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Combined function isolation/barrier precaution (pos pressure) room design

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  • #70368
    John Ferguson
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    Author:
    John Ferguson

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    Dear Brainstrust

    Some time ago, I came across a novel configuration of a single room that provides for both protective (positive pressure barrier) and isolation (negative pressure) requirements. Extensive testing was described at the Hospital Infection Society Conference, Amsterdam 2006. It was specified under Building Note 4 by HEFMA but the link no longer works and I’ve been unsuccessful with chasing down the design. Concept involves an isolation room with a positive pressure anteroom and exhaust from the ensuite room which is entered from the main room. The design is relatively fail-safe and does not need to be manually configured.

    I wondered whether anyone has come across this? Has anyone built functioning dual purpose isolation/barrier rooms? We are building a new paed ICU and we need both types of room !

    thanks

    John

    http://hicsigwiki.asid.net.au/index.php?titleBuilt_Environment

    Dr John Ferguson
    Director, Infection Prevention & Control, Hunter New England Health
    Infectious Diseases Physician, Division of Medicine, John Hunter Hospital
    Clinical Microbiologist, Hunter Area Pathology, Pathology North
    Conjoint Associate Professor, University of Newcastle, Adjunct Professor, University of New England
    Locked Bag 1, Newcastle Mail Centre, NSW 2310
    Tel 61 2 4921 4444 | Fax 61 2 4921 4440 | Mob +61 428 885 573 | john.ferguson@hnehealth.nsw.gov.au | http://www.hicsiganz.org
    [cid:image001.jpg@01CE9DA5.63986720]

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    #70371
    Montague, Cathi (Health)
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    Author:
    Montague, Cathi (Health)

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    Hi John, someone on this list posted a link to a portable isolation / negative pressure / antechamber system that looked quite interesting, where you could set up such a system over a single bed without having to have a specific room purpose built.

    I can’t remember the product / company however, and am not sure on the clinical efficacy/evidence around this type of equipment / system but may be worth a look (if someone else can recall the post with the link to the company – I deleted it as not much call in my area for this!!!)

    Good luck!

    Best Regards,
    Cathi

    Cathi Montague RN, MClinNsg, FCENA
    Nurse Management Facilitator – Clinical Care Systems Co-ordination

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    Dear Brainstrust

    Some time ago, I came across a novel configuration of a single room that provides for both protective (positive pressure barrier) and isolation (negative pressure) requirements. Extensive testing was described at the Hospital Infection Society Conference, Amsterdam 2006. It was specified under Building Note 4 by HEFMA but the link no longer works and I’ve been unsuccessful with chasing down the design. Concept involves an isolation room with a positive pressure anteroom and exhaust from the ensuite room which is entered from the main room. The design is relatively fail-safe and does not need to be manually configured.

    I wondered whether anyone has come across this? Has anyone built functioning dual purpose isolation/barrier rooms? We are building a new paed ICU and we need both types of room !

    thanks

    John

    http://hicsigwiki.asid.net.au/index.php?titleBuilt_Environment

    Dr John Ferguson
    Director, Infection Prevention & Control, Hunter New England Health
    Infectious Diseases Physician, Division of Medicine, John Hunter Hospital
    Clinical Microbiologist, Hunter Area Pathology, Pathology North
    Conjoint Associate Professor, University of Newcastle, Adjunct Professor, University of New England
    Locked Bag 1, Newcastle Mail Centre, NSW 2310
    Tel 61 2 4921 4444 | Fax 61 2 4921 4440 | Mob +61 428 885 573 | john.ferguson@hnehealth.nsw.gov.au | http://www.hicsiganz.org
    [cid:image001.jpg@01CE9DA5.63986720]

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    #70373
    CAMERON, Donna
    Participant

    Author:
    CAMERON, Donna

    Position:

    Organisation:

    State:

    Hi John,

    We have these types of rooms in the recently opened wards of the new
    Olivia Newton John Cancer and Wellness Centre (ONJCWC). There is one on
    each of the 3 wards. I’m happy to provide further information off-line
    if required.

    Regards,
    Donna.

