Poignant new study sets new standard for patient rooms in the hospital
Fighting pathogens begins in the patient’s hospital room
Blueprint for infection prevention
M:IP should not be left to medical professionals alone. Disciplines such as architects, designers or biologists, must take on the challenge, too.
The precedent-setting research project unquestionably demonstrates that infection prevention in the hospital cannot solely rest on the shoul-ders of medical professionals: „Finding solutions for better controlling and fighting infections should not be left to one isolated group of ex-perts,“ agrees the KARMIN project’s principal investigator and architect, Wolfgang Sunder, PhD, from the Institute of Construction Design, Indus-trial and Health Care Building (IKE) at Technische Universität Braun-schweig (TU Braunschweig). „Rather, such undertaking requires the insight and expertise of an interdisciplinary team of experts from various professions and fields of study.“
Interdisciplinary team of experts designs prototype
Indeed, a team of architects, designers, medical professionals and mo-lecular biologists from TU Braunschweig and Charité Berlin was the first to identify risk factors of infection transmission in a hospital room across disciplines. Together, they designed the optimal floor plan and outfitted the room with the best-possible equipment to all but eliminate contamina-tion with dangerous pathogens.
In particular, hygiene hinges on people’s activities in the hospital room: patients’ behaviour, how workflows guide staff around the room, where and how visitors stay in the room and how the room is cleaned and disin-fected. Consequently, any object in the KARMIN prototype room that touches the ground is movable so it can easily be moved during clean-ing, to name one example.
Workflows and hand disinfection
KARMIN dispensers are strategically placed to promote hand disinfection
The patient room’s wholesome design
„Healing Architecture“ — designed with wellbeing in mind
Not just the COVID-19 pandemic brought to light what has long been evident: A future-proof hospital room must protect people in close proximity to one another against pathogens and has to be adaptable to the situation at hand. „A modern patient room,“ Sunder says, „is subject to quickly and constantly changing circumstances, which depend on medical advancements, societal demands, and progress in the fields of architecture and construction.“ One of the biggest challenges were the rise of infections and multi-resistant germs, demographic changes, innovations in medical technology, new treatments and the change in patients expectations.
Floor plan and interior design support physical and mental health
Healing architecture considers the needs and conditions of patients during illness, the stresses of hospitalisation, as well as the recovery and healing process. Floor plan and interior design support the physical and emotional wellbeing of patients and their families. The flow of the room as well as furniture and equipment are designed to optimise staff’s work-flows, make them simpler, easier.
The KARMIN hospital room represents an indicatory example of healing architecture. Goal of the project was to design a room that effectively eliminates cross-contamination with pathogens between doctors, nurs-es, patients and cleaning staff.
Infection-proof design must be adaptable
"A modern patient room is subject to quickly and constantly changing circumstances, which depend on medical advancements, societal demands, and progress in the fields of architecture and construction."
The ideal two-bed patient room
KARMIN researchers interviewed experts as well as the various types of users of a hospital room. The team took sample swabs of surfaces and objects, such as door knobs and sinks. Even swabs of the patients’ body were taken. At the same time, the interdisciplinary team analysed work-flows and routes of nurses, doctors and cleaning staff in the room. One conclusion, for instance, was that pathogens are most often transmitted between the cohabiting patients when doctors and nurses interact with one patient while treating the other, for instance, if that patient calls a nurse over to his or her bed for help.
Based on the new insights and analysis, the team developed require-ments for an infection-proof patient room, including the bathroom. „The KARMIN patient room represents the first prototype of a two-bed room with two bathrooms, designed, furnished and equipped to adequately prevent infections. It was also the first prototype an interdisciplinary team of researchers was able to plan, realise and analyse,“ project leader Sunder says.
Specifically, the solution includes a thoroughly considered, specially zoned room layout, innovative furnishings and features, such as BODE/HARTMANN’s disinfectant dispenser Eurospender 3 flex at the foot of the beds, the nightstand, the bedside terminal displaying innova-tive content with targeted informational campaigns for the patient, plus, last but not least, a well-thought-out lighting concept.
Infection-proof KARMIN two-bed patient room
The floor plan
Intuitive disinfection, easy cleaning
The innovation lies in the details
Virtual patient education and empowerment
The bedside terminal with swivelling arm is the essential hub for patient information, education and empowerment. The content educates the user on hygiene habits, practices and best ways to prevent infection. The virtual centrepiece empowers the patient to actively contribute to preventing infections during his or her hospital stay.
Seamless KARMIN bedside table
No nooks or grooves where germs could hide
Reducing the number of components allowed for a seamless design, making it significantly easier to clean the bedside table. Why? Hinges and grooves are excellent hiding places for germs. The novel equipment is easier to handle and the rounded surfaces and drawers are easier to disinfect.
Nurse’s work station
Everything on hand for intuitive infection prevention
The work station’s counter and cupboard clearly bundle tasks and allow for safe prep-work in direct proximity to the patient’s bed. Used materials can be safely disposed, new medical and care products, gloves and a disinfectant dispenser are conveniently in reach.
Open, inviting and easy to disinfect
The welcoming visitors’ area below the large panorama window comprises a deep, split-seat bench as well as a table and chair on either side for each patient. The suspended bench allows quick and easy cleaning. The cove beneath, where floor and wall meet, further facilitates sweeping and mopping.
Innovative KARMIN disinfectant dispenser
Specially developed by TU Braunschweig
Disinfectant dispensers, such as TU Braunschweig’s KARMIN-dispenser and BODE/HARTMANN’s Eurospender 3 flex, are placed along the work paths to prevent medical staff from transmitting pathogens from one patient to the other. The dispenser counts who pumps how many times, rewarding adequate disinfection with a smiley to promote compliance.
Dangerous multi-resistant pathogens lurk in the bathroom
One path-setting result of the study was that multi-resistant pathogens are often transmitted in the patient bathroom. Thus, the KARMIN two-bed room is designed with two bathrooms to prevent cross-contamination that happens when two patients share a bathroom and touch the same surfaces.
Unobstructed view of the patients
The entrance to the room opens up toward the patient beds to give medical personnel easy, unobstructed view of the patients.
Spotlight on hygiene
The control panel by the entrance door lets staff choose various lighting scenarios based on their activity in the room. Depending on their task, nurses and cleaning personnel can choose the best lighting to support what they are doing at the time.
Vision: The infection-proof patient room as positive place to heal and unbend
New insights inspire advancements
HARTMANN was part of the network of industry partners supporting the KARMIN project, which took several months to complete. In late 2020, a prototype was installed on the campus of Charité Berlin, giving experts and the public the opportunity to explore the KARMIN hospital room and provide constructive feedback. Moving forward with the project, the researchers are set on continually expanding and optimising the concept.
The current pandemic will provide researchers additional new insights, allowing them to approach healing architecture from yet another new perspective. At this point, the KARMIN project has revealed evidence and set a new standard for sensibly planning hospital rooms of the future — far from a scary place where the invisible risk of infection lures in every corner but rather a highly functional and comfortable place of wellbeing and coming together.
Das Patientenzimmer — Planung und Gestaltung
Accompanying book on the KARMIN research project [in German]
In November 2020, KARMIN project leader Wolfgang Sunder, PhD, et al. released the book about planning and designing the exemplary KARMIN hospital room (in German language): Das Patientenzimmer – Planung und Gestaltung.
The publication for medical professionals and architects pre-sents the planning parameters and introduces 25 examples. What’s more, the book includes scientific floor plan analyses of 25 hospital rooms around the world, based on infection research.