Optimal design/personnel for control of intensive care unit infection.

Apart from the special mechanisms for spread of IV device and respiratory equipment-related infections, the mechanisms for spread of infections in the intensive care unit (ICU) are no different from other areas of the hospital. Control of transmission must emphasize the necessity of blocking the contact and airborne routes of spread. Hand disinfection with an alcoholic preparation and the use of patient-bound gowns for all direct patient contact are efficient measures against contact spread of infections. Airborne spread is best reduced by nursing patients in one-patient rooms with doors closed. A substantial part of the beds should be in such rooms. However, they are of little value if basic barrier nursing techniques are neglected. An ante-room to the one-patient room is practical for hand disinfection, gowning, etc., and if ventilated, offers added protection against airborne spread. Barriers against transmission of microorganisms must be created between patient rooms. Since basic barrier nursing techniques are the determining factors for infection control, the need for adequate numbers of well-trained and well-educated staff cannot be overestimated.