COVID-19 has put healthcare facilities under extraordinary pressure to accomplish more with less. Nurses and doctors had to care for waves of sick patients with limited resources. Medical personnel simply didn’t have the equipment or facilities needed to keep up with patient demand, and they struggled to contain the virus with makeshift solutions.
The most obvious way to protect patients and staff from those infected with COVID-19, or any other infectious disease, is to isolate them. Proper isolation rooms have dedicated HVAC and HEPA filtration capabilities. These rooms are constructed according to stringent guidelines from the CDC and other professional associations. Isolation rooms don’t share air or controls with the rest of the medical facility to prevent the risk of cross-contamination. However, at the height of the pandemic, even the most advanced, well-funded institutions could not isolate their contagious patients.
Protecting Patients and Staff
The most common type of isolation room utilizes negative pressure. These spaces have lower pressure inside the room than in the surrounding environment. As a result, contaminants can’t sneak out of the room and spread to the rest of the hospital. A negative pressure environment is maintained by using a dedicated HVAC system that continuously pumps clean air into the room near the floor and filters and sucks it back out through a grill near the ceiling. Other patients and medical staff are protected from the sick person.
Positive pressure rooms maintain higher pressure inside a space than the surrounding environment. These rooms are connected to a hospital HVAC system, which pumps clean, filtered air into the room. When the door to the space is opened, the high pressure forces out clean air and prevents any contaminants from entering the area. Positive pressure rooms are valuable for compromised patients—burn victims, surgery patients, birthing women, and injured emergency room patients—highly susceptible to infection or pathogens.
Perhaps now more than ever, building isolation spaces dedicated to protecting and treating vulnerable patients is a prohibitively expensive option for most hospitals.
Between forced facilities shutdowns and increased costs surrounding COVID-19 preparedness, U.S. hospitals lost an estimated $323 billion in 2020. Moreover, hospitals and health systems are projected to lose between $53 to $122 billion more in 2021. Beyond shrinking budgets, administrators can be slow to adopt change due to protracted stakeholder approval processes. The path of least resistance is often to maintain the status quo.
Versatility for Enhanced Level of Patient Care
Air Innovations strives to truly understand the challenges our customers and potential clients grapple with beyond controlling temperature and humidity. Adopting a holistic approach enables us to engineer lasting solutions that are adaptable to meet their evolving needs.
We designed the IsolationAir® system so that hospitals and medical facilities could continue delivering high-quality care to their most vulnerable patients without taking on a renovation project. Our systems convert standard-sized patient rooms into positive or negative pressure spaces depending on demand. Since the unit is portable, it limits the need for stakeholder approval often required for renovation projects. IsolationAir contamination control units are considered devices and not intrinsic parts of a hospital.
HEPA Filtration & UV Light
The portable unit includes medical-grade HEPA filtration to remove potentially harmful particles from a negative pressure space or into a positive pressure patient room. The unit also has UV-C light to sterilize contaminants that stick to the back of the unit and can be ingested by sick patients.
Designed for Patient Comfort
IsolationAir systems have onboard heating and cooling to keep patients comfortable when they are cut off from the hospital HVAC system. The AC functionality also serves to dehumidify exam and patient rooms.
Each unit comes equipped with flexible ductwork, and there are two ways to implement them.
To boost readiness to respond to increased patient volumes, hospitals can pre-facilitate inpatient or exam rooms by having a universal grill adapter connected to the return grill in the ceiling. At that time, maintenance staff can check for other air exhausts or leaks in the room and seal them up. When it becomes necessary to expand surge capacity for any reason, hospital staff can rapidly deploy an IsolationAir unit by simply plugging the unit into an emergency outlet and connecting the flexible ductwork to the available adapter.
Alternatively, medical facilities can simply wheel an IsolationAir unit into a particular exam or treatment room and install a return grill adapter to which the flexible ductwork on the unit will connect. Maintenance teams can seal up visible air leaks around windows and doors. Once on-site, the process takes less than an hour and doesn’t require specialty HVAC professionals. Installing a return grill adapter as needed before connecting the unit’s ductwork is a viable option when hospitals can foresee a rise in patient demand, as we did with COVID-19.