    Donna Cameron
    Manager Infection Control Team

    Austin Health
    P.O. Box 5555
    HEIDELBERG Vic 3968
    ( 9496 6625
    * donna.cameron@austin.org.au

    Behalf Of John Ferguson
    room design

    Dear Brainstrust

    Some time ago, I came across a novel configuration of a single room that
    provides for both protective (positive pressure barrier) and isolation
    (negative pressure) requirements. Extensive testing was described at the
    Hospital Infection Society Conference, Amsterdam 2006. It was specified
    under Building Note 4 by
    HEFMA but the link no longer works and I’ve been unsuccessful with
    chasing down the design. Concept involves an isolation room with a
    positive pressure anteroom and exhaust from the ensuite room which is
    entered from the main room. The design is relatively fail-safe and does
    not need to be manually configured.

    I wondered whether anyone has come across this? Has anyone built
    functioning dual purpose isolation/barrier rooms? We are building a new
    paed ICU and we need both types of room !

    thanks

    John

    http://hicsigwiki.asid.net.au/index.php?titleBuilt_Environment

    Dr John Ferguson
    Director, Infection Prevention & Control, Hunter New England Health

    Infectious Diseases Physician, Division of Medicine, John Hunter
    Hospital

    Clinical Microbiologist, Hunter Area Pathology, Pathology North

    Conjoint Associate Professor, University of Newcastle, Adjunct
    Professor, University of New England

    Locked Bag 1, Newcastle Mail Centre, NSW 2310
    Tel 61 2 4921 4444 | Fax 61 2 4921 4440 | Mob +61 428 885 573 |
    john.ferguson@hnehealth.nsw.gov.au | http://www.hicsiganz.org

    http://www.health.nsw.gov.au/images/communications/e-signatures/images/N
    SW-Health-Hunter-New-England-LHD.jpg

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    #70375
    Gerald Cha
    Participant

    Author:
    Gerald Cha

    Position:

    Organisation:

    State:

    Dear John,
    We’ve got 2 dual-purpose isolation rooms currently in service that were probably based on older guidelines (before my time here).
    These rooms have the ability to switch from positive to negative pressure by the flick of a key-switch (the ante-room is always positive pressured with the exhaust located in the ensuite).
    Current guidelines do not support these designs owing to the huge risk they pose if activated incorrectly by staff e.g. sputum positive TB cases having positive pressure instead of negative pressure by inattentive staff, etc.
    It would be preferable, from a risk perspective, that your Type 5 negative pressured rooms remain as dedicated negative pressured ones… these settings are thus pre-configured and your Engineering departments then conduct regular servicing and monitors the air pressure exchanges.
    We are currently undergoing a major hospital redevelopment and have factored in dedicated Type 5 negative pressured rooms in our planning for various wards.
    Airflow for these rooms come via positive pressure from the anteroom and from the doorway leading to the ward corridor (if the door is temporarily opened)… the air then flows to the negative pressured exhausts in the ensuite and the main room.
    The air is exhausted out of the building immediately and does not get re-circulated (some older designs filter the exhausted air from these rooms or not at all, and re-circulate it… this is not ideal).
    I’m very keen to have a look at the functional design of this novel concept isolation room should you manage to find the link, John.
    Kind regards,
    Gerald

    Gerald Chan
    Coordinator Infection Control

    St John of God Murdoch Hospital
    100 Murdoch Drive
    MURDOCH. WA 6150

    P: 9366 1552
    M: 0405 495 906 (7804)
    F: 9311 4604
    E: Gerald.Chan@sjog.org.au
    W: http://www.sjog.org.au/murdoch

    facebook.com/stjohnofgodmurdoch ( http://www.facebook.com/stjohnofgodmurdoch )
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    >>> John Ferguson 20/08/2013 1:26 PM >>>

    Dear Brainstrust
    Some time ago, I came across a novel configuration of a single room that provides for both protective (positive pressure barrier) and isolation (negative pressure) requirements. Extensive testing was described at the Hospital Infection Society Conference, Amsterdam 2006. It was specified under Building Note 4 ( http://www.hefma.org.uk/news/hbn4consult.pdf ) by HEFMA but the link no longer works and I’ve been unsuccessful with chasing down the design. Concept involves an isolation room with a positive pressure anteroom and exhaust from the ensuite room which is entered from the main room. The design is relatively fail-safe and does not need to be manually configured.
    I wondered whether anyone has come across this? Has anyone built functioning dual purpose isolation/barrier rooms? We are building a new paed ICU and we need both types of room !
    thanks
    John
    http://hicsigwiki.asid.net.au/index.php?titleBuilt_Environment

