Hospital-Acquired (nosocomial) infections are a huge safety concern for all people entering your Hospital; and could result in a huge cost to your Healthcare facility, both financial, as well as your reputation. Are you doing everything you can to prevent airborne cross-contamination?
Airborne bacteria can cause contamination and disease in areas outside where the bacteria was initially exposed. According to a World Health Organization (WHO) study using 55 hospitals in 14 countries, at any time, over 1.4 million people suffer from infectious complications acquired in the hospital1.
Though this issue appears extremely important, many Healthcare Facilities focus only on PERIODICALLY and MANUALLY checking for problems. Once the morning testing is performed and the box on the form has been checked, will patients be safe for future cases over the course of the day? Studies throughout the world document that nosocomial infections are a major cause of morbidity and mortality2. Nosocomial infections are sadly one of the leading causes of death3 and the economic costs to the healthcare facility are considerable4,5.
This periodic and manual method might have been acceptable years ago, without current technology available, but a better approach today is to constantly monitor the critical data and allow software to analyze and diagnose all your systems and alert the appropriate personnel when necessary. Leveraging data acquisition, automation, and analytics can proactively notify the right people or Control Systems when there are real data anomalies worth investigating; not hoping that your staff will find something relevant during their periodic review. This allows your team to focus their attention on corrective actions to prevent future issues; which will save money, reduce infectious disease outbreaks, and build a stronger trust with the community.
Sound too good to be true?… It’s not! In today’s world of Monitoring-Based Commissioning Systems, all data can easily be monitored and accessed remotely. Stand-alone sensors, BMS / BAS Systems, SCADAs, Historians, and various Control Systems store the data and maintain local control. Continuous Commissioning Systems, like FacilityConneX, can visualize all your disparate data from multiple systems and vendors and make it available 24/7. Infectious Disease Analytics continuously executing on your data provides Operating Room Directors and Infectious Disease Managers peace of mind that the issues are constantly being evaluated and notifications are sent to them, if, and when, control actions need to occur.
As far as protecting the Healthcare provider, how comfortable are you that you are doing everything you can to prevent these nosocomial infections at your facility? Would you be liable if a patient experienced issues during a surgery? Could your hospital be the cause of a local contamination in people who were not even patients? In areas where air quality is not maintained properly, infectious organisms can be transferred from infectious patients and discharged into the air, where contamination to multiple individuals is possible. Maintaining the air quality within the contamination area is important and necessary; but also ensuring that air quality is maintained where patients (and potential future customers) are, is equally important. Could your laundry room have caused contamination in a near-by patient waiting room? It has in the past!
A high frequency of nosocomial infections is evidence of poor quality of health service delivery, which leads to avoidable costs. According to the CDC Environmental Infections Control Guidelines, Air-Handling Systems in Health-Care Facilities (Feb 2017), recommendations include:
- Monitoring ventilation systems
- Monitoring areas with special ventilation requirements
- Implementing a Schedule for Acute Care and Pressure Differentials, taking into account the age and reliability of the system
- Documentation of Pressure Differentials and other Parameters
- Engineering humidity controls into the HVAC system and monitoring the controls to ensure proper moisture removal
- Ensure that fresh air requirements for the area are met
- Conducting infection-control risk analysis on special / isolation / sterile rooms
- Periodically measuring output to monitor system function
- Emphasizing restoration of proper air quality and ventilation conditions in special / isolation / sterile rooms, operating rooms, emergency departments, and intensive care units
Does your healthcare Facility have processes in place that meet these requirements? Do you do enough to satisfy all these concerns (at a reasonable cost), in the event of an infectious outbreak?
According to the CDC Guidelines6 for Infection Control, one of the recommended measures is to Monitor and document daily the negative airflow in airborne infection isolation rooms and positive airflow in protective environment rooms, especially when patients are in these rooms. Is once a day sufficient?
Healthcare Facilities Today (6/14) stated, “Current design guidelines suggest air change rates up to 25 (up to five of them as outdoor air) for new facilities, depending on the space served. At 6 ACH an aerosol of infectious agents can stay airborne for 10 minutes”!
Pressurization is critical to protecting your facility against airborne infectious disease cross-contamination from one space type to that of another. This is especially important in Healthcare, but very difficult to control. Frequently opened doors are extremely common, and allows contaminated air to pass to other spaces. Positive Pressure is configured by design in Operating Rooms and other Sterile Areas, but may not really be operating that way when an air handler’s airflow has been compromised! Measles and influenza viruses and the tuberculosis bacteria are diseases known to be transmitted by means of shared air between infected and susceptible persons, and they do not need to be in the same location within a building!
Again, Is manual monitoring sufficient? NO! Addressing infection control in hospitals requires integrating HVAC and air-pressure-control with dedicated and automated infection-control systems.
A Monitoring-Based Commissioning package, such as FacilityConneX, that contains Infectious Disease monitoring and Air Optimization analytics for Labs, Healthcare, and Research facilities, can do this work for you 24/7, so you know it is sufficient and you are protected! Eliminate the manual, and error prone, periodic human reviews and have a system notify the appropriate personnel when there are actions to take and let your Operating Room Managers focus on what they do best.
- Tikhomirov E. WHO Programme for the Control of Hospital Infections. Chemiotherapia, 1987, 3:148– 151.
- Prevention of hospital-acquired infections, 2nd edition, World Health Organization CHO/CDS/CSR/EPH/2002.12.
- Ponce-de-Leon S. The needs of developing countries and the resources required. J Hosp Infect, 1991, 18 (Supplement):376–381.
- Plowman R et al. The socio-economic burden of hospital-acquired infection. London, Public Health Laboratory Service and the London School of Hygiene and Tropical Medicine, 1999
- Wenzel RP. The economics of nosocomial infections. J Hosp Infect 1995, 31:79–87.
- Centers for Disease Control and Prevention, Guidelines for Environmental Infection Control in Health-Care Facilities 2003; https://www.cdc.gov/infectioncontrol/guidelines/environmental