Analyzing ICU Patient Room Environmental Quality Through Unoccupied, Normal, and Emergency Procedure Modes: An EQI Evaluation
Health Environments Research & Design Journal
ARTICLE
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Background:
There is increasing need to perform invasive surgical procedures in intensive care units (ICUs). Traditional ICUs differ from operating rooms (ORs) in several ways including air changes per hour (ACH) and pressurization. Increased ACH and positive pressurization of ORs intend to provide more aseptic environments for surgery. Development of procedure ready ICUs that transition through unoccupied, occupied, and procedure modes is one solution to improve environmental quality when performing surgery in ICUs. This study assessed the efficacy of two airflow control systems, variable air volume (VAV) and Venturi control, in preventing contaminants from entering ICU from adjacent corridors.
Study Design:
Controlled contaminants, sulfur hexafluoride (SF6) and baker’s yeast (CFU/m3), were released in the corridor adjacent to the ICU. SF6 and CFU/m3 were detected inside the ICU at the patient bed during a dynamic simulation of code blue event. VAV and Venturi were compared as they cycled the room through unoccupied, occupied, and procedure modes.
Results:
VAV and Venturi showed significantly fewer CFU/m3 at the patient bed than corridor point of release (p < .05). Although not significant, Venturi cultured 14% fewer CFU/m3 than VAV at the patient bed. There was less SF6 detected at the patient bed with VAV and Venturi (p < .05). There was less SF6 detected at the patient bed with Venturi compared to VAV (p < .05). Venturi transitioned between modes faster than VAV (p < .05).
Conclusion:
Using efficient mode transitioning systems in ICUs may be effective in creating a more aseptic environment that mimics that of the OR.
Jennifer Wagner, Ph.D., CIC
Microbiologist
Managing Partner, OnSite - LLC
Jennifer has dedicated her efforts and expertise to infection prevention program design through evidence-based science, research, education and consulting. She has nearly twenty years of experience in environmental and clinical microbiology and is board certified in infection prevention and control (CIC). As managing partner of OnSite-LLC, she is dedicated to improved clinical outcomes through data driven solutions and has worked in numerous hospitals both nationwide and internationally. Collaborative efforts to develop the use of Environmental Quality Indicators (EQI) for healthcare spaces have been validated in nearly 100 procedures and are published in the American Journal of Infection Control (AJIC), The Journal of American College of Surgeons (JACS), ASHRAE Journal and others. With OnSite’s multidisciplinary team of clinicians, microbiologist, epidemiologists, healthcare engineers and designers, she has worked to optimize the asepsis of critical spaces in hospitals and has developed the tools, with over one hundred thousand data points, to accurately predict the risk of microbial contamination in critical spaces in the built environment. Her future endeavors continue to explore innovative solutions for successful and prudent improvement of infection prevention.
Damon G. Greeley, PE, CEM, HFDP, CBCP, EDAC, CHFM, a-IPC
Aerobiological Engineer, Co-Managing Partner
Onsite-LLC | Global Health Systems Inc.
Damon Greeley is an aerobiological engineer and co-Managing Partner of OnSite-LLC. For almost 30 years he has lead endeavors in research, planning, assessment, design, commissioning, infection prevention, and environmental monitoring of healthcare spaces and infrastructure systems. His vision is to continuously improve infection prevention in the healthcare operations environment through engaging innovation and creativity. As co-Managing Partner of OnSite-LLC he works with his business partner, Dr. Jennifer Wagner, CIC, investigate newer methodologies or technologies that improve infection control coupled with best life cycle costs. He is LUMA Institute (LI) trained, and facilitates human centered solutions that build consensus around the most advanced yet acceptable (MAYA) approach. Greeley serves on The Center for Health Design's EDAC Advisory Council and is charged with educating healthcare engineers on implementing Evidence Based Design. He received his professional engineering (PE) license in 2000, CEM (Certified Energy Manager) in 2004, HFDP (Healthcare Facility Design Professional) certification in 2005, CBCP (Certified Building Commissioning Professional (CBCP) certification in 2006, EDAC (Evidence Based Design) accreditation in 2011, CHFM (Certified Healthcare Facility Manager) certification in 2016, and his certification in Infection Prevention and Control via the Certification Board of Infection Prevention and Epidemiology (CBIC) in 2020.
Host:
Deborah Wingler, PhD, MDS-HHE, EDAC
Vice President and Healthcare Research Lead
HKS, Inc
Dr. Wingler is Vice President and Healthcare Research Lead for HKS. Dr. Deborah Wingler’s research focuses on improving the patient and staff experience within the ambulatory care environment through research studies that utilize real-time data collection techniques to elicit insight into patient and staff physiological, psychological and neural responses to high stress healthcare environments. Her research interests also include bringing high-quality care to vulnerable populations and medically underserved communities within the United States and internationally.
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