    Dr John Ferguson
    Director, Infection Prevention & Control, Hunter New England Health
    Infectious Diseases Physician, Division of Medicine, John Hunter Hospital
    Clinical Microbiologist, Hunter Area Pathology, Pathology North
    Conjoint Associate Professor, University of Newcastle, Adjunct Professor, University of New England
    Locked Bag 1, Newcastle Mail Centre, NSW 2310
    Tel 61 2 4921 4444 | Fax 61 2 4921 4440 | Mob +61 428 885 573 | john.ferguson@hnehealth.nsw.gov.au | http://www.hicsiganz.org

    MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.
    The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.
    Archive of all messages are available at http://aicalist.org.au/archives – registration and login required.
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    #70378
    Lee, Rosie
    Participant

    Author:
    Lee, Rosie

    Position:

    Organisation:

    State:

    Hi John

    When we renovated our ICU in 2004, we created 4 isolation rooms at
    positive pressure relative to the anteroom and sluice room.

    The anteroom and sluice room is at negative pressure relative to the
    isolation room and corridor. These are used primarily for our Burns
    patients and immunocompromised patients with ARO’s.

    Although in principle you should be able to utilise this for
    immunocompromised patients with airborne infections as the ante room is
    negative to corridor we opted not to take this risk. I cant recall us
    ever having a Burns or immunocompromised patient with airborne
    infections and if we did we would place them in a negative pressure room
    with ante room negative to room and corridor.

    Our Burns unit was built in 2005 with positive pressure rooms, ante
    rooms negative to isolation room but negative to corridor. We have not
    had any ARO outbreaks in this unit

    Regards

    Rosie

    Rosie Lee
    RN. BSc. CICP

    Coordinator – Infection Prevention & Management
    SMH Service – Royal Perth Hospital

    Ph + 61 8 9224 2805 Fax + 61 8 9224 1989

    IMPORTANT NOTICE: The contents of this email (including any attachments)
    may be privileged and confidential. Any unauthorised use of its
    contents is expressly prohibited.

    If you received this email in error, please advise me by reply email or
    telephone

    ________________________________

    Behalf Of John Ferguson
    room design

    Dear Brainstrust

    Some time ago, I came across a novel configuration of a single room that
    provides for both protective (positive pressure barrier) and isolation
    (negative pressure) requirements. Extensive testing was described at the
    Hospital Infection Society Conference, Amsterdam 2006. It was specified
    under Building Note 4 by
    HEFMA but the link no longer works and I’ve been unsuccessful with
    chasing down the design. Concept involves an isolation room with a
    positive pressure anteroom and exhaust from the ensuite room which is
    entered from the main room. The design is relatively fail-safe and does
    not need to be manually configured.

    I wondered whether anyone has come across this? Has anyone built
    functioning dual purpose isolation/barrier rooms? We are building a new
    paed ICU and we need both types of room !

    thanks

    John

    http://hicsigwiki.asid.net.au/index.php?titleBuilt_Environment

    Dr John Ferguson
    Director, Infection Prevention & Control, Hunter New England Health

    Infectious Diseases Physician, Division of Medicine, John Hunter
    Hospital

    Clinical Microbiologist, Hunter Area Pathology, Pathology North

    Conjoint Associate Professor, University of Newcastle, Adjunct
    Professor, University of New England

    Locked Bag 1, Newcastle Mail Centre, NSW 2310
    Tel 61 2 4921 4444 | Fax 61 2 4921 4440 | Mob +61 428 885 573 |
    john.ferguson@hnehealth.nsw.gov.au | http://www.hicsiganz.org

    http://www.health.nsw.gov.au/images/communications/e-signatures/images/N
    SW-Health-Hunter-New-England-LHD.jpg

    MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND
    DO NOT REPRESENT THE OPINION OF ACIPC.

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    #70387
    John Ferguson
    Participant

    Author:
    John Ferguson

    Position:

    Organisation:

    State:

    Dear all,
    thanks everybody for your replies very useful!

