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Canadian Journal of Infectious Diseases and Medical Microbiology - Volume 25 2014, Issue 5, Pages 265-270

Original Article

Alberta Health Services, Calgary and Area, University of Calgary, Alberta Health Services, Calgary and Area, Calgary, Alberta, Canada

Department of Community Health Sciences, University of Calgary, Alberta Health Services, Calgary and Area, Calgary, Alberta, Canada

Institute for Public Health, University of Calgary, Alberta Health Services, Calgary and Area, Calgary, Alberta, Canada

Department of Medicine, Faculty of Medicine, University of Calgary, Alberta Health Services, Calgary and Area, Calgary, Alberta, Canada

Department of Sociology, Faculty of Arts, University of Calgary, Alberta Health Services, Calgary and Area, Calgary, Alberta, Canada

Calvin, Phoebe and Joan Synder Institute for Chronic Diseases, Faculty of Medicine, University of Calgary, Alberta Health Services, Calgary and Area, Calgary, Alberta, Canada



Copyright © 2014 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

BACKGROUND: Renovation of a general medical ward provided an opportunity to study health care facility design as a factor for preventing hospital-acquired infections.

OBJECTIVE: To determine whether a hospital ward designed with predominantly single rooms was associated with lower event rates of hospital-acquired infection and colonization.

METHODS: A prospective controlled trial with patient allocation incorporating randomness was designed with outcomes on multiple ‘historic design’ wards mainly four-bed rooms with shared bathrooms compared with outcomes on a newly renovated ‘new design’ ward predominantly single rooms with private bathrooms.

RESULTS: Using Poisson regression analysis and adjusting for time at risk, there were no differences P=0.18 in the primary outcome 2.96 versus 1.85 events-1000 patient-days, respectively. After adjustment for age, sex, Charlson score, admitted from care facility, previous hospitalization within six months, isolation requirement and the duration on antibiotics, the incidence rate ratio was 1.44 95% CI 0.71 to 2.94 for the new design versus the historic design wards. A restricted analysis on the numbers of events occurring in single-bed versus multibed wings within the new design ward revealed an event incidence density of 1.89 versus 3.47 events-1000 patient-days, respectively P=0.18, and an incidence rate ratio of 0.54 95% CI 0.15 to 1.30.

CONCLUSIONS: No difference in the incidence density of hospital-acquired infections or colonizations was observed for medical patients admitted to a new design ward versus historic design wards. A restricted analysis of events occurring in single-bed versus multibed wings suggests that ward design warrants further study.





Autor: Jennifer Ellison, Danielle Southern, Donna Holton, Elizabeth Henderson, Jean Wallace, Peter Faris, William A Ghali, and John Conl

Fuente: https://www.hindawi.com/



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