I would love to see CDC and other federal agencies collect all the knowledge that we learned in the three years that we spent fighting this terrible pandemic and come up with solutions that perhaps could be incorporated into maybe a 2026 or 2028 revised EIC guideline .” — Douglas Erickson
a lot more than was anticipated . So , of course , trying to go to a negative-pressure room from an equal- or positive-pressure patient room , a lot of conversions were being done .”
Erickson adds , “ That said , I don ’ t believe that the research and the technology have worked their way through the science yet . A lot of the infection preventionists I talked to said they would never convert patient rooms to negative-pressure rooms simply because they didn ’ t think that would be of assistance in trying to keep the airborne infectious disease contained within the room or keep it from spreading to other areas of the hospital . Others thought that negative pressure was the way to go , and they converted all their patient rooms to negative pressure . I would love to see CDC and other federal agencies collect all the knowledge that we learned in the three years that we spent fighting this terrible pandemic and come up with solutions that perhaps could be incorporated into maybe a 2026 or 2028 revised EIC guideline .”
Many have characterized the 2003 EIC guideline as the “ go-to guideline ” because it covers so many relevant , practical , real-world issues that impact infection prevention and control in the healthcare environment .
“ It ’ s very unusual for a guideline or a standard to stand the test of time for 20 or more years ,” Erickson concurs , “ as most standards and guidelines are revised every three or four years . So , to have something like the EIC guideline out there for 20 years and to be valuable for all those years is a testament to its content . It is written in common , not obtuse English , meaning it doesn ’ t contain a lot of clinical terms or construction or architectural language to bog down the reader . That allows the document to be used by so many different types of professionals .”
But that doesn ’ t mean that all readers of the 2003 EIC guideline were pleased by its content .
“ When we rolled out these environment-of-care concepts in the late 1980s , continued to teach it during the 1990s , and then the guideline came out in 2003 , there was a lot of resistance ,” Erickson recalls . “ Many people said , ‘ I ’ ve been a hospital engineer for 40 years , and I ’ ve never had to do any of this , all you are doing is adding more time to my daily tasks , adding more costs , more contractors , etc . and we ’ re never going to get our work done because of all these constraints .’ It took us almost a decade to dispel all of those beliefs . Many of them on the construction side eventually discovered that they were saving money , time and resources by following the recommendations in the 2003 EIC guideline . So , in the beginning it was a very hard sell , but now it ’ s second nature to everyone , which I think is a feather in the cap of everybody who either worked on the EIC guideline or been involved with infection prevention and the built environment .”
As we have seen , the built environment is invisible , so to speak , to the average clinician who is laser- focused on patient care , yet it is instrumental to quality patient outcomes .
“ It ’ s a matter of out of sight , out of mind , as a lot of the systems , like ventilation , are hidden behind walls ,” Erickson confirms . “ Clinicians are not focusing on them because they have their own priorities on the clinical side . So , when I ’ m asked the question , ‘ What is the impact of a properly designed and maintained physical environment or built environment on healthcare delivery ?’ my answer is , ‘ You must give clinicians the tools they need to do their work properly .’ That means it ’ s an opportunity for us as engineers , architects and designers of healthcare facilities to ensure that they can wash their hands at sinks that are located appropriately , or access hand sanitizer dispensers that are easy to use at the point of care , or making sure that surfaces used in the healthcare facility can be cleaned and disinfected properly . Proper placement of effective tools is critically important so that clinicians can be good stewards of patient care .”
To that point , human factors engineering ( HFE ) is defined as a science dealing with the application of information on physical and psychological characteristics to the design of devices and systems for human use . As a body of knowledge , human-factors engineering is a collection of data and principles about human characteristics , capabilities , and limitations in relation to machines , jobs , and environments . As a process , it refers to the design of machines , machine systems , work methods , and environments to consider the safety , comfort , and productiveness of human users and operators .
Erickson laments that the 2003 EIC guideline preceded the application of HFE to healthcare by a few years .
“ The guideline was a little bit too early for HFE as we know it today ; however , within the guidelines for design and construction provided by the FGI , we continued to bring in the human factor as we talk about the placement of certain elements within hospital rooms . As an example , right now we ’ re conducting research on patient falls and how human factors can play a role ; for example , where is the bed located compared to the door to the patient ’ s bathroom ? Where is the bed located with regard to the door or to the corridor ? All these factors come into play , and we ’ re using virtual reality to identify the best locations for everything from beds to bathrooms , to doors , and even family zones . If we could have had more in the way of human factors engineering input for the 2003 EIC guideline , it would have been even better than it already was .”
24 august 2023 • www . healthcarehygienemagazine . com