Reducing Infection: What Surgery Facility Staff Members Should Watch Out For
When we cite facilities concerning the physical environment of care it typically falls into three main categories below.
- Air pressure relationships
Air pressure relationships ensure a proper heating and cooling system is in place to support proper infection control.
Ambulatory surgical facility heating and cooling systems must support proper infection control. The air vents not only assist with heating and cooling; if properly constructed they vent fumes, odors and pathogens to the exterior of the building. Fresh air supply entering the building or space is clean. Exhaust air removed from the building is dirty. By supplying and removing the air at different proportions, you can design the building to create rooms where the air can be relatively clean or dirty.
You must supply operating rooms, procedure rooms and clean storage areas with incoming air at a greater rate than the removed air. This creates a positive atmospheric pressure. The positive pressure prevents airborne contaminants from entering the space. Conversely, dirty rooms such as decontamination rooms, restrooms, and labs receive air at a lesser rate than the removed air, creating a negative pressure relationship. These pressure relationships need to be designed into the system during construction.
Some systems provide ventilation that, over time, swings between positive and neutral or negative pressure. This isn't acceptable. Ventilation systems also degrade over time; fans fail and need replacing. An air balancing report is a reliable method of checking airflow at a given point in time, but a complete report must show constant pressurization.
To contact someone to talk about air pressure reports call 360-236-2944.
- Clean and soiled supply separation
Cleanable critical surfaces protect critical rooms by maintaining cleanliness to a high standard with cleanable surfaces.
You must provide appropriate separation between soiled and clean materials to lessen the risk of cross-contamination. Often the use of separate temporary storage containers can provide the appropriate separation, but every facility must identify a permanent, dedicated, location for clean supplies and a separate location for soiled materials. The size of the rooms may vary based on the scope of work. Enclosed clean storage areas may exist in many places throughout the facility, but must be located to prevent cross-contamination from other soiled materials or processes.
Department of Health employees have seen many innovative solutions that we can approve. We encourage facilities we've cited to have frank and open conversations with our facility surveyors to make sure that we fully understand how a facility works.
If we determine that construction work is necessary, our construction review staff members can meet with you and your design professional to identify solutions that reduce the risks of infection.
For more information about preventing cross-contamination at your facility call 360-236-2944.
- Cleanable critical surfaces
Clean and soiled supply separation arrange for proper separation of supplies to lessen the risk of cross-contamination.
The physical environment of an ambulatory surgical facility (ASF) should be clean and orderly. Typical housekeeping services will be sufficient to maintain a clean environment in most areas (exam rooms, toilet areas, waiting areas, etc.). Some rooms in an ASF are more critical due to the risk of cross-contamination and organism transmission. These include operating rooms, procedure rooms and clean storage rooms. These areas should be equipped with surfaces that require rigorous cleaning. Also, these surfaces must be maintained or replaced as they age and fail.
Ensure operating room surfaces are sealed to provide a cleanable surface. Bare wood, unpainted drywall or other paper finishes are examples of non-cleanable surfaces. The operating room should also be free of cracks or crevices that harbor environments for bacterial or fungal growth. Often bacteria and other organisms in these cracks and crevices can move to unseen areas of the building that are never cleaned, such as areas above the ceiling, wall cavities, etc.
For more information or clarification about a cleanable surface call 360-236-2944.