    I was particularly after the design that does not require switching of ventilation

    Thanks to Marija, I’ve located the design which is described in the UK document, The link has been updated on the built environment web page. The design is called a positive pressure ventilated lobby room. Would be very interested to hear from anyone with experience of this design. Donna, is this the design you have ? Rosie, your design is different – is it specified/validated anywhere?

    http://hicsigwiki.asid.net.au/index.php?titleBuilt_Environment

    kind regards,
    John
    Dr John Ferguson
    Director, Infection Prevention & Control, Hunter New England Health
    Tel 61 2 4921 4444 | Fax 61 2 4921 4440 | Mob +61 428 885 573 | john.ferguson@hnehealth.nsw.gov.au | http://www.hicsiganz.org

    [cid:image001.jpg@01CE9E6F.00ED6740]

    Dear John,

    We’ve got 2 dual-purpose isolation rooms currently in service that were probably based on older guidelines (before my time here).

    These rooms have the ability to switch from positive to negative pressure by the flick of a key-switch (the ante-room is always positive pressured with the exhaust located in the ensuite).

    Current guidelines do not support these designs owing to the huge risk they pose if activated incorrectly by staff e.g. sputum positive TB cases having positive pressure instead of negative pressure by inattentive staff, etc.

    It would be preferable, from a risk perspective, that your Type 5 negative pressured rooms remain as dedicated negative pressured ones… these settings are thus pre-configured and your Engineering departments then conduct regular servicing and monitors the air pressure exchanges.

    We are currently undergoing a major hospital redevelopment and have factored in dedicated Type 5 negative pressured rooms in our planning for various wards.

    Airflow for these rooms come via positive pressure from the anteroom and from the doorway leading to the ward corridor (if the door is temporarily opened)… the air then flows to the negative pressured exhausts in the ensuite and the main room.

    The air is exhausted out of the building immediately and does not get re-circulated (some older designs filter the exhausted air from these rooms or not at all, and re-circulate it… this is not ideal).

    I’m very keen to have a look at the functional design of this novel concept isolation room should you manage to find the link, John.

    Kind regards,
    Gerald

    Gerald Chan
    Coordinator Infection Control

    St John of God Murdoch Hospital
    100 Murdoch Drive
    MURDOCH. WA 6150

    P: 9366 1552
    M: 0405 495 906 (7804)
    F: 9311 4604

    E: Gerald.Chan@sjog.org.au
    W: http://www.sjog.org.au/murdoch

    [cid:UQZWZWQVZHQK.IMAGE_32.BMP]
    [cid:BUDUQINJYCRW.IMAGE_91.png] facebook.com/stjohnofgodmurdoch

    [cid:ABYGQXSVVMZY.IMAGE_92.png] twitter.com/sjgh_murdoch
    >>> John Ferguson <John.Ferguson@HNEHEALTH.NSW.GOV.AU> 20/08/2013 1:26 PM >>>

    Dear Brainstrust

    Some time ago, I came across a novel configuration of a single room that provides for both protective (positive pressure barrier) and isolation (negative pressure) requirements. Extensive testing was described at the Hospital Infection Society Conference, Amsterdam 2006. It was specified under Building Note 4 by HEFMA but the link no longer works and I’ve been unsuccessful with chasing down the design. Concept involves an isolation room with a positive pressure anteroom and exhaust from the ensuite room which is entered from the main room. The design is relatively fail-safe and does not need to be manually configured.

    I wondered whether anyone has come across this? Has anyone built functioning dual purpose isolation/barrier rooms? We are building a new paed ICU and we need both types of room !

    thanks

    John

    http://hicsigwiki.asid.net.au/index.php?titleBuilt_Environment

    Dr John Ferguson
    Director, Infection Prevention & Control, Hunter New England Health
    Infectious Diseases Physician, Division of Medicine, John Hunter Hospital
    Clinical Microbiologist, Hunter Area Pathology, Pathology North
    Conjoint Associate Professor, University of Newcastle, Adjunct Professor, University of New England
    Locked Bag 1, Newcastle Mail Centre, NSW 2310
    Tel 61 2 4921 4444 | Fax 61 2 4921 4440 | Mob +61 428 885 573 | john.ferguson@hnehealth.nsw.gov.au | http://www.hicsiganz.org
    [cid:image001.jpg@01CE9DA5.63986720]

    MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

    The use of trade/product/commercial brand names through the list is discouraged by ACIPC. If you wish to discuss specific reference to products or services by brand or commercial names, please do this outside the list.

