Disconnects in design and infection prevention and control – how the design of products and the environment in neonatal intensive care may be undermining infection prevention practice

Abstract

This study examined the role design plays in infection prevention and control within an existing neonatal intensive care unit. Methods from human-centred design such as planning, stakeholder meetings and naturalistic observation were used to obtain infection prevention information related to the existing unit design, interactions with products and the environment, and perspectives of front-line staff on design. Thematic analysis was used to categorize and structure the issues that were identified.

The analysis revealed that the design of products and the environment may be undermining best practice in infection prevention. Health care workers experience a variety of difficulties in maintaining the recommended barriers to infection transmission, difficulties which stem from deficiencies in products and the environment. Various aspects of the neonatal care design lack the feedback or supports needed to help health care workers differentiate or work between infection transmission zones making the design challenging to use or maintain in a manner that supports best practice in infection prevention. Identifying issues in the design of products and the environment related to infection prevention practice led to the development of a ‘Design Exploration Guide’. The guide outlines issues and strategies for remediation based on feasibility within the project constraints.