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HVAC Systems and Their Role in Infection Control and Prevention Presented by: John Martinelli Corporate Director of Healthcare Services Forensic Analytical.

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Presentation on theme: "HVAC Systems and Their Role in Infection Control and Prevention Presented by: John Martinelli Corporate Director of Healthcare Services Forensic Analytical."— Presentation transcript:

1 HVAC Systems and Their Role in Infection Control and Prevention Presented by: John Martinelli Corporate Director of Healthcare Services Forensic Analytical Consulting Services. Inc. November 14, 2013 – CSHE Orange County Chapter In-Service Webcast

2 Upon completion of this session you will be able to: : Discuss the impact of HVAC system on infection control and prevention in hospital settings; Describe the importance of pressure relationships established by the HVAC systems; Explain how air exchange rates and pressure differentials work together to control and remove airborne contaminants; List resources available to assist in determining how a rooms HVAC system should perform based on the room use; Describe the impact of temporary or unplanned changes to the HVAC systems function can impact the environment; and Describe methods and tools used to confirm the system is functioning as designed

3 Major Functions of HVAC Provide fresh air Control temperature and humidity Filter air coming in to the building Control air flow – By creating pressure differentials – Directional supply (laminar flow) – Alignment of supply and exhaust/return Quickly relocate, dilute and remove airborne contaminants

4 Teamwork Required Air Exchanges – Calculations based on space volume and total air supplied to the space (20 x 20 x 10 = 400 cubic foot space, with 100 CFM supplied gets one room volume of air exchange every 4 minutes or 15 ACH) Pressure differentials – Barriers required (walls and doors, ceilings and floors) – Open doors can defeat the design – Amount of air supplied and air removed must be different

5 Air Exchanges What it does Supplies filtered, fresh air to the space – In with the good Dilutes and replaces – Out with the bad – CO2, airborne contaminants

6 Presumes no new contaminant being introduced Presumes perfect air mixing

7 Pressure Differential (ΔP) Positive pressure – More air supplied to space than removed Examples – Protective Environment (PE) Rooms – Patients at high risk of acquiring infection – Operating Rooms – Wrap and Pack (Clean side) of Sterile Processing

8 Pressure Differential (ΔP) Negative pressure – More air removed from space than is supplied Examples – Airborne Infection Isolation Rooms (AIIRs) – Restrooms – Scope Wash – Decontamination (Dirty side) of Sterile Processing

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10 Why Bother? Required by Code – ANSI/ASHRAE/ASHE Standard (Table 7.1) – AIA Guidelines, 2001 – FGI Guidelines, 2010 – TJC (EOC Standard) – Cal Mechanical Code (Table 4A) - OSHPD Written Policy/Management Plans And It Works! – Reduces HAIs – Provides defensibility

11 Why Bother? Stepped up enforcement – Joint Commission looking at pressure differentials more closely than ever – ORs, Endoscopy, SPD/CSP – Findings can be for EOC and Leadership

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15 But it was compliant when it was built (So do I have to bring it up to current code?) Can remain as installed unless: – Change in Room Function (per paragraph 104.3) – Remodel (per paragraph 104.1, minor remodel OK) – Deemed necessary by building official for the general safety and welfare of the occupants and the public (per paragraph 102.6) Per OSHPD Code Application Notice,

16 Can Minor Adjustment = Major Changes IAQ Complaints – Staff restricting flow, changes things everywhere Outdoor intakes require inspection and maintenance Filter replacements – Clogged filters impact air supply (Quantity) Impact of Construction Projects – Temporary Negative Pressure Areas Impact other Areas

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19 How do we know its working? Test and Balance Reports – Measure supply (and exhaust/return) volumes from all registers in all critical spaces – Check Pressure Differentials at all doors and windows – Open windows and doors? – SPD doors open for work flow – Roll up doors at Materials Receiving and doors to hall propped open = ??

20 How do we know its working? Tools to Test Test and Balance Pressure Differentials Balometer Micromanometer Rotating Vane Anemometer

21 : The HVAC system can have a significant positive impact on infection control and prevention in hospital settings; In addition to making the indoor environment comfortable air exchange rates and pressure differentials work together to control and remove airborne contaminants; The California Mechanical Code provides tables to show how the HVAC system should perform based on space use; Temporary or unplanned changes to the HVAC systems function can impact the environment; and We can use a variety of tools and specialty vendors to test how well our permanent and temporary ventilation systems are working.

22 Questions?


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