From the Guidelines
Every room in an intensive care unit should have a door, preferably a sliding door, to facilitate efficient workflow, infection control, and patient privacy. The most recent and highest quality study, 1, published in 2020, emphasizes the importance of having single rooms with doors, especially for patients with suspected or confirmed COVID-19, to prevent cross-contamination and minimize nosocomial transmission. According to this study, if airborne infection isolation rooms (AIIRs) are unavailable, patients can be placed in adequately ventilated single rooms with the doors closed, as recommended by the World Health Organization (WHO).
Key Considerations for ICU Doors
- The doors should be wide enough (at least 1.2 meters or approximately 4 feet) to accommodate hospital beds, ventilators, and other medical equipment 1.
- The doors should be designed to minimize noise transmission while allowing staff to maintain visual observation of patients 1.
- Many guidelines recommend that ICU doors have windows to facilitate patient monitoring without entering the room, reducing unnecessary entries and potential contamination risks 1.
- For isolation rooms, the doors should maintain appropriate pressure differentials (positive or negative pressure depending on the isolation requirements) and should close automatically 1.
- Door handles should be designed for easy cleaning and disinfection to prevent healthcare-associated infections 1.
Importance of Single Rooms in ICUs
- Single rooms are strongly recommended to minimize cross-contamination and minimize patient stress because of unrelated illness, noise, and activities, to improve patients' long-term outcomes 1.
- The ratio of isolation rooms to the total number of ICU beds should be in the range of 1–2 per 10 beds, but may be higher (5–6:10) in special ICUs (burn units, transplantation departments, infection units, etc.) 1.
In summary, having doors in every room in an intensive care unit is crucial for maintaining patient privacy, preventing cross-contamination, and ensuring efficient workflow. The design and functionality of these doors should prioritize infection control, patient monitoring, and easy cleaning and disinfection.
From the Research
International Recommendations for Intensive Care Unit Design
- The design of an intensive care unit (ICU) is crucial for providing a safe and efficient environment for patients and healthcare professionals 2.
- According to the Guidelines for Intensive Care Unit Design, a multidisciplinary approach is recommended for the design, construction, and occupancy of a new or renovated ICU 2.
- The use of doors in ICUs is not explicitly mentioned in the provided studies, but the design of ICUs should prioritize patient safety and infection control 3, 4, 5.
- A study on a novel ICU hand-over tool, the Glass Door of the Patient Room, suggests that the use of glass doors can improve communication among healthcare providers and reduce errors 6.
- However, there is no direct evidence to support the recommendation that every room in an ICU should open or use a door.
Infection Control and Patient Safety
- Nosocomial infections are a major complication in ICUs, and adherence to recommended techniques for patient care can help prevent them 4.
- A study on the proportion of ICU-acquired infections caused by patient-to-patient transmission found that a minority of infections can be attributed to direct patient-to-patient transmission 5.
- Patient safety is an important aspect of ICU design, and measures such as regular training, the use of bundles of care, and a blame-free environment can promote patient safety 3.