Risks and absolutes in hospital renovation

Abstract

Risks and absolutes in hospital renovation Dorothy Pequegnat and Robert H. Elder Ottawa Civic Hospital, Ottawa, Ontario Kl Y 4E9, Canada During the past 3 years the Ottawa Civic Hospital has undergone extensive renovations of patient care areas and the construction of new special treatment facilities. From an infection control perspective numerous problems were encountered in respect of space configuration, equipment design, air management and the finishes of floors, walls and ceilings. Failure to consistently involve infection control practitioners at the initial design phase sometimes led to costly last-minute revisions. Inappropriate choice of equipment or the unavailability of suitable equipment from an infectiomn control point of view created on-going problems. Air management systems did not always function according to specifications. Throughout the process financial constraints made it necessary to decide when a degree of risk could be accepted and when there was no alternative to absolutes. The point system for selection of patient care products I. Gureviclh, P. Tafuro and B. A. Cunha Nassau Hospital, Mineola, New York, USA Although nurses use many products while caring for their patients, they rarely have input into the selection of these products. Usually a purchasing agent chooses an item based on its cost and on the recommendations of sales representatives who, understandably, stress only the advantages, never the disadvantages, of their product. Closed urinary drainage systems used with indwelling catheters are a typical example of an item that must be chosen carefully. They can contribute to the risk of infection, many types are available from several manufacturers, and they are handled predominantly by nurses. Using this as an example of product evaluation, our presentation explains the 15 or more features that should be considered when a drainage system is chosen. Some designs can make the system more convenient to use, such as the emptying device or the hanging components, or influence the acquisition of infection. Others sound useful but in reality are not really necessary and just add to the cost of the product. A point system weighted according to the importance of each feature will be discussed. If Infection Control Practitioners use the steps discussed in this presentation, they will be able to contribute to a product selection process that assures safety, quality, and cost effectiveness. A systems approach to infection assessment enhances patient care and infection control practices P. Jemison-Smith and L. Thrupp University of California, Irvine, Medical Centre, Orange, California, USA Assessment of the patient is an important nursing practice and should be performed at least every shift. By incorporating into that evaluation process an infection control assessment, the following may be achieved: early identification of an infectious process; appropriate