Current approaches for preventing environment-associated contamination in healthcare facilities: a systematic literature review by open access database

Abstract

This article presents a Systematic Literature Review (SLR) whose objective is to identify aspects related to the built environment of Emergency Rooms (ERs) and healthcare facilities that interfere with infection by respiratory diseases. The SLR presented is a relevant part of ongoing research dedicated to discussing the built environment’s role on contamination, considering the COVID-19 pandemic scenario and the ER of the University Hospital of the University of São Paulo (USP), sited in São Paulo city, Brazil, as a case study. The results of this SLR showed that the main aspects discussed in the selected articles are: Heating, Ventilation, and Air Conditioning (HVAC) systems; disinfection and hygiene; layout and spatial organisation; air curtain and air purification; natural ventilation; door opening; and surface material. As major findings, the importance of properly designed mechanical ventilation systems and of the parameters’ control for the maintenance of Indoor Air Quality (IAQ) are highlighted. In addition, the existence of isolation rooms; periodic assessments based on guides and protocols; self-sanitising materials surfaces; and environmental design strategies are presented, together with the development of technologies, often incorporated into hospital furniture. Thus, as contribution, the article highlights the importance of the association of several measures related to the performance of the built environment to minimise respiratory infections in healthcare environments. As a limit of this research, only open access articles and reviews from 2017 to 2021 were considered, so that the article reveals trends in this field of study, not covering the entirety of content.

Congruence Mapping of the Activity Flows Allocated in Built Environments: A Pilot Application of Under-Development Software in an Emergency-Care Service

“…Others have pointed out that healthcare workers exhibited reduced efficiency when they were performing their tasks in unsuitable working environments [15,16]. In particular, a problematic ED design can have a potentially detrimental effect on patient and staff health, safety, and satisfaction, leading to contamination, and crowding issues [1,5,18,19]. Unfortunately, reports of EDs with long waiting times, busy staff, and crowded and uncomfortable rooms are recurrent [1].…”

Evaluation of an emergency room in operation during the COVID-19 pandemic: diagnoses and recommendations concerning environmental factors

“…In addition, effective actions include handwashing, wearing a mask, avoiding sharing objects, adhering to social distancing measures, maintaining well-ventilated and clean environments, organizing activity flows, and covering one's nose and mouth with an elbow or a scarf when coughing (WHO -World Health Organization, 2020; Waroonkun and Prugsiganont, 2022;Salonen et al, 2023). The following are some of the aspects of the built environment that can interfere with the occurrence of contamination by respiratory diseases: Heating, Ventilating and Air Conditioning (HVAC) systems; disinfection and hygiene; layout and spatial organization; air curtain and air purification; natural ventilation; door opening and surface material (Soares et al, 2022). Also, greater use of natural lighting in hospitals is recommended (Emmanuel, Osondu, Kalu, 2020).…”

Ambiente em uso para isolamento hospitalar: procedimentos para avaliação de desempenho

“…Para desempenhar o seu papel, esses ambientes devem ser projetados de maneira adequada, cumprindo diversos requisitos existentes em normas, entre eles: apresentar pressão negativa em relação às áreas adjacentes (com monitoramento); taxa de renovação do ar específica; e sistemas de exaustão do ar, de filtragem do ar e de controle de temperatura e de umidade relativa do ar [5]. Além disso, o tipo de porta (de abrir ou de correr), a velocidade e a frequência de abertura podem perturbar as condições de isolamento, ocasionar falhas na contenção e influenciar na dispersão dos patógenos pelo ar [8].…”