Re: Combined Negative/Postive isolation room

[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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[Joanna Harris]

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—–

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

> The contents of this email, including any attachments sent with it,
> are confidential. The contents are intended only for the named
> recipient of this email. If the reader of this email is not the
> intended recipient, please note that any use, reproduction,
disclosure
> or distribution of the information contained in this email must not
> occur with the express permission of the sender If you have
received
> this email in error, please notify the sender.
>
>
>

This e-mail message and any accompanying files may contain
information that is confidential and subject to privilege. If you
are not the intended recipient, and have received the e-mail
in error, you are notified that any use, dissemination,
distribution, forwarding, printing or copying of the message
and any attached files is strictly prohibited. If you have
received this e-mail message in error please immediately
advise the sender by return e-mail, or telephone 1800 243 903.
You must destroy the original transmission and its contents.
Any views expressed within this communication are those of
the individual sender, except where the sender specifically
states them to be the views of Ramsay Health Care.
This communication should not be copied or disseminated
without permission.
————————————————————————

Messages posted to this list are solely the opinion of the authors, and
do not represent the opinion of AICA.
Archive of all messages are available at
http://aicalist.org.au/archives – registration and login required.
Replies to this message will be directed back to the list. To create a
new message send an email to aicalist@aicalist.org.au
To send a message to the list administrator send an email to
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(without the quotes) to listserv@aicalist.org.au

______________________________________________________________________________

This electronic message and any attachments may be confidential. If you
are not the intended recipient of this message would you please delete the
message and any attachments and advise the sender. Sydney West
Area Health Service (SWAHS) uses virus scanning software but excludes
any liability for viruses contained in any email or attachment.

This email may contain privileged and confidential information intended
only for the use of the addressees named above. If you are not the
intended recipient of this email, you are hereby notified that any use,
dissemination, distribution, or reproduction of this email is prohibited. If
you have received this email in error, please notify SWAHS
immediately.

Any views expressed in this email are those of the individual sender
except where the sender expressly and with authority states them
to be the views of SWAHS.

Messages posted to this list are solely the opinion of the authors, and do not represent the opinion of AICA.
Archive of all messages are available at http://aicalist.org.au/archives – registration and login required.
Replies to this message will be directed back to the list. To create a new message send an email to aicalist@aicalist.org.au
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[John Ferguson]

I agree that we should not go for switchable rooms!

I should clarify my posting- the design that I was speaking of is not a reversible configuration.
It is a set up that achieves both isolation AND barrier requirements.
It would be good to assess existing research and practice in this area internationally as these new room types are being implemented successfully overseas as Jane Carthey mentions.

John

Dr John Ferguson
Director, Infection Prevention and Control Unit
Microbiologist and Infectious Diseases Physician
HUNTER NEW ENGLAND HEALTH
Locked Bag 1, Newcastle, NSW 2310, Australia
tel 61 2 49214422, fax 61 2 49214440
Visit http://www.hicsiganz.org for updates on healthcare infection prevention & control from around Australia and NZ.

Messages posted to this list are solely the opinion of the authors, and do not represent the opinion of AICA.
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