When hospital care is required, people expect and deserve a safe environment. And meeting that expectation begins before a hospital is built, during construction when an infection prevention plan is put into place.

The new Lakeview Medical Center (LMC) building design began with carefully weighing benefits of an open, accessible public place with the need to prevent the spread of infection and disease. Issues considered early on were:

• Airborne infection control in patient rooms - how air is circulated to and from patient rooms and all parts of the hospital

• Use of surfaces, finishes and furnishings that are easily cleaned and maintained

• Placing protective equipment and disposal containers where needed

• Placement and easy access of hand-washing stations – hand-washing sinks convenient for staff and visitors’ use

“We are incorporating the latest building standards to help minimize infection in hospitals; standards that were not in place even 10 years ago,” said LMC President Ned Wolf. “LMC is making a significant investment in safety that is not readily apparent to the community but it’s a cutting-edge approach to patient care and safety.”

One major change is having private patient rooms.

“Nationally, we are seeing more antibiotic-resistant bacterial infections than ever before and we have taken aggressive measures in the new building design to minimize chances of such infections,” said LMC Infection Control Coordinator Terri Ruppel.

“All patient rooms are private, with hand-washing stations and personal protective masks, gloves and gowns conveniently stored in each room.

“Having private patient rooms is a necessary and important step in reducing infectious disease transmission,” added Ruppel. “The ability to keep patients physically separate from each other drastically reduces the chance of a patient being infected by exposure to another patient.”

During design and construction phases, Ruppel has been a communication link with program administrators, architects and engineers. Considerations taken in LMC’s design and construction directly affecting safety are water and air systems, as well as construction processes and procedures.

Water System

Transmission of Legionnaire’s disease, in most cases, occurs when still-water allows Legionella bacteria to multiply. When water is released into the air by shower heads, air conditioning or faucets, bacteria is inhaled and causes pneumonia in people prone to the illness. The most effective control is to prevent bacteria growth from the beginning.

The new LMC will have a system to treat water as it comes into the building, preventing growth of Legionella and other water-borne bacteria.

During construction, the new hospital’s water system is separate from Marshfield Clinic – Rice Lake Center’s system. When the two buildings are connected, new pipes will be tested and flushed before being connected to the center’s system and before the hospital is occupied.

Water features, such as waterfalls and decorative fountains, were not included because people with weakened immune systems are susceptible to Legionnaire’s disease.

“We have taken all of this into consideration and want to make sure we are protecting people coming into our facility,” said Ruppel.

Sinks were selected for depth and faucets selected with a filter flow aerator, limiting and directing water flow to minimize risk of water spray and airborne particles.

Air Handling Systems

Air flow must be managed to accommodate different patient care needs.

Clean, sterile areas need filtered air with higher pressure so “dirty” air from outside the room doesn’t enter; and air pressure in rooms for patients with infections is lower, preventing air within the room to be drawn out. These special rooms will be used for patients with communicable diseases, like chicken pox and tuberculosis.

The new hospital will have more patient specialty-care rooms with negative exhaust systems so air in these rooms will be channeled out of the building through HEPA filters.

Construction Process

Practicing safe building habits is critical for controlling infections throughout the building’s life. Concerns during construction include:

• Mold - wet sheet rock can cause mold to develop in walls, a problem that could take years and many dollars to fix. To prevent mold, sheet rock was not hung until the building was enclosed and windows in place. Sheet rock was stored off the floor to prevent potential moisture damage and, if it got wet, it was immediately discarded and replaced.

• Dust - a short-term dilemma that can cause long-term infection problems. Dust is a common carrier of mold and may cause pneumonia in immune-compromised people and vulnerable patients. Measures are in place for dust-generating activities to prevent release into the air and on surfaces. Steps have also been taken to direct dust away from patient areas and Marshfield Clinic - Rice Lake Center, including scheduled air filter changes and existing air intakes for the Center.

“Infection prevention is a complicated, multi-faceted process that starts early,” said Ruppel. “Ultimately, we have taken the latest steps to keep our staff, patients and visitors safe when we move in.”

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