Several users have requested a library for documents of general interest to IFHE members. The library is hereby established, and our first achievement is publishing papers selected from presentations to the 2008 IFHE Congress of Barcelona.
In this particular case some are written in Spanish and some in English.
Each article will begin with an abstract in English, followed by the full paper in original version, preferable in English but not excluding other languages.
They should constitute a seed for more articles and collaborations from around the world, from Journals or from Congresses of A Members.
ABSTRACT
The work is part of the VALSAI project co-ordinated by the Finnish Institute of Occupational Health.. Related hygiene aspects and factors were studied in four hospitals in southern Finland in winter 2007. Bacteria and moulds were measured in surgery, emergency, intensive care, and internal disease units or departments. Inspection of ventilation system and particle measurements in indoor and supply air was done simultaneously. Microbial air samples were collected using a six-stage cascade impactor and settled dust samples with a sterile moisture swab on horizontal surfaces (e.g. book shelves) at a height of 1.5 m. Surface samples were cultivated directly on the growth media, and the results were thus expressed on a semi-quantitative scale. No outdoor air samples were needed in the subarctic climate.
Air hygiene in the hospitals was mostly at a good level. However, severe functional problems were detected in some ventilation systems, which resulted in elevated concentrations of airborne bacteria. In one intensive care unit, pathogenic bacteria were found in a room of four patients, which entails a possible infection risk via air. Opportunistic fungi and/or actinobacteria were detected in three hospitals indicated probably moisture and mould damages. In addition, the surfaces of some cooling systems were contaminated with moulds. In conclusion, the maintenance of ventilation systems should be more careful. Hygiene of cooling systems needs more research
08.01.2009
Hospital design to accomodate multiressistant TB patients.doc
ABSTRACT
South Africa faces one of the most devastating Mycobacterium tuberculosis (TB) epidemics in the world in terms of TB incidence (or number of cases per capita) and overall TB burden (or total number of cases). Recent studies by the Medical Research Council (MRC) indicate that more than half the TB patients are also HIV-infected, with the co-infection rate approaching 75% in some provinces.
The availability of antiretroviral therapy in Africa brings hope for the management of HIV-associated TB. However, the treatment brings together individuals with undiagnosed TB, or MDR-TB (and now XDR-TB), and immune-suppressed HIV-infected individuals in congregate settings, resulting in high risk to hospital workers and patients. Tuberculosis (TB) is an airborne infectious disease that is curable. The impact of TB in South Africa is exacerbated by the vulnerability of people with HIV and AIDS, leading to high co-infection rates. Drug resistant TB however, requires longer treatment and isolation from other TB patients and the general public in order to stop the spread of those strains.
Little, if any, guidance is currently provided to design new health facilities or the refurbishing of existing structures. Moreover, the need to improve the quality and functionality of health facilities through better design and operational management is a priority and the development of appropriate guidelines for facility design, infection control and functional methods for in-house risk management to prevent airborne infection are sorely needed.
This paper provides an overview of hospital design solutions to accommodate M(X)DR-TB patients and methodologies adopted to fast track the provision of much needed beds in the various high burden provinces in South Africa.
08.01.2009
The role of Engineering and Architecture in Infection Control.doc
ABSTRACT
Fighting against infection control in the healthcare facilities may find a powerful ally in the Architecture and Engineering. There are many technologies that architects and engineers can use to contribute to this objective. Delimitation of the space in critical, semi-critical and non-critical area, physical barriers erected between areas, air contamination control, proper workflow and correct choice of finishing materials, these are some strategies that, along with medical and nursing procedures, contribute to achieve a minimization of the infection rate in a healthcare facility.
However, many architecture solutions are presently adopted with the false idea that they contribute to infection control, however without any practical result. For instance, exclusive circulation hallways for “cleaned” material, are one of the actions that raise the construction and maintenance costs in the facility. The best infection prevention is to treat contaminated elements in the place where they are generated. Then the transport of the contaminated material can be made through any area, if it is conditioned with suitable sealing technique, and move through sterilized material and patient without any risk.
Either architecture or engineering solutions should be adopted based on facts evidence and on scientific knowledge, breaking down a few myths.
Materials are an important issue, too. During the definition of the finishing material to be used, the construction project team should observe, besides the esthetics, acoustics, durability, price, etc, the performance of the material related to water absorption, since less water absorption reduces the risk of microorganism proliferation. One should look for materials that turn the wall, floor, ceiling and counters, surfaces resistant, washable, smooth, impermeable or almost, and easy for cleaning and disinfection .
Author: P.Petinga, P.Petit, PJ Vialle, S Delaby, Robine and E.Gehin – France
ABSTRACT
A new photocatalytic air cleaner applied to the management of the microbiological indoor air quality is examined in this article. Ths research studied the effectiveness of the devices used in the microbiological purification of the air. This specifically involves the inactivation of biological aerosols in the air handling unit, the first device working on the principle of photocatalysis. This system, called NEO and developed by CIAT involves the combination of filtration, adsorption, and heterogeneous photocatalysis
Author : Bob Heavisides- Milton Keynes Hospital- UK
ABSTRACT
This article will examine the basis of the current NHS Estate Strategy and compare this with a view of what constitutes a Master Planning document, and how such a document can be an integrated pathway to a wider health economy view
Author : Ghasson Shabha – Birmingham City University, UK
ABSTRACT
The effectiveness of current design and management intervention systems in combating hospital acquired Methicilin Ressistant Staphilococus Aurea ( MRSA ) infections in British hospitals is examined in this article. MRSA is a prevalent bacterium in UK hospitals which together with other organisms remain a cause for concern amid increasing incidences of healthcare-associated infection. It has penetrated virtually every hospital, and a chronic state remains in most, with episodes of cross-infection and outbreaks
28.02.2010
Do single patient rooms reduce infection risks.pdf
Government guidelines for new built hospitals in England and Wales currently states that 50% of patient bedrooms should be single rooms. There is an ongoing debate among healthcare professionals regarding the benefits of single rooms.. Although some evidence exists, more research is needed to investigate patient safety in single rooms particularly with regards to reducing the risk of cross-infection by other patients
Author : Sydney Parsons, Geoff Abbot, Peta de Jager. South Africa
ABSTRACT
In South Africa the district hospital figures prominently in the struggle against communicable diseases. Among them , TB ( now drug-resistant TB ) is the most perilous after HIV/ AIDS. Much needed are guidelines for facility design, environmental infection control measures and functional methods to prevent airborne infection
Author: Patrick Waterson Loughborough University , UK
ABSTRACT
The last few years have seen a great deal of media attention in the UK regarding hospital infection control. High profile hospital outbreaks involving Clostridium and MRSA have made infection control a central priority for the NHS and other healthcare systems. One possible way forward is to adopt a System Approach in order to probe deeper into the causes of hospital-
