Essential Requirements for Infection Prevention Control in the Hospital Built Environment
Health care associated infections (HAI), or nosocomial infections, are a global problem that is frequently encountered in low-resource settings, contexts where MSF operates. In an era of increasing antimicrobial resistance, the importance to enhance the measures for Infection Prevention and Control (IPC) seem more relevant than ever.
A growing number of studies are providing evidence associating the design of healthcare facilities with clinical outcomes. (Ulrich, 2008) Researches indicates that well-designed physical settings make healthcare facilities safer for patients, create an efficient working environment and, most important, have a significant impact in the transmission of pathogens, mitigating the risk of infection to patients and staff. (Hall, 2013) In addition, since last year, the hospital built environment is listed as a core component of IPC programmes at the national and acute health care facility level. (WHO, 2016). Nevertheless, it is imperative to reach a balance between desired hospital built environment requirements and context limitations. In this regard, the definition of what could be considered as the basic standards or essential structural requirements for hospital built environment remains without an answer.
The aim of this project is to identify and select designs criteria to optimize the hospital built environment in order to enhance and facilitated the behaviour of healthcare workers regarding the execution of IPC measures. We aim to optimize both existing and newly built hospitals, specifically modular facilities.
Definition of the initial set of recommendations of Essential Requirements (EReq) for Infection Prevention Control in the Hospital Built Environment. We intend to identify and select built environment requirements — or design features — considered essential for the proper execution of IPC measures in healthcare facilities operating under MSF programmes. The requirements will focus on hand hygiene, environmental cleaning and isolation precautions and it will cover the following medical activities: surgical facilities, emergency facilities, delivery room and inpatient areas (NICU, ICU, postpartum and surgical wards).
Evaluation of feasibility, process and outcomes indicators of the proposed requirements. The intention of Phase II is to evaluate the feasibility of the implementation of the initial set of recommendations; assessing the resilience of existing healthcare facilities to compliance to the EReq. It will also include an interventional study (before and after) in order to provide evidence of the effectiveness of the EReq in the prevention and control of infections. The outcome of Phase II is the final set of recommendations for Essential Requirements for Infection Prevention Control in the Hospital Built Environment.
Implementation and diffusion of the EReq. The set of requirements will be translated into a performance evaluation tool for healthcare facilities. This tool intended to support field staff and/or expats to assess the healthcare facility compliance with the EReq and support them, providing recommendation and instructions, for the implementation of the EReq.
Operational Centre Brussels, Medical Department
Institut für Industriebau und Konstruktives Entwerfen, Technische Universität Braunschweig, Germany