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Private ICU Rooms Slash HAI Rates by Half

 |  By cclark@healthleadersmedia.com  
   January 12, 2011

Hospitals with multi-bed intensive care units are well advised to convert to single bed private rooms with their own sinks, according to authors of a study that found such a transition resulted in a 54% decline in rates for three types of hospital-acquired bacterial infections.

"Conversion to single rooms can substantially reduce the rate at which patients acquire infectious organisms while in the ICU," wrote Dana Teltsch and colleagues at McGill University Health Centre in Montreal.

The researchers found declines in combined rates of Clostridium difficile, vancomycin-resistant Enterococcus species and methicillin-resistant Staphylococcus aureus.

That's statistically significant, because 30% of ICU patients are diagnosed with a health-care associated infection, which is associated with significant morbidity and mortality, increased lengths of stay of eight or nine days, and $3.5 billion per year in estimated additional health care costs in the U.S., the authors wrote.

The article was published this week in the Archives of Internal Medicine.

While hospital architectural recommendations call for new facilities to include single patient ICUs, some older hospitals have not made the switch. Also, results from studies on the topic have produced mixed results, with only three of eight studies showing reduced rates of ICU infections after a facility changed its ICU design.

The researchers set out to compare rates of risk-adjusted hospital-acquired infections at two McGill Hospitals. The comparison hospital used is McGill's Royal Victoria Hospital, which has s 25-bed adult ICU divided into rooms with two, five or six beds and eight single-bed rooms.

The intervention hospital was Montreal General Hospital, 1.4 miles away, which had a 24-bed ICU consisting of two large rooms of 12 beds, two private rooms within each larger room and four sinks prior to 2002. But in 2002, Montreal General moved its ICU to a different area in the hospital to 24 single private rooms, each with a sink and two additional sinks outside each private room.

Some 19,343 ICU admissions over 2000 and 2005, and 85,9995 patient days were evaluated. The hospitals shared the same patient-nurse ratio, the same infection control service and director and the same policies and practices.

In addition to the decline in rates of infection, the authors found that the average length of stay Royal Victoria increased after Montreal General's conversion while Montreal General's fluctuated but did not increase overall.

"The drastic improvement in the physical facility of the ICU from common rooms to private rooms yielded a dramatic reduction in the transmission of bacteria and yeast," the authors wrote.

 

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