INFECTION CONTROL IN HOSPITAL

Infection Control in Hospital

Infection Control in Hospital

Abstract

Infection control input is vital throughout the planning, design and building stages of a new hospital project, and must continue through the commissioning (and decommissioning) process, evaluation and putting the facility into full clinical service. Many hospitals continue to experience problems months or years after occupying the new premises; some of these could have been avoided by infection control involvement earlier in the project. The importance of infection control must be recognized by the chief executive of the hospital trust and project teams overseeing the development. Clinical user groups and contractors must also be made aware of infection control issues. It is vital that good working relationships are built up between the infection control team (ICT) and all these parties. ICTs need the authority to influence the process. This may require their specific recognition by the Private Finance Initiative National Unit, the Department of Health or other relevant authorities. ICTs need training in how to read design plans, how to write effective specifications, and in other areas with which they may be unfamiliar. The importance of documentation and record keeping is paramount. External or independent validation of processes should be available, particularly in commissioning processes. Building design in relation to infection control needs stricter national regulations, allowing ICTs to focus on more local usage issues. Further research is needed to provide evidence regarding the relationship between building design and the prevalence of infection.

Introduction

In March 2003, a group of medical microbiologists and infection control nurses met to share their experience of infection control issues related to new hospital building projects. The Project Group members were involved in hospital developments throughout the UK and Ireland. Some projects had been completed, some were in progress, and others were just beginning. Different design teams, builders and facilitators were involved in each project. Some of the schemes were built under the Private Finance Initiative (PFI), while others used public sector monies. Although there are specific issues regarding PFI projects that need to be addressed, most of the practical experiences are applicable to all hospital building initiatives, whatever their funding source or political setting.

It is now accepted that infection control should be integral to the planning and subsequent building and operation of all healthcare premises. A recent publication by the UK National Health Service (NHS) body, NHS Estates—'Infection control in the built environment' (2002)—provides very helpful guidance to all professionals involved in the development of new healthcare facilities. This document had not been available to most members of the Project Group at the beginning of their projects, and much time was spent gathering information and considering problems without any relevant guidance. The Project Group does not intend the present report to duplicate material contained in that publication, but instead to complement it, distilling the practical experiences gained from a number of new hospital developments.

Some problems encountered were unique to a particular building project, but most were common to all. If these problems are recognized at an early stage, ...