Construction and airborne infection vulnerabilities go hand in hand, especially in the health industry. The advancement of technologies in the healthcare industry has been forcing the corresponding facilities to renovate or restructure their facilities.

As the health industry is scrambling to meet such demands, the importance of infection control during the renovation process is often overlooked.  When it comes to construction or renovation in healthcare facilities, there are multitudes of measures that needs to be taken into account ranging from infection isolation rooms (AIIRs) to Heating, ventilation, and air conditioning (HVAC).

Considering how important and impactful construction in hospitals could be, it is better to seek the help of a specialist with expertise in proper environmental management, especially, planning and controlling of airborne infections disease outbreaks.

This piece of content highlights some crucial measures that need to be incorporated infection control and emergency response plans of both the hospitals and the construction, renovation specialists.

Hospital airborne infectious management standards

The airborne infection control in healthcare facilities could be viewed and addressed from the following three perspectives:

  • Administrative controls: involves the measures taken to address exposure risks to individuals with an airborne infectious disease along with the infection control precautions and response plans undertaken.
  • Workplace controls: Physical or mechanical measures considered, for example, AIIRs, ventilation, filters.
  • Personal Protection Equipment: involves regulating and monitoring the equipment worn by the stakeholders including both the construction and healthcare workers.

Environment air controls:

Construction and renovations in any building creates pressure difference and air quality concerns. It is when the structure under consideration is a healthcare facility that the need for additional considerations arises.

Pressure difference drives the air from high pressure to low-pressure areas. The velocity of airflow is exponential to the margin of pressure difference. In a hospital setting, the air pressure arises between the corridor and the isolation or patient rooms. This creates vulnerabilities that second the spread of airborne infections.

Temporary Negative Pressure Isolation:

TNPI is the prime choice in the absence or scarcity of Airborne Infection Isolation Rooms (AIIRs). Setting up TNPI helps to thwart the airborne infection by isolating the patient room. TNPI could be set up in multiple ways, which involves discharging air to the outside or to the return air system.

Discharging air to the outside

This is the easiest means to achieve TNPI. The setting lays out the need for setting up a window adapter in the designated patient room where a HEPA filter is used to exhaust room air.

The HEPA filter induces negative pressure within the room, which in turn forces air from the corridor. The air grille has to be sealed properly to prevent any air pulling from the return air system.

Discharging air to return air system

A patient room without any transfer grilles is the ideal room setting. In any room without transfer grilles, additional care has to be taken to seal all the grilles completely. Using a flex duct adapter and the ducts, connect the desired return grille and the HEPA filter.

Once the HEPA filter is turned on, regulate the airflow to achieve the desired negative pressure, and keep monitoring it daily.

Curtain TNPI

This does not create negative pressure for the whole room. Usually used for non-ambulatory patients, this method is used to create a negative air pressure bubble around the patient.

In this method, fire-rated plastic sheeting is set around the patient’s bed with a standing height at least six inches.  The plastic sheet should be ideally taped to the floor and the ceiling. The HEPA machine is then inserted into the sheet with all the edges sealed off completely and efficiently. The machine is then turned on to create negative pressure.

Due to the close proximity of the HEPA machine to the patient, noise and comfort considerations must be taken.

Surge capacity

Surge capacity is employed to isolate large volumes of patients contracted with infectious diseases. The basic methodology is by setting up an Infection Disease Zone (IDZ) to accommodate all the infected patients. A safe room is then set up adjacent to the IDZ. The HEPA machine is set up in the safe room to draw air from the IDZ and this air is discharged to the non-IDZ area.

Setting up HEPA filters to control airborne infections in hospitals is a widely adopted strategy. It is mandatory that connections to any return grille and the HEPA machine itself are sealed and monitored completely. This is where a professional assistance could be a godsend.