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Hospital ward design and prevention of hospital-acquired infections: A prospective clinical trial

Authors: Ellison, Jennifer(Alberta Health Services, Calgary and Area) Southern, Danielle(Department of Community Health Sciences, University of Calgary) Holton, Donna(Alberta Health Services, Calgary and Area) Henderson, Elizabeth(Alberta Health Services, Calgary and Area) Wallace, Jean(Department of Sociology, Faculty of Arts) Faris, Peter(Department of Community Health Sciences, University of Calgary) Ghali, William A(Alberta Health Services, Calgary and Area) Conly, John(Alberta Health Services, Calgary and Area);

Hospital ward design and prevention of hospital-acquired infections: A prospective clinical trial

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.

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18 references, page 1 of 2

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citations
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
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