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

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dc.contributor.authorEllison, Jennifer
dc.contributor.authorSouthern, Danielle
dc.contributor.authorHolton, Donna
dc.contributor.authorHenderson, Elizabeth
dc.contributor.authorWallace, Jean
dc.contributor.authorFaris, Peter
dc.contributor.authorGhali, William A
dc.contributor.authorConly, John
dc.date.accessioned2018-09-27T11:35:17Z
dc.date.available2018-09-27T11:35:17Z
dc.date.issued2014-01-01
dc.date.updated2018-09-27T11:35:17Z
dc.description.abstractBACKGROUND: 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.
dc.description.versionPeer Reviewed
dc.identifier.citationJennifer Ellison, Danielle Southern, Donna Holton, et al., “Hospital ward design and prevention of hospital-acquired infections: A prospective clinical trial,” Canadian Journal of Infectious Diseases and Medical Microbiology, vol. 25, no. 5, pp. 265-270, 2014. doi:10.1155/2014/685402
dc.identifier.doihttps://doi.org/10.1155/2014/685402
dc.identifier.urihttp://hdl.handle.net/1880/108213
dc.language.rfc3066en
dc.rights.holderCopyright © 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.
dc.titleHospital ward design and prevention of hospital-acquired infections: A prospective clinical trial
dc.typeJournal Article
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