Course Access
Linda,
As per the Victorian Department of Health, “Guidelines for the
classification and design of isolation rooms in health care facilities,
Victorian Advisory Committee on Infection Control 2007”, rooms with
reversible airflow mechanisms enabling the room to be either negative or
positive pressure are not recommended. Problems with such rooms include the
difficulty of configuring appropriate airflow for two fundamentally
different purposes, the risk of operator error, complex engineering and fail
safe mechanisms.
Ref 1. Guidelines for the classification and design of isolation
rooms in health care facilities, Victorian Advisory Committee on Infection
Control 2007
http://www.health.vic.gov.au/infectionprevention/publications/design_isolati
on_rooms.htm
A busy ED department, staff with no training in air handling and
ventilation systems for hospitals and a switch that is will be used
infrequently is probably not a good mix!
Prior to the above guidelines in Victoria the hospital I worked at had some
rooms with these switches – outcome – often turned on the wrong way and not
recognised until some hours later(staff in ED, ICUs etc have other
priorities when admitting very unwell pts). These human errors result in
staff and patient exposures and significant increased workload for all
concerned.
In addition outside of patients who have had a bone marrow transplant the
evidence for the use of positive pressure rooms is also limited.
regards
Glenys
Glenys Harrington
Consultant
Infection Control Consultancy (ICC)
PO Box 5202
Middle Park
Victoria, 3206
Australia
H: +61 3 96902216
M: +61 404 816 434
infexion@ozemail.com.au
ABN 47533508426
—–Original Message—–
Joanna Harris
room
Hi Lindy and Mary-Rose,
We are also being asked this question as part of the discussions we are
involved with for our ED refurbishment. We have had significant concerns and
a number of incidents (none significant thankfully) over the past two years
regarding the ‘switchable’ options that were previously authorised and are
still in place in our facility.
We’re happy that the latest HSF guidelines are very clear on not permitting
the use of switchable systems.
Jo
Nurse Manager, Infection Management and Control Service (IMACS)
Level 1, Lawson House
The Wollongong Hospital
LMB 8808
SCMC NSW 2521
—–Original Message—–
Lindy Ryan
Dear mary – Rose,
check out Australasian health faciltiy guidelines – chapter 20 pg 8 –
combined alternating pressure isolation rooms (see link below)
http://www.healthfacilityguidelines.com.au/guidelines.htm
this document indicates that duel positive/negative pressure is not
permitted and based on previous experience with this myself (we managed
to get rid of this duel option that was in place our designated rooms
from the arc days & perhaps before adam was born I am sure……….) it
was a nightmare as no one even engineering dept was even sure or knew
which switch was which way for onor off or standby etc as the writing
had worn off, and docuemntation long lost and it was all operating via
chinese whispers of how a negative or positive prssure room was meant to
work (we had to do the old tissue against the door trick) and
eventually found that the rooms at times were not fuctioning …gladly
we got rid of these and moved to just one system of negative pressure
and a quality manitenence monitoring system which these rooms aircon
included it being attached to our BMS alarm system and also that
Infection control get quartely reports of that the checks and
functionility for allour neg pressure rooms are all working and Ok to
use (important to have this in place for future)
we do not currently have any rooms designated as postive pressure
(except in out OT of course) in the cluster I work in. We have toyed
with the idea for our oncology autologous transplants we do here but as
these rooms are multi purporse in the wards when not being used for a
transplant pt (we dont have the luxury here of closing rooms when beds
are premium) the concerns that an infection risk pt may end up in the
room (even though we ask them not too) and / or a transplant pt may also
run the risk of having an MRO colonisation and inadvertantly positive
pressure is used (in my previous exerience it didn’t matter what you
policy or processes were the switiches can get flipped on or off belfore
you know it if they are there) – so after some disucssion we believed
the risks outweighed the benfits at this time for including positive
pressure rooms (we do not do large numbers of transplant and we do not
manage severe burns pts …perhaps you may get other advice here)
i am happy to hear others thoughts on the use of positive pressure
rooms and risk and benefits they may have come across in their
experience and their frequenecy of use vs cost benefit.
hope this helps the disucssion
regards
Lindy
Lindy Ryan
Infection Control Clinical Nurse Consultant (CNC)
Nepean Hospital,
Western Cluster
Sydney West Area Health Service
email: ryanl@wahs.nsw.gov.au
“Infection Control is Everybody’s Business”
>>> WishartM@ramsayhealth.com.au 25/06/2010 5:57 pm >>>
[Posted on behalf of Mary-Rose Godsell – Moderator]
Dear All,
I have been asked to investigate the possibility of including a room
that
can have both negative pressure and then be changed into a positive
pressure isolation room – (so interchangable) for some upcoming
renovation in an ICU and ED.
I haven’t read in the literature or heard of this being a viable
option,
however would like to canvass the AICA list to gather some evidence
around this. Also the efficacy of using positive pressure isolation
rooms in the first instance.
Thank you
Regards
Mary-Rose Godsell
RGON, AFAAQHC, GDipHSM, CICP, MAdvancedPrac(Infection Control)
South West Infection Control Nurse Consultant
WA Country Health Service
‘Hand hygiene reduces the
spread of infection’
ph:08) 9722 1490
mobile 04 3996 1015
e-mail: Mary-Rose.Godsell@health.wa.gov.au
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