The structural and spatial design of German intensive care units from the point of view of infection control measures Survey among ICU-KISS participants

Introduction: Intensive care unit (ICU) structural and spatial design may play a role in infection prevention and control. Methods: Between 09/2021 and 11/2021we performed an online survey among ICUs in Germany, Austria and Switzerland. Results: A total of 597 (40%) of the invited ICUs answered the survey; 20% of the ICUs were built before 1990. The median number of single rooms with interquartile range is 4 (IQR 2-6). The median total room number is 8 (IQR 6-12). The median room size is 19 (IQR 16-22) m(2) for single rooms and 31 (26-37.5) m(2) for multiple bed rooms. Furthermore, 80% of ICUs have sinks and 86.4% have heating, ventilation, air conditioning (HVAC) systems in patient rooms. 54.6% of ICUs must store materials outside of storage rooms due to lack of space and only 33.5% have a room dedicated to disinfection and cleaning of used medical devices. Comparing ICUs built before 1990 and after 2011 we could show a slightly increase of single rooms (3 [IQR 2-5] before 1990 vs. 5 [IQR 2-8] after 2011; p< 0.001). Discussion: A large proportion of German ICUs do not meet the requirements of German professional societies regarding the number of single rooms and size of the patient rooms. Many ICUs lack storage space and other functional rooms. Conclusion: There is an urgent need to support the construction and renovation of intensive care units in Germany with adequate funding.