Building new hospitals: a UK infection control perspective

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Summary

Infection control input is vital throughout the planning, design and building stages of a new hospital project, and must continue through the commissioning (and decommissioning) process, evaluation and putting the facility into full clinical service. Many hospitals continue to experience problems months or years after occupying the new premises; some of these could have been avoided by infection control involvement earlier in the project. The importance of infection control must be recognized by the chief executive of the hospital trust and project teams overseeing the development. Clinical user groups and contractors must also be made aware of infection control issues. It is vital that good working relationships are built up between the infection control team (ICT) and all these parties. ICTs need the authority to influence the process. This may require their specific recognition by the Private Finance Initiative National Unit, the Department of Health or other relevant authorities. ICTs need training in how to read design plans, how to write effective specifications, and in other areas with which they may be unfamiliar. The importance of documentation and record keeping is paramount. External or independent validation of processes should be available, particularly in commissioning processes. Building design in relation to infection control needs stricter national regulations, allowing ICTs to focus on more local usage issues. Further research is needed to provide evidence regarding the relationship between building design and the prevalence of infection.

Section snippets

Introduction and aims of the Project Group

In March 2003, a group of medical microbiologists and infection control nurses met to share their experience of infection control issues related to new hospital building projects. The Project Group members were involved in hospital developments throughout the UK and Ireland. Some projects had been completed, some were in progress, and others were just beginning. Different design teams, builders and facilitators were involved in each project. Some of the schemes were built under the Private

Formation of guidelines and action points

The Project Group felt that it would be most helpful to structure the guidelines chronologically, so that the key action points are identified for each stage of the developmental process. Each scheme can be subdivided into the following sections.

  • 1.

    Concept and feasibility studies. Departmental and support service output specifications (i.e. details of how they will operate).

  • 2.

    For PFI projects: invitation for expressions of interest by potential sponsors. Preliminary and final invitations to contract

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