Youngseon Choi

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About Me

  • I'm a Ph.D. student in Architecture at Georgia Tech, specializing in the area, ACB (Architecture, Culture, and Behavior). I got my Bachelor's degree in architectural engineering and had some time for practice back in Korea and came here at Tech for the professional degree in Architecture. Currently I'm very intersted in the role of physical environment such as addressing the needs of care model & process and then, involving in enhancing process and quality of care.
  • I'm also a mother of 16 months old boy! He is a very healthy and happy boy! I can't imagine being in a hospital with him... Just imagining that is quite terrifying... It would be out of imagination being actually in a hospital with the little one... I hope I can really understand their (families and children) feelings and needs and can reflect those into the design of the pediatric health center.

With Ryan.jpg

Blog starts here!

Site Visit at the Children's at Hughes Spalding

Media:5 observations, 5 ideas, and 3 conversations.pdf

Research related to handwashing

[Environmental intervention]

  • Hand washing is improved by increasing the ratio of the number of sinks or hand-cleaner dispensers to beds (Cohen et al, 2003; Kaplan & McGuckin, 1986; Vernon et al, 2003)
  • Providing automated water/soap sinks appears not to increase hand washing rates compared to traditional non-automated sinks (Larson et al, 1991; 1997)
  • A combination of bedside antiseptic hand-rub dispensers and posters to remind staff to clean their hands substantially increased compliance (Pittet et al, 2000)
  • Placing alcohol-gel dispensers next to the doors of patient rooms did not increase adherence (Muto et al, 2000)
  • Improved accessibilty to sinks (more sinks) does not lead to an improvement in healthcare workers' handwashing compliance (Whitby, 2004)
  • Glove use was shown to diminish compliance with pre-care handwashing by as much as 25% (Whitby, 2004)
  • Wilson (2006) Reducing hospital-acquired infection by design: the new University College London Hospital

- A case study of the planning and building of new University College London Hospital to reduce infection by design

Figure 1.jpg

- They tried to make hand basins as visible and prominent as possible. Hand basins were placed as the window wall in front of appraching staff and one the peninsula units, so that staff had to walk past them on the way into each bay (Figure1)

- Alcohol hand gel was also planned for every bedside

- However, they did not evauluate the impact of their design on infection control

  • Vietri_2004 The effect of moving to a new hospital facility on the prevalence of methicillin-resistant Staphylococcus aureus

- They compared the prevalence of MRSA in the 2 institutions before and after the move

- The design of the new facility is much more conducive to the performance of good infection control practices; for example, ward beds are segregated into 1- to 4-bed rooms, with a sink at each room entrance, and intensive care unit (ICU) beds are individually partitioned, each with at least 2 dedicated sinks. The New Brooke Army Medical Center stands in marked contrast to Old Brooke Army Medical Center, which had 12- to 35-bed open wards and ICUs, and a dearth of sinks for handwashing

- Radical facility design changes, which would be permissive of optimal infection control practices, were not sufficient, by themselves, to reduce the nosocomial spread of MRSA in our institution.

[Organizational and technological intervention]

  • McGuckin (2006) The effect of random voice hand hygiene messeages delivered by medical, nursing, and infection control staff on hand hygiene compliance in intensive care

- They found that using random voice message increased handwashing compliance.

- Twelve voice messages on Handwashing compliance facts such as "hand hygiene should occur before and after patient contact," and so on were installed to deliver prompts to 2 amplified external speakers.

- They measured product usage (soap and sanitizer)and bed-days. During the 6-week baseline period, 18,000 ml soap and 9940 ml sanitizer were used versus 21,000 ml soap and 15,496 ml sanitizer during the intervention.

  • Larson et al, 2005 Effect of antiseptic handwashing vs alcohol sanitizer on health care-associated infections in neonatal intensive care units

- Two hand hygiene products were tested: a traditional antiseptic handwash and an alcohol hand sanitizer.

- Each product was used for 11 consecutive months in each neonatal intensive care unit in random order.

- There were no significant differences in neonatal infections between the two products.

- The skin condition of participating nurses was significantly improved during the alcohol phase (P=.02 and P=.049 for observer and self-assessments, respectively), but there were no significant differences in mean microbial counts on nurses hands

- However, assessing the impact on infection rates of a single intervention is challenging because of multiple contributory factors such as patient risk, unit design, and staff behavior. Other practices such as frequency and quality of hand hygiene are likely to be as important as product in reducing risk of cross-transmission.

  • Weinstein (2004) Guideline for hand hygiene in healthcare settings

- Interesting article to look at Media:Weinstein_2004.pdf - It explains the recommended hand hygiene practices in healthcare settings!

Two more studies we need to look at Media:Pittet_2006.pdf Media:O'Malley_2005.pdf