When Flexibility Matters Most
Anytime a room is used to “open up” patients, they are immediately susceptible to potentially life-threatening pathogens. Dedicated surgical theaters are typically designed as positive pressure rooms. However, there have been instances where hospitals have opted to permanently convert surgical spaces from positive rooms to negative rooms, a transition that requires planning and time.
Trauma patients and burn victims have the best chance of survival when treated in positive pressure rooms. Issues arise when a crisis happens, and hospitals don’t have enough positive pressure rooms to treat victims. The flexibility to transform an unpressurized room into a positive pressure space quickly enables a medical establishment to treat and save more patients.
Surprisingly enough, most labor and delivery floors and emergency units don’t have contamination control even though these patients are vulnerable to infections. Often, it is impossible to anticipate whether rooms should be positive or negative pressured spaces. Hospitals, extended care facilities, and emergency preparedness centers need the flexibility to determine—sometimes on the fly—whether patients need positive or negative pressure to save their lives or to prevent catastrophe.
The Final Verdict
Despite the enormous challenges and constraints facing hospitals today, administrators have solutions available to help them respond with agility to varying patient needs. We are proud our IsolationAir system can help medical professionals do their jobs easier and enable them to save more lives. When it comes to creating spaces to care for our most vulnerable patients, versatility is the name of the game.
IsolationAir® Systems meet the following industry guidelines:
12 air changes per hour via HEPA filters
Each IsolationAir unit conditions rooms up to 375 sq ft with an 8’ ceiling
A pressure differential of 0.01” minimum between a room and adjoining spaces (May require additional seals around doors or other significant leak points in large rooms with poorly sealed doors).
Continuous operation when plugged into an emergency generator outlet
Provides stable temperature control for patient comfort
Originally designed to meet the U.S. Department of Health and Human Services’ critical benchmarks:
Negative or positive pressure rooms are often necessary to prevent contamination and maintain a climate-controlled environment in various applications. While these rooms are somewhat similar, there are certain differences between their designs and requirements. Here we’ll give an overview of both of these types of environments, including their intended applications and design requirements.
Negative Pressure Rooms
Negative pressure rooms have air pressure that is lower than the external air pressure. Negative pressure is achieved through the use of an exhaust system that frequently includes a high-efficiency particulate air (HEPA) filter connected to a sealed room. These rooms can trap potentially dangerous particles to prevent cross-contamination in external air. This is why they’re often used to isolate infected patients while keeping people outside of the room consistently safe.
Negative pressure rooms are designed to contain airborne infections. To do so, there are various design requirements that these rooms must follow, which are outlined by CDC Guidelines, ASHRAE standards, and Healthcare Design Construction Guidelines. As summarized in these guidelines:
Negative pressure rooms must undergo at least 12 total room air changes every hour.
They need to maintain a negative pressure differential of at least 0.01’’.
Exhaust from these rooms and any connected anterooms or toilet rooms needs to travel directly outdoors with no chance of contaminating exhaust from other spaces.
If an anteroom is included in the setup, airflow needs to travel into the anteroom via the corridor. From there, it should be channeled into the patient isolation room.
The quantity of air exhaust needs to be higher than the supply airflow to maintain a consistent pressure differential.
The exhaust grille must be located in the ceiling and near the head of the bed.
All exhaust air must be discharged through a HEPA filter if the fan is below the roof line.
Misconceptions About Negative Pressure Rooms
One potentially dangerous misconception about negative pressure rooms is that medical personnel are safer when performing aerosol-generating procedures on patients in these rooms. This is due to the Centers for Disease Control and Prevention (CDC) recommendation that these procedures be performed in isolation rooms. However, negative pressure rooms do little to protect individuals inside the room. Their main purpose is to help protect people outside of the room by keeping aerosols and other particles within the room.
Positive Pressure Rooms
A positive pressure room is intended to protect patients from infectious diseases if they’re immunocompromised. While this type of room is somewhat similar in concept to negative pressure rooms, it features certain differences in its function and design. Positive pressure rooms contain a higher pressure in the containment area than the external environment, preventing air from leaving the room and circulating back inside. This prevents occupants in the room from being exposed to any outside contaminants, including potentially harmful particles and germs.
