A comparative evaluation of handwashing and visitation at the old and new critical care units at St. Joseph Regional Health Center, Bryan, TX

Abstract

This study compares single-bed rooms and multi-bed rooms with respect to their ability to support and facilitate healthcare staff handwashing and family and friend visitation in intensive care settings. Staff handwashing contributes to nosocomial infection control by reducing contact transmission of infectious pathogens. Family and friend visitation, as a major source of social support for patients, helps to improve patient health outcomes and satisfaction. Unobtrusive observation of nurse handwashing and family and friend visitation was carried out in three types of patient care areas—old multi-bed open bays, old small single rooms, and new large single rooms—in the old and new critical care units at St. Joseph Regional Health Center, Bryan, TX. A total of 24 nurses were observed and 2056 potential handwashing opportunities were recorded. Controlling for nurses’ individual differences, the study found significantly higher handwashing compliance in new single rooms (47.0%) and old single rooms (36.8%) than in old open bays (27.0%). Consistent with the results of observation, medical records showed a significant decrease in nosocomial infection rates from the old unit to the new unit (averaging 11.25 and 6.25 infections per 1,000 patient days, respectively). Family and friend visitors stayed significantly longer (about 35% longer) in the old and new single rooms than in open bays. Patient and family respondents to questionnaire surveys reported fewer problems and higher satisfaction with the new unit. The data strongly suggest that single-bed rooms with conveniently located handwashing equipment and more space and amenities for visitors should have high priority in programming and designing intensive care units and other healthcare facilities.