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    #70391
    Lee, Rosie
    Participant

    Author:
    Lee, Rosie

    Position:

    Organisation:

    State:

    Hi John

    It was something we came up with and designed with our engineer based on
    infection prevention principles as there was not much out there in
    recommendations when the design was started around 2002. So it has not
    been validated except that we have not had any ARO outbreaks in our unit
    despite having to care for long term patients have very resistant ARO’s.

    Regards

    Rosie

    Rosie Lee
    RN. BSc. CICP

    Coordinator – Infection Prevention & Management
    SMH Service – Royal Perth Hospital

    Ph + 61 8 9224 2805 Fax + 61 8 9224 1989

    IMPORTANT NOTICE: The contents of this email (including any attachments)
    may be privileged and confidential. Any unauthorised use of its
    contents is expressly prohibited.

    If you received this email in error, please advise me by reply email or
    telephone

    ________________________________

    Behalf Of John Ferguson
    pressure) room design

    Dear all,

    thanks everybody for your replies – very useful!

    I was particularly after the design that does not require switching of
    ventilation

    Thanks to Marija, I’ve located the design which is described in the UK
    document, The link has been updated on the built environment web page.
    The design is called a positive pressure ventilated lobby room. Would be
    very interested to hear from anyone with experience of this design.
    Donna, is this the design you have ? Rosie, your design is different –
    is it specified/validated anywhere?

    http://hicsigwiki.asid.net.au/index.php?titleBuilt_Environment

    kind regards,

    John

    Dr John Ferguson

    Director, Infection Prevention & Control, Hunter New England Health
    Tel 61 2 4921 4444 | Fax 61 2 4921 4440 | Mob +61 428 885 573 |
    john.ferguson@hnehealth.nsw.gov.au | http://www.hicsiganz.org

    http://www.health.nsw.gov.au/images/communications/e-signatures/images/N
    SW-Health-Hunter-New-England-LHD.jpg

    Behalf Of Gerald Chan
    pressure) room design

    Dear John,

    We’ve got 2 dual-purpose isolation rooms currently in service that were
    probably based on older guidelines (before my time here).

    These rooms have the ability to switch from positive to negative
    pressure by the flick of a key-switch (the ante-room is always positive
    pressured with the exhaust located in the ensuite).

    Current guidelines do not support these designs owing to the huge risk
    they pose if activated incorrectly by staff e.g. sputum positive TB
    cases having positive pressure instead of negative pressure by
    inattentive staff, etc.

    It would be preferable, from a risk perspective, that your Type 5
    negative pressured rooms remain as dedicated negative pressured ones…
    these settings are thus pre-configured and your Engineering departments
    then conduct regular servicing and monitors the air pressure exchanges.

    We are currently undergoing a major hospital redevelopment and have
    factored in dedicated Type 5 negative pressured rooms in our planning
    for various wards.

    Airflow for these rooms come via positive pressure from the anteroom and
    from the doorway leading to the ward corridor (if the door is
    temporarily opened)… the air then flows to the negative pressured
    exhausts in the ensuite and the main room.

    The air is exhausted out of the building immediately and does not get
    re-circulated (some older designs filter the exhausted air from these
    rooms or not at all, and re-circulate it… this is not ideal).

    I’m very keen to have a look at the functional design of this novel
    concept isolation room should you manage to find the link, John.

    Kind regards,

    Gerald

    Gerald Chan

    Coordinator Infection Control

    St John of God Murdoch Hospital
    100 Murdoch Drive
    MURDOCH. WA 6150

    P: 9366 1552

    M: 0405 495 906 (7804)
    F: 9311 4604

    E: Gerald.Chan@sjog.org.au

    W: http://www.sjog.org.au/murdoch

    facebook facebook.com/stjohnofgodmurdoch

    twitter twitter.com/sjgh_murdoch

    >>> John Ferguson 20/08/2013 1:26
    PM >>>

    Dear Brainstrust

    Some time ago, I came across a novel configuration of a single room that
    provides for both protective (positive pressure barrier) and isolation
    (negative pressure) requirements. Extensive testing was described at the
    Hospital Infection Society Conference, Amsterdam 2006. It was specified
    under Building Note 4 by
    HEFMA but the link no longer works and I’ve been unsuccessful with
    chasing down the design. Concept involves an isolation room with a
    positive pressure anteroom and exhaust from the ensuite room which is
    entered from the main room. The design is relatively fail-safe and does
    not need to be manually configured.

