Airborne Infectious Disease Management: Methods for ...

1 Airborne InfectiousDisease ManagementMethods for Temporary Negative Pressure IsolationMinnesota Department of HealthOffice of Emergency PreparednessHealthcare Systems Preparedness ProgramOffice of Emergency PreparednessHealthcare Systems Preparedness ProgramAirborne Infectious Disease ManagementMethods for Temporary Negative Pressure IsolationThis guide has been produced by:This user guide has been written by the Minnesota Department of Healthin conjunction with the University ofMinnesota to assist hospital personnel in the management of Airborne infection.

2 Jeanne AndersonInfection Control Practitioner Office of Emergency PreparednessMinnesota Department of HealthAndrew GeeslinEngineering/Infection Control Inter n University of MinnesotaAndrew StreifelHospital Environmental Health SpecialistEnvironmental Health and SafetyUniversity of MinnesotaMinnesota Department of Health does not endorse particular brands amongcompeting products. Examples shown in these materials are for illustration material in this document is in the publicdomain and may be used and reprintedwithout special authors gratefully acknowledge theMinnesota Emergency ReadinessEducation and Training (MERET)at theUniversity of Minnesota Centers forPublic Health Education and Outreachand the following individuals for theirparticipation, assistance, and support of this project.

3 Keith CarlsonDirector of Facilities ManagementMercy Hospital and Health Care CenterMoose Lake, MNGary DavisPlant EngineerLakeWood Health CenterBaudette, MN Pete SwansonFacility Services ManagerPipestone County Medical CenterPipestone, MN The following individuals are gratefullyacknowledged for their invaluablesuggestions:Judene BartleyVice PresidentEpidemiology Consulting Services Hills, MIRick HermansSenior Project ManagerCenter for Energy and EnvironmentMinneapolis, MN Curtain TNPI photographs courtesy of Ken Meade, Research MechanicalEngineer, NIOSH/CDC, USPHS MERET photos provided by Paul BernhardtFor further Information, please contact:Office of Emergency PreparednessMinnesota Department of Health625 Robert Street Box 64975St.

4 Paul, MN 55164-0975 Phone: (651) 201-5701 Fax: (651) 201-5720 This user guide is available on theMinnesota Department of Health Web site: Infectious Disease Management Methods for Temporary Negative Pressure IsolationAcknowledgements1 IntroductionPrinciples of Airborne Infectious diseasemanagement2 Airborne Infectious Disease MANAGEMENT PREPARED BY THE MINNESOTA DEPARTMENT OF HEALTH TNPIT emporary NegativePressure Isolation5 Portable anteroom13 Environmentalcontrols3 Surgecapacity16 Appendix20 Audiencefor this GuideThe intended audience for this guideline includes health care.

5 Facility engineering and maintenance infection control environmental health and safety management personnelPurposeof this Guide Provide guidanceon environmentalcontrols for Airborne infectiousdisease management Provide a general guide fortemporary setup, installation,and operationof portable HEPA machines when used to createnegative pressure in a hospitalroom/area Provide instruction on the use of:Pressure gaugesParticle counters Outline of preventativemaintenanceschedule for HVAC equipment related to AIIRG oalof this GuideA timely response is crucial foridentification and containment of potentially Infectious goal is for facilities to develop a 12-hour responseto implementcontainment measures.

6 Temporarynegative pressure isolation methodsare a safe alternative for hospitals that lack engineered can be utilized in facilities tomeet increased surge capacity forpatient isolation. TNPI should also be used during hospital constructionprojects to reduce risks associatedwith Airborne Infectious diseases. These temporary measures should be incorporated into the facility sinfection control and emergencyresponse plans. Hospital preparednessforbioterrorism and other public healthemergencies such as emerging airborneinfectious diseases requires strategicplanning to ensure that all componentsof respiratory protection programs,including environmental controls, are in place forairborne infectionisolation rooms (AIIRs).

7 Hospitalshave insufficient facilities to provideairborne infection isolation for largenumbers of patients with airborneinfectious diseases presenting in a short time , 2 However, AIIR shave been increased recently, due torequirements of National BioterrorismHospital Preparedness adequate environmentalcontrols, patients with airborneinfectious diseases will pose a risk to other patients and health , ventilation,and air conditioning (HVAC)expertise is essential for properenvironmental management whenplanning control of Airborne infectiousdisease outbreaks (natural orintentional).

8 Design manuals andguidelines provide direction forinfectious Disease to Appendix A, 2006 AIAC riteria on page guide will assist health care facilityplant maintenance and engineeringstaff, in coordination with infectioncontrol professionals, to prepare for a natural or terroristic event, involvingan Infectious agent transmitted byairborne droplet nuclei. Examples of such agents include measles,varicella, and Infectious Disease MANAGEMENT PREPARED BY THE MINNESOTA DEPARTMENT OF HEALTH Administrative(work practice) controls Managerial measures that reducethe risk for exposure to personswho might have an airborneinfectious Disease .

9 Work practice controls includeusing infection control precautionswhile performing aerosol-generatingprocedures, closing doors to AIIRs,hand hygiene, and equipment (PPE) Equipment worn by health careworkers and others to reduceexposure to Physical or mechanical measures(as opposed to administrativecontrol measures) used to reducethe risk for transmission of airborneinfectious infection isolation is based on the following hierarchy of control measures. Administrative (work practice) controlsEnvironmental controlsPersonal protective equipment (PPE)These measures are intended toreduce the risk for exposure toairborne Infectious Disease agents by uninfected persons.

10 AIIRs andhospital systems in general must be monitored to provide continualprotective measures. Refer toAppendixes B and C, AIIR and HVAC System MaintenanceSchedules, on pages 22 and of Airborne Infectious Disease managementEXAMPLES gownsglovesmasksrespiratorseye protection EXAMPLES ventilationfiltrationultraviolet germicidalirradiationAIIRs local exhaustventilation devicesEXAMPLES written policies andprotocols to ensurethe rapid identification,isolation, diagnosticevaluation, andtreatment of personslikely to have anairborne infectiousdisease 2 Introduction1 Principles of Airborne Infectious Disease managementTNPIT emporary NegativePressure Isolation5 Portable anteroom13 Environmentalcontrols3 Surgecapacity16 Appendix20 References373 Introduction1 EnvironmentalcontrolsTNPIT emporary NegativePressure Isolation5 Principles of Airborne Infectious diseasemanagement2 Portable anteroom13 Surgecapacity16 Appendix20 Airborne Infectious Disease MANAGEMENT PREPARED BY THE MINNESOTA DEPARTMENT