Does the Architecture of Hospital Facilities Influence Nosocomial Infection Rates? A Systematic Review — Dettenkofer 2015
The purpose of this study is to examine the evidence regarding the effects of hospital design and construction interventions on the incidence of nosocomial infections. Review of experimental and non-experimental architectural intervention studies in intensive care units (ICUs), surgical departments, isolation units, and hospitals in general. The studies were published in English, French, German, Italian, and Spanish in 1975. The studies were identified using seven medical databases, reference lists, and expert consultation, regardless of their format. Results: One hundred seventy-eight scientific articles were found, but none of them described a meta-analysis, systematic review, or randomized, controlled trial. The majority of articles were classified as having the lowest level of evidence (expert judgment or consensus statements). Only 17 completed concurrent or historical cohort studies described in the literature met the inclusion criteria (ICUs, 9; surgical departments, 4; isolation units, 2; hospitals in generai, 2). Typically, the interventions involved relocating to a new location or renovating. However, in numerous studies, the ratio of staff to patients improved. Due to confounding factors and frequently small study populations, this finding cannot be generalized, despite the fact that some studies have demonstrated a reduction in infection rates following intervention. Conclusions: The lack of conclusive evidence linking hospital design and construction with the prevention of nosocomial infection is partially attributable to the multifactorial nature of these infections. However, if basic conditions such as the availability of sufficient space, isolation capacity, and handwashing facilities are met, there will be some improvement. To our knowledge, however, other factors, particularly the improper hand hygiene of medical personnel, have a greater effect.
Dettenkofer, M., Seegers, S., Antes, G., Motschall, E., Schumacher, M., & Daschner, F. (2004). Does the Architecture of Hospital Facilities Influence Nosocomial Infection Rates? A Systematic Review. Infection Control & Hospital Epidemiology, 25(1), 21-25. doi:10.1086/502286
