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

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

Giannitsioti et al. investigated the appropriate performances of hand hygiene compliance in two internal medicine departments [14] . The patient beds in department A were equipped with an alcohol-based handrub antiseptic on each bed rail while department B provided dispensers on each wall of the wards. For one month, the investigators anonymously recorded opportunities for hand hygiene as well as appropriate uses of antiseptic hand rub. Hand hygiene recording was conducted for a second time period after the bed-rail system had been installed in department B. The study revealed an increased hand hygiene compliance rate in department B following implementation of the bed rail system from 36.4 to 51.5% (p < 0.01), while the compliance rate in department A remained almost unchanged (36.4% vs. 35.9%). In a follow-up study conducted six months later, investigators recorded 70 uses of 255 opportunities (27.5%) in department A, in contrast to 80 uses of 302 opportunities (26.5%; p < 0.01) in department B over a time period of one month.