    I wondered whether anyone has come across this? Has anyone built
    functioning dual purpose isolation/barrier rooms? We are building a new
    paed ICU and we need both types of room !

    thanks

    John

    http://hicsigwiki.asid.net.au/index.php?titleBuilt_Environment

    Dr John Ferguson
    Director, Infection Prevention & Control, Hunter New England Health

    Infectious Diseases Physician, Division of Medicine, John Hunter
    Hospital

    Clinical Microbiologist, Hunter Area Pathology, Pathology North

    Conjoint Associate Professor, University of Newcastle, Adjunct
    Professor, University of New England

    Locked Bag 1, Newcastle Mail Centre, NSW 2310
    Tel 61 2 4921 4444 | Fax 61 2 4921 4440 | Mob +61 428 885 573 |
    john.ferguson@hnehealth.nsw.gov.au | http://www.hicsiganz.org

    http://www.health.nsw.gov.au/images/communications/e-signatures/images/N
    SW-Health-Hunter-New-England-LHD.jpg

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    #70395
    Wilson, Fiona (TIPCU)
    Participant

    Author:
    Wilson, Fiona (TIPCU)

    Position:

    Organisation:

    State:

    Hi John, just a couple of things to point out re the ‘Isolation Guidelines for Infectious Patients in Acute Settings’ (Department of Health UK) which I got to via the link on HICSIG:
    The guidelines are only for isolation room design for infectious patients and the exclusions are (p8): ‘This manual does not describe the specialist facilities required in high security infectious disease units, isolation wards for cohorting groups of infectious patients,
    protective isolation for severely immuno-compromised patients, critical care areas and special care baby units’. The document also states that ‘The provision of isolation rooms that are switchable from positive to negative air pressure is not recommended because of the risk to people inside and outside the room in the event of the setting being incorrect’ which is what the various guidelines in Australia also stress.
    The guide outlines two options for isolation rooms – one is the ‘classic’ negative pressure ventilated room (negative pressure to the corridor) while the other is the positive pressure ventilated lobby (PPVL) room which has a positive pressure anteroom or lobby, a neutral or atmospheric pressure in the isolation room along with negative pressure in the en-suite. Both of these types are outlined as suitable for preventing airborne transmitted infections.
    So I think caution needs to be used before using or quoting these guidelines in the design of rooms to provide both protective (positive pressure barrier) and isolation (negative pressure).

    Cheers

    PS – Kevin Moon, an engineer from Victoria has done a lot of work re this issue and was one of the authors of the original Victorian Isolation Room Guidelines back in about 1998 I think. I do not know his current contact details but I could find them and send them to you off-line if you wish to chat to him.

    Fiona Wilson I CNC, Infection Control, TIPCU
    Population Health I Department of Health and Human Services
    Post GPO Box 125 Hobart Tas 7001 | Email tipcu@dhhs.tas.gov.au
    Phone (03) 6222 7684 | Fax (03) 6233 0553
    A fair and healthy Tasmania

    Dear all,
    thanks everybody for your replies – very useful!

    I was particularly after the design that does not require switching of ventilation

    Thanks to Marija, I’ve located the design which is described in the UK document, The link has been updated on the built environment web page. The design is called a positive pressure ventilated lobby room. Would be very interested to hear from anyone with experience of this design. Donna, is this the design you have ? Rosie, your design is different – is it specified/validated anywhere?

    http://hicsigwiki.asid.net.au/index.php?titleBuilt_Environment

    kind regards,
    John
    Dr John Ferguson
    Director, Infection Prevention & Control, Hunter New England Health
    Tel 61 2 4921 4444 | Fax 61 2 4921 4440 | Mob +61 428 885 573 | john.ferguson@hnehealth.nsw.gov.au | http://www.hicsiganz.org

    [http://www.health.nsw.gov.au/images/communications/e-signatures/images/NSW-Health-Hunter-New-England-LHD.jpg]

    Dear John,

    We’ve got 2 dual-purpose isolation rooms currently in service that were probably based on older guidelines (before my time here).

