A research team from the McGill University Health Centre (MUHC) and McGill University has demonstrated that private rooms in the Intensive Care Unit (ICU) play a key role in reducing hospital infections like C-difficile. The study, published January 10, 2011 in the journal Archives of Internal Medicine, also suggests that length of stay would be shorter and this could lead to cost savings to the healthcare system.
Infection control in hospitals is a worldwide health concern that can have a serious impact on patient morbidity, mortality and the cost of treatment – particularly in the ICU, where patients are highly susceptible to infection. Single-patient rooms have long been considered to provide patients with better protection from hospital infections. However, previous studies investigating this issue have been inconclusive. “We had a valuable opportunity to examine the rates of acquisition of infection in patients during a change from multi-bed to single rooms in the ICU at the MUHC,” explains Dana Teltsch, lead author of the study and Ph.D. candidate in the Dept. of Epidemiology, Biostatistics and Occupational Health at McGill.
The results show that the infection acquisition rate after room privatization fell about 50 percent for three bacteria of most concern – Staphylococcus aureus (MRSA), C-difficile and Enterococcus (VRE). “We also observed a 10 percent reduction in the length of stay in the ICU after changing to private rooms. These findings provide a basis of comparison of the savings versus the costs to the healthcare system on top of the health benefits to patients,” said Teltsch. It is estimated each case of C. difficile can cost of up to $7000 per episode. “
This study is the first evaluation of the full range of the benefits of private rooms in an ICU environment and highlights the important role that physical infrastructure plays in the prevention of transmission of healthcare associated pathogens,” said Dr. Vivian Loo, one the co-author’s of the study, Chief of Microbiology at the MUHC and Associate Professor in McGill’s Department of Medicine. “
Of course, other factors are also important in preventing transmission, like hand hygiene, isolation precautions, antibiotic stewardship and housekeeping practices, but this study clearly demonstrates the crucial need for private rooms, particularly for this patient population.”
“Private rooms can help our patients avoid infections and also aid the healthcare system as a whole in decreasing length of stay associated with hospital-acquired infections,” says Dr. David Buckeridge, senior author, Associate Professor in the Dept. of Epidemiology, Biostatistics and Occupational Health at McGill and a Medical Scientist in the Department of Medicine at the Research Institute of the MUHC. “We did not measure all of the costs and benefits of private rooms in our study, but they are an investment that, once built, should continue to provide substantial benefit.
” All rooms at the New MUHC, at the Glen, Lachine and Mountain campuses, will be single-patient rooms where natural light, a comfortable family area, and a private bathroom will contribute to the healing of both body and mind. Apart from limiting the spread of infections, single-patient rooms ensure privacy and confidentiality, give patients a sense of control and provide enough space for medical equipment to be wheeled in beside beds, meaning that patients can stay in their rooms for routine exams, treatments or tests.
About the study: The study entitled “Infection Acquisition Following Intensive Care Unit Room Privatization has been co-authored by Dana Teltsch (McGill), James Hanley (McGill,MUHC), Vivian Loo (McGill, MUHC), Peter Goldberg (MUHC), Ash Gursahaney (MUHC) and David Buckeridge (McGill,MUHC). It was funded in part by a research grant from the Canadian Institutes of Health Research (CIHR) and the Natural Sciences and Engineering Research Council. Click here for online access: www.jamamedia.org.
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