INFECTION PREVENTION AND CONTROL
Designers need to better understand the risks
In the second in a series of three articles on an infection and prevention control theme from the established architectural practice – the first appeared in the October 2024 HEJ – Melanie Jacobsen Cox, head of Healthcare at HLM Architects, considers some of the key infection and prevention and control (IPC) challenges healthcare design teams face, and suggests there is still a lack of sufficient knowledge on the subject among many such teams designing hospitals and other healthcare buildings.
As healthcare architects, we cover a vast array of topics in a day – from Net Zero Carbon to digital transformation, wellbeing, and clinical services. At the heart of everything we do is safety, and the recent Building Safety Act, whilst inherently focused on fire compliance issues post-Grenfell, also stresses the overarching requirement for people to be safe in our buildings. There is a necessity for patients to feel protected in our healthcare facilities, and for staff to feel assured that they can deliver their services without harm.
How unsafe can a hospital building be? But just how unsafe can a hospital building be? When in hospital for a recent operation, brown water came out the tap in my pre-admission room while I was washing my hands. I immediately called Alyson Prince, Consultant nurse specialist, RGN, BSC, and a Built Environment Infection Control Consultant, knowing that she would advise exactly what that meant and what to do. ‘It’s rusty water from corroded pipework,’ she said, and then guided me through the correct hand-sanitising procedure. Spend just a few moments with Alyson, and it’s not difficult to see where her passions lie. Thanks to her, the words ‘pathogens’ and ‘biofilms’ frequent the HLM Healthcare team’s healthcare vocabulary now. It’s fair to say that she opened our eyes and ears to some of the ‘invisible’ issues that our healthcare – and particularly our hospital buildings face, with catastrophic consequences. Infection Prevention Control (IPC) incidents are not
on the decline. The ever more complex hospital and other healthcare sites and projects that we see these
days pose challenges through all stages of a project, which can dramatically affect outcomes. Truth be told, however, and patient safety and IPC considerations are still not often front and centre in our healthcare building designs, instead in some cases being relegated until such a point that they can be seen as tokenistic. While there have been numerous revised publications issued post- pandemic focusing on staff infection control measures, how relevant is HTM 00-09: Infection control in the built environment today, and what are the challenges healthcare design teams face when it comes to IPC matters?
Armed with Alyson’s narrative, we invited her to undertake six one-hour education sessions across our healthcare team. These were not intended to scare our colleagues, although one did say that they might struggle to leave their home without a full kit of PPE going forward. Instead, the intention was to open their eyes and empower them to actively consider infection prevention and control all the way through our design development, and to be very clear on where the real risks lay. The sessions’ content included:
Session 1: Healthcare planning and design, and infection prevention and control n Infection prevention and control – what are the roles and responsibilities?
n Healthcare-associated infection (HAI) standards: What are they, and how do they apply to design schedules?
Session 2: IPC and the law – compliance and assurance n IPC stages of risk assessment in the built environment.
Below left: Melanie Jacobsen Cox said: “Compliance has multiple aspects which need to be at our fingertips in terms of awareness and knowledge.”
Below right: The far- reaching implications of guidance on patients go beyond the built environment.
November 2024 Health Estate Journal 61
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