    These rooms have the ability to switch from positive to negative pressure by the flick of a key-switch (the ante-room is always positive pressured with the exhaust located in the ensuite).

    Current guidelines do not support these designs owing to the huge risk they pose if activated incorrectly by staff e.g. sputum positive TB cases having positive pressure instead of negative pressure by inattentive staff, etc.

    It would be preferable, from a risk perspective, that your Type 5 negative pressured rooms remain as dedicated negative pressured ones… these settings are thus pre-configured and your Engineering departments then conduct regular servicing and monitors the air pressure exchanges.

    We are currently undergoing a major hospital redevelopment and have factored in dedicated Type 5 negative pressured rooms in our planning for various wards.

    Airflow for these rooms come via positive pressure from the anteroom and from the doorway leading to the ward corridor (if the door is temporarily opened)… the air then flows to the negative pressured exhausts in the ensuite and the main room.

    The air is exhausted out of the building immediately and does not get re-circulated (some older designs filter the exhausted air from these rooms or not at all, and re-circulate it… this is not ideal).

    I’m very keen to have a look at the functional design of this novel concept isolation room should you manage to find the link, John.

    Kind regards,
    Gerald

    Gerald Chan
    Coordinator Infection Control

    St John of God Murdoch Hospital
    100 Murdoch Drive
    MURDOCH. WA 6150

    P: 9366 1552
    M: 0405 495 906 (7804)
    F: 9311 4604

    E: Gerald.Chan@sjog.org.au
    W: http://www.sjog.org.au/murdoch

    [cid:UQZWZWQVZHQK.IMAGE_32.BMP]
    Share facebook.com/stjohnofgodmurdoch

    twitter.com/sjgh_murdoch
    >>> John Ferguson <John.Ferguson@HNEHEALTH.NSW.GOV.AU> 20/08/2013 1:26 PM >>>

    Dear Brainstrust

    Some time ago, I came across a novel configuration of a single room that provides for both protective (positive pressure barrier) and isolation (negative pressure) requirements. Extensive testing was described at the Hospital Infection Society Conference, Amsterdam 2006. It was specified under Building Note 4 by HEFMA but the link no longer works and I’ve been unsuccessful with chasing down the design. Concept involves an isolation room with a positive pressure anteroom and exhaust from the ensuite room which is entered from the main room. The design is relatively fail-safe and does not need to be manually configured.

    I wondered whether anyone has come across this? Has anyone built functioning dual purpose isolation/barrier rooms? We are building a new paed ICU and we need both types of room !

    thanks

    John

    http://hicsigwiki.asid.net.au/index.php?titleBuilt_Environment

    Dr John Ferguson
    Director, Infection Prevention & Control, Hunter New England Health
    Infectious Diseases Physician, Division of Medicine, John Hunter Hospital
    Clinical Microbiologist, Hunter Area Pathology, Pathology North
    Conjoint Associate Professor, University of Newcastle, Adjunct Professor, University of New England
    Locked Bag 1, Newcastle Mail Centre, NSW 2310
    Tel 61 2 4921 4444 | Fax 61 2 4921 4440 | Mob +61 428 885 573 | john.ferguson@hnehealth.nsw.gov.au | http://www.hicsiganz.org
    [http://www.health.nsw.gov.au/images/communications/e-signatures/images/NSW-Health-Hunter-New-England-LHD.jpg]

    MESSAGES POSTED TO THIS LIST ARE SOLELY THE OPINION OF THE AUTHOR, AND DO NOT REPRESENT THE OPINION OF ACIPC.

