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

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

We included intervention studies that examine the colonization with multidrug-resistant organisms (MDRO) or infection with any type of pathogen by comparing patient care in single bedrooms with multi-bedrooms or with an open ward design. We excluded surveys of single room isolation, in which single patient rooms or patient cohorting in isolation wards were examined as an infection control measure for already colonized or infected patients. Moreover, we removed studies that discussed bundled interventions, for example additional patient decolonization strategies or healthcare worker education programs. We also excluded a prevalence study, in which the routine use of single patient rooms was analyzed as a variable in a multivariate analysis [12] . We also excluded studies that Flow diagram of the study selection process for studies examining the impact of the patient's room size and physical proximity between patients on healthcare-associated colonization or infection rates investigated outcomes other than infection or acquisition of multidrug-resistant organisms, for example psychological effects on patients, economic aspects, and the patient's length of stay or medication errors.