Relationship between hospital ward design and healthcare-associated infection rates: a systematic review and meta-analysis

Stiller, Andrea; Salm, Florian; Bischoff, Peter; Gastmeier, Petra

Preventing healthcare-associated infections, especially with multidrug-resistant bacteria, is paramount for patient safety [1] . In a point prevalence survey conducted between 2011 and 2012 in thirty European countries with 947 acute care hospitals and including 231 459 patients, the European Center for Disease Prevention and Control (ECDC) found a prevalence of 5.7% of healthcare-associated infections (HAI) [2] . There is still insufficient evidence of any correlation between hospital design and infection control. Moreover, the guidelines for healthcare facilities are often vague in their formulation of infrastructural characteristics due to limited evidence in this field of research. While the German Commission for Hospital Hygiene and Infection Control (KRINKO) recommends 10-20% single-patient rooms in a normal care unit, the Facility Guidelines Institute (FGI) recommends performing all patient care in single-patient rooms in its Guidelines for Design and Construction of Hospitals and Outpatient Facilities [3, 4] . According to this, the ratio of single-patient rooms in hospitals is increasing in Europe as well as in North America [5, 6] .