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    #70419
    Glenys Harrington
    Participant

    Author:
    Glenys Harrington

    Position:
    Consultant

    Organisation:
    Infection Control Consultancy (ICC)

    State:

    Hi John,

    See link to the Victorian DOH “Guidelines for the classification and design
    of isolation rooms in health care facilities”

    http://www.health.vic.gov.au/infectionprevention/publications/design_isolati
    on_rooms.htm

    Full PDF at the bottom of the page

    As Kevin mentioned in his response dual purpose room are not recommended –
    see 2.4 Class A-Alternating pressure (negative/positive pressure) on page 7

    “Rooms with reversible airflow mechanisms enabling the room to be either
    negative or positive pressure are not recommended.(7) Problems with such
    rooms include the difficulty of configuring appropriate airflow for two
    fundamentally different purposes (see section 5.4), the risk of operator
    error, complex engineering and fail safe mechanisms”

    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

    Of John Ferguson
    precaution (pos pressure) room design

    Dear Brainstrust

    Some time ago, I came across a novel configuration of a single room that
    provides for both protective (positive pressure barrier) and isolation
    (negative pressure) requirements. Extensive testing was described at the
    Hospital Infection Society Conference, Amsterdam 2006. It was specified
    under Building Note 4 by
    HEFMA but the link no longer works and I’ve been unsuccessful with chasing
    down the design. Concept involves an isolation room with a positive pressure
    anteroom and exhaust from the ensuite room which is entered from the main
    room. The design is relatively fail-safe and does not need to be manually
    configured.

    I wondered whether anyone has come across this? Has anyone built functioning
    dual purpose isolation/barrier rooms? We are building a new paed ICU and we
    need both types of room !

    thanks

    John

    http://hicsigwiki.asid.net.au/index.php?title=Built_Environment

    Dr John Ferguson
    Director, Infection Prevention & Control, Hunter New England Health

    Infectious Diseases Physician, Division of Medicine, John Hunter Hospital

    Clinical Microbiologist, Hunter Area Pathology, Pathology North

    Conjoint Associate Professor, University of Newcastle, Adjunct Professor,
    University of New England

    Locked Bag 1, Newcastle Mail Centre, NSW 2310
    Tel 61 2 4921 4444 | Fax 61 2 4921 4440 | Mob +61 428 885 573 |
    john.ferguson@hnehealth.nsw.gov.au | http://www.hicsiganz.org

    http://www.health.nsw.gov.au/images/communications/e-signatures/images/NSW-H
    ealth-Hunter-New-England-LHD.jpg

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    #70424
    John Ferguson
    Participant

    Author:
    John Ferguson

    Position:

    Organisation:

    State:

    Thanks Glenys
    Agree reversible rooms not a good idea
    The single design with dual function is the go

    Hi John,

    See link to the Victorian DOH “Guidelines for the classification and design of isolation rooms in health care facilities”

    http://www.health.vic.gov.au/infectionprevention/publications/design_isolation_rooms.htm

    Full PDF at the bottom of the page

    As Kevin mentioned in his response dual purpose room are not recommended – see 2.4 Class A-Alternating pressure (negative/positive pressure) on page 7

    “Rooms with reversible airflow mechanisms enabling the room to be either negative or positive pressure are not recommended.(7) Problems with such rooms include the difficulty of configuring appropriate airflow for two fundamentally different purposes (see section 5.4), the risk of operator error, complex engineering and fail safe mechanisms”

    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

    Dear Brainstrust

    Some time ago, I came across a novel configuration of a single room that provides for both protective (positive pressure barrier) and isolation (negative pressure) requirements. Extensive testing was described at the Hospital Infection Society Conference, Amsterdam 2006. It was specified under Building Note 4 by HEFMA but the link no longer works and I’ve been unsuccessful with chasing down the design. Concept involves an isolation room with a positive pressure anteroom and exhaust from the ensuite room which is entered from the main room. The design is relatively fail-safe and does not need to be manually configured.

    I wondered whether anyone has come across this? Has anyone built functioning dual purpose isolation/barrier rooms? We are building a new paed ICU and we need both types of room !

    thanks

    John

    http://hicsigwiki.asid.net.au/index.php?titleBuilt_Environment

    Dr John Ferguson
    Director, Infection Prevention & Control, Hunter New England Health
    Infectious Diseases Physician, Division of Medicine, John Hunter Hospital
    Clinical Microbiologist, Hunter Area Pathology, Pathology North
    Conjoint Associate Professor, University of Newcastle, Adjunct Professor, University of New England
    Locked Bag 1, Newcastle Mail Centre, NSW 2310
    Tel 61 2 4921 4444 | Fax 61 2 4921 4440 | Mob +61 428 885 573 | john.ferguson@hnehealth.nsw.gov.au | http://www.hicsiganz.org
    [cid:image001.jpg@01CE9DA5.63986720]

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