Prevention of Surgical Infections: Building or Renovating a New Intensive Care Unit.

Abstract

Renovating or building a new intensive care unit (ICU) can be a challenging project. Planning the renovation or rebuild as a quality improvement project will help break down the process into manageable pieces with clear goals. Literature was reviewed with regards to ICU design and renovation, with specific attention to patient quality improvement, process and structural change, healthcare systems engineering, emerging technology, and infection control. In any quality improvement initiative, a first step is to create a multidisciplinary change team charged with leading the rebuild process. This team should include frontline providers, administration, architects, infection prevention specialists, and healthcare system engineers. Healthcare system engineers (HSEs) are specialized system and human factors engineers who can assist with data analysis, create mathematical models to anticipate areas of difficulty, and perform simulations to assist with the actual structural changes as well as the process changes aimed at eliminating nosocomial infections. Every aspect of creating a new ICU space should begin with infection control standards of practice ranging from selection of furniture and computer keyboards, to identifying the best location of the soiled utility rooms. There are many infection control products that may be considered during the building process such as tele-tracking hand hygiene stations and heavy-metal-coated surfaces aimed at decreasing surface colonization and subsequent infections. This article offers suggestions on renovating or rebuilding an ICU aimed at eliminating the preventable harm associated with hospital acquired infections.