Chapter 4 - Infection Control in the Built Environment and Decontamination
Introduction
Currently, chapter 4 exists as a repository for evidence reviews and tools relating to IPC in the built environment including delivery of appropriate decontamination within health and care settings and risk mitigation for water based pathogens.
Content going forward will be developed via the ARHAI Scotland Infection Control in the Built Environment and Decontamination (ICBED) programme informed by stakeholder engagement and requirements, learning from NHS Assurance programme and outbreaks and incidents.
Links to tools and guidance developed by ARHAI Scotland’s Clinical Assurance Programme will also be included within chapter 4.
This chapter is in the early stages of development.
Bed spacing
Guidance consistently recognises that bed spacing requirements contribute towards the control of HAIs. All NHS boards and care providers should aim to meet the minimum bed spacing requirements laid out in the guidance below and in keeping with the date of design and construction of the building. This takes account of ergonomics within the clinical environment and not just healthcare associated infection (HAI) risk. Some other health and care settings may choose to adopt this guidance e.g. hospice settings.
Adult in-patient facilities designed post 2010 should achieve 3.6m (width) x 3.7m (depth) dimensions of SHPN 04-01, HBN 00-03 and SHFN 30. Width of 3.6m is measured from bed centre to bed centre. Since 2014, HBN 00-03’s Figure 45 states a day treatment bay should achieve 2.45m width/centre-to-centre dimension.
Current NHS Scotland Guidance on bed spacing is listed below:
- Core guidance - General design for healthcare buildings (HBN 00-01)
- Core guidance - Clinical and clinical support spaces (HBN 00-03)
- Critical care units (HBN 04-02)
- HAI-SCRIBE Manual information for project teams (SHFN 30 Part A)
- HAI-SCRIBE Implementation strategy and assessment process (SHFN 30 Part B)
- HAI-SCRIBE question sets and checklists (SHFN 30 Part C)
- Adult in-patient facilities (SHPN 04-01)
- In-patient accommodation - supp 1 - Isolation facilities in acute settings (SHPN 4 sup 1)
Publications
Work undertaken and published to date has been cited here for ease of reference and use at a clinical level.
Many of these publications were produced prior to development of chapter 4 and were published outwith the existing manual methodology.
Updates to publications will be made where required as part of the ARHAI programme work plans.
ARHAI Scotland will work with SG directorates responsible for these areas in planning to establish planned implementation.
Decontamination
Probes
Equipment and environment cleaning
- NHSScotland Guidance for Decontamination and testing of Cardiac Heater Cooler Units (HCUs). v1.0 | National Services Scotland
Alternative approaches to decontamination
- Literature Review and Practice Recommendations: Existing and emerging technologies used for decontamination of the healthcare environment
Built environment
Water
Clinical Assurance
ARHAI Scotland’s Clinical Assurance programme provides clinical and infection prevention and control (IPC) expertise to complement the work undertaken by the NHSScotland’s Assure (NHSSA) assurance service. More information about the programme and a list of tools and guidance developed is available.
Key Stage Assurance Reviews (KSAR) focus on ensuring infection prevention and control is a key consideration for healthcare construction projects. ARHAI Scotland have developed notes for NHS Board IPC Teams which aim to help navigate this process.
Below is an educational animation which focuses on clinical hand wash basins (CHWBs), their intended purpose, water associated infection risks, and what we all can do together to reduce this risk. The animation is supported by a poster for use beside CWHBs to locally promote good practice for health and care staff as well as the general public who may visit those settings.