Quiz 5: Infection control considerations for healthcare facility design
Please choose the one, most correct answer to each question or statement.
- The most important consideration when designing a new healthcare facility is:
- The budget available for the project
- The disease profile of the local community
- The community’s stated service needs
- The existing facilities available in the area.
- Infection control practitioners should be involved in healthcare facility design because:
- They can advise on design elements to reduce healthcare-associated infection (HAI)
- They will have to work in the facility once built
- They know better than clinicians what is required for a new building
- They are required by law in all countries to be involved in all building projects.
- Infection control practitioners should be involved in healthcare facility design:
- Just before the ward is opened to admit new patients
- Just before the building or renovation work starts
- After the approved plans have been received from the architect
- When the ideas for the building or renovation are first being discussed.
- Infection control practitioners should advise on the following aspects:
- Resuscitation and clinical equipment needed
- The colour of the walls and floors
- Isolation rooms, ventilation, layout and fittings
- The admission criteria for patients to the new ward/area.
- Beds in the general wards should be separated by at least:
- 2.5 metres (centre of bed to centre of next bed)
- 3.0 metres (edge of bed to edge of next bed)
- 3.5 metres (centre of bed to centre of next bed)
- 2.5 metres (edge of bed to edge of next bed).
- In general wards, at least one dedicated handwash basin should be provided:
- For every bed
- For every two beds
- For every four beds
- For every six beds.
- The common route/s for infection transmission in clinics include:
- Respiratory
- Respiratory and contact
- Faeco-oral
- Inoculation.
- The highest risk of infection in dental clinics is from:
- Blood-borne viruses
- Bacteria
- Gastro-intestinal viruses
- Prions.
- Isolation rooms:
- Should make up at least 30% of all hospital beds
- Should always be mechanically ventilated under positive pressure
- Do not need en suite bathrooms
- Function to separate infectious patients from susceptible patients.
- Operating theatres:
- Should be mechanically ventilated under negative pressure
- Should be kept at temperatures between 24 and 28 °C
- May routinely sterilize their own surgical equipment in the theatre
- Should have well-demarcated ‘clean’ and ‘sterile’ zones.
- Intensive care units (ICU):
- Do not require isolation rooms as the beds are far apart
- Should have a minimum of 2.5 metres space between beds
- Require at least one handwash basin for every six ICU beds
- Should regularly train their staff on hand hygiene and aseptic technique.
- Accident and emergency units:
- Do not require isolation rooms/bays
- Should have sharps containers within easy reach of every bed/bay
- Must have negative pressure ventilation
- Are not high-risk areas for needlestick injuries.
- Patients in burns wards:
- Are not at particularly high risk of infection
- Acquire infections mostly by respiratory transmission
- Acquire infections by contact with staff, equipment and the environment
- Should all be placed under protective isolation.
- Neonatal wards require:
- One isolation room for every 30 beds
- Disease screening protocols for mothers admitted to kangaroo care units
- Handwash basins next to every cot/incubator
- Specialised environmental disinfection of all surfaces.
- Milk preparation areas:
- Are a high-risk area for microbial contamination of infant feeds
- Can store milk in fridges together with medication and foodstuffs
- Can prepare feeds up to 48 hours in advance
- Can use low-level disinfection for babies’ bottles and teats.
- With regard to expressed breastmilk (EBM):
- The risk of HIV or hepatitis transmission through breastmilk is low
- Mothers may express, label and store the EBM themselves
- EBM should be stored at 4–6 °C and used within 24 hours
- Pasteurisation is not needed for pooled EBM.
- Mortuary workers:
- Do not require personal protective equipment since corpses do not transmit infections
- Are at risk of penetrating injuries, mucosal splashes and infection with respiratory pathogens
- Are not required to change out of their personal clothing before coming on duty
- Are not required to shower before coming off duty.
- Ambulance staff:
- Should try to establish any infection transmission hazards before transporting a patient
- Should wear surgical masks when transporting patients with pulmonary TB
- Should ask patients with pulmonary TB to wear N95 respirators when inside the ambulance
- May use alcohol handrub to decontaminate hands covered in blood or mucus.
- Hospital kitchens:
- Staff require only routine pre-employment health checks
- Require the same personal protective equipment as the clinical staff
- May prepare raw and cooked food in the same area
- Require an uninterrupted supply of hot and cold water.
- Support services staff:
- Are at lower risk for pathogen exposure than clinical staff
- Should receive pre-employment hepatitis B immunisation
- Are not required to wear personal protective equipment
- Are not required to undergo training in infection prevention and control.