radiologist wanting a new CT scanner, or the Infection Control Officer looking for a new ventilation system, everything costs a great deal of money. This is especially true in the world of healthcare because you cannot often just buy something if it is a major investment. You may need to go through the CON (certificate of need) process, acquire funding, etc… Compared to a 256-slice CT scanner, HEPA filters may not seem outrageously priced but the administrator needs to consider other options as well as the return on investment that can be expected. Estimated HEPA filter costs for a 32-bed unit with 90% efficiency filters would have an additional first cost of $15,000. Additional operating cost per unit per year would be around $4,000 for the increased power necessary, and HEPA filter replacement would cost approximately $6,000 per year for the materials and labor. While HEPA filters are recommended for healthcare facilities by the Centers for Disease Control and Prevention (CDC) and the Healthcare Infection Control Practices Advisory Committee (HICPAC), they are not exclusively and consistently used. The added cost just listed is the reason for not exclusively using them. Monetary values did not seem to be available for the return on investment that could be expected from using HEPA filters. The ROI would come from patients recovering quicker and going home sooner. Another source would be preventing readmission. If people improve their health substantially while they are inpatients they are much more likely to stay healthy once they leave the hospital (Joseph 2006). Compared to some thing simple such as staff education or placing alcohol hand sanitizing stations in convenient areas, HEPA filtration actually looks rather expensive. Whereas alcohol stations have low initial cost and low maintenance, HEPA filters cost thousands of dollars to both initiate and maintain. These are the issues to be dealt with by the administrative staff. 18
Patient Room and Infection Control Steps to reduce the spread of infection can take many different forms. From HEPA filters to hand washing, all things need to be considered. With this consideration comes the design implications of implementation. Hand washing is widely accepted as a simple way to reduce rates of infection. Some barriers to hand washing include; inconvenient sink location, lack of time, lack of soap or paper towels, and forgetfulness. This is as reported by hospital staff. Anjali Joseph goes on to discuss an Ulrich study that found there is some support for the notion that providing numerous, conveniently located alcohol-rub dispensers or washing sinks can increase compliance. Installing alcohol-based dispensers at the bedside in particular leaders to improved adherence. Joseph goes on to look at the work of Pittet who found that a combination of bedside antiseptic hand-rub dispensers and posters reminding staff to clean their hands increased compliance (Joseph 2006). Clearly the location of sinks and dispensers influences the actions of clinicians. If a patient is located in the middle of the room but a nurse has to go past them to get to a sink near the window they are less likely to do so because of the inconvenience. In the same way if the sink is located behind the door so that they have to walk in, close the door, turn their back to the patient and then wash their hands they are, again, less likely to comply. 19
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 16 and 17: Airborne Infection: Patient Room an
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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