One of the fastest growing Joint Commission citations has to do with Environment of Care issues, with over 46% of hospitals being cited during their 2013 surveys. The year before, only 34% of hospitals were found to be non-compliant. The citations were under code EC.02.05.01 with a focus specifically on the ventilation system being unable to provide adequate critical room pressurization relationships, air-exchange rates, and efficiency of filtration.
Some rooms in a hospital need to be put under positive pressure, which is used to protect the occupants of the room from outside contaminants getting in. When the room is under positive pressure, it is pushing air out and nothing new can make its way into the room through the airflow. Positive pressure can also make sure that sterilized supplies do not become contaminated by airborne pathogens, or that someone undergoing an operation does not become infected from a pathogen in another room of the hospital. Critical room pressure failing to be positive or not being strong enough puts people at severe risk of infection.
The American Society for Healthcare Engineering (ASHE) says that rooms that should be positively pressurized are:
- Operating rooms
- Delivery rooms
- Trauma rooms
- Newborn intensive care
- Protective environment rooms
- Pharmacy
- Laboratory, media transfer
- Medical and Surgical Supply Clean workrooms
- Medical and Surgical Supply Sterile Storage
The opposite type of critical room pressurization that should be used is negative pressure, which is done to protect the airborne contents of the room from spreading into other areas of the building. By putting the room into negative pressure it will always be sucking new air into the room, and nothing will be able to escape. This can be used for anything from bad smells to pathogens to dangerous chemicals.
ASHE guidelines say that the following rooms should be put under negative pressure for the safety of building occupants:
- ER waiting rooms
- Radiology waiting rooms
- Triage
- Bathrooms
- Airborne infection isolation rooms
- Various laboratories
- Autopsy rooms
- Soiled workrooms or holding rooms
- Soiled or decontamination room for supplies
- Soiled linen and trash chute rooms
- Janitors’ closets
enTaB can get your Environment of Care issues compliant before your Joint Commission inspection. Contact us now to find out how we can help.