Positive pressure rooms must follow various design requirements to keep patients protected from outside contaminants. Included in these requirements are the following elements:
Positive pressure rooms require at least 12 air changes every hour.
They must maintain a minimum positive pressure differential of 0.01’’.
If anterooms are used, the airflow must travel to the anteroom from the patient room and then into the adjacent corridor.
Normally, a 150 to 200 CFM airflow difference is sufficient for maintaining the ideal pressure differential in these rooms.
HEPA filters are required to supply clean air. These filters are normally located at the room’s supply terminals or the main air-handling unit.
Airflow to the room needs to stay at a constant volume for consistent ventilation.
Create Custom Positive and Negative Pressure Environments with Air Innovations
If you require flexible positive or negative pressure rooms for your application, Air Innovations has the expertise and solutions you need. Our IsolationAir® unit offers a portable contamination control system that can efficiently convert standard-sized patient rooms into either positive or negative pressure environments. Some of the features of our IsolationAir® system include ductwork, UV sterilization, and HEPA filtration connections. The system also allows for temperature control, isolating the room from the central HVAC system.
Learn how Community Health Net created Negative & Positive Pressure Environments to create better patient outcomes and safer spaces for employees and patients. Watch the video below.
For more information about our systems, contact us today. You can also request a quote to get started on a custom solution for your project.
Negative pressure rooms control airborne pathogens by exhausting contaminated air from the building while preventing the air from leaking into other parts of the facility. These rooms are a necessity to maintain the safety of guests, patients, and hospital staff.
At Air Innovations, Inc., our expertise in negative pressure HVAC systems will ensure that your hospital’s negative pressure rooms comply with industry standards.
What Are Negative Pressure Rooms?
Negative pressure rooms have inside air pressure that is lower than the air pressure outside of the room. This serves to prevent contaminated air from exiting the room while allowing non-contaminated air to flow into it. Contaminated air flows through a controlled HVAC system, where the air is purified using specialized filters before it exhausts from the facility.
Creating Negative Air Pressure in a Hospital Room
Negative pressure rooms are crucial in hospital settings as they isolate airborne diseases like COVID-19, SARS, and MERS from the rest of the facility and prevent them from spreading to patients, staff, and guests. A negative pressure room requires a dedicated space, where a barrier will keep the room as air-tight as possible. For isolation rooms in more open areas, a heavy plastic curtain can block air circulation. If the area has a door, it is important to block any gaps to create a tight seal.
When establishing an isolation room in a hospital, the HVAC system will require adjustments to ensure the room has a continuous inflow of fresh air. The contaminated air must be forced out through exhaust vents with a filtration system to purify the air before it exits the facility. An existing HVAC system may be suitable, or a portable contamination system can be used to focus on a particular area.
Types of Negative Pressure Isolation Rooms
There are two classes of negative pressure isolation rooms, class N and class Q. A class N room isolates airborne diseases within a room to protect the facility from exposure. They are typically near the entrance of an inpatient ward to prevent the spread of the disease during patient transport.
Class Q rooms also isolate airborne diseases but implement stricter safeguards. Some primary features include an anteroom, self-closing doors, a private restroom to keep the isolation room sealed, and a ventilation system that prevents exhausted air from re-entering the isolation room. Class Q rooms also feature a monitoring system that alerts staff if the pressure changes. These are all crucial features to ensure optimal infection control.
Hospital Spaces to Negatively Pressurize
Various hospital spaces should be negatively pressurized for safety and compliance. According to ANSI/ASHE/ASHRAE standard 170-2017 of the 2018 FGI guidelines, negative pressure spaces include but are not limited to:
Isolation Rooms for Airborne Infections
Public Waiting Areas and Radiology Department Waiting Areas
Emergency Department Decontamination Bays
Various Laboratory Work Areas
Sterile Processing Areas and Soiled Decontamination Areas
Soiled Workrooms and Holding Rooms
Soiled Linen Sorting and Storage Areas
General patient examination, X-ray, and nursery areas typically do not require negative pressure rooms.
Testing and Monitoring Room Pressure
Monitoring for consistent low pressure in an isolation room is vital to ensure the safety of a facility. While a tissue or smoke capsule can confirm if the room is pressurized, modern equipment provides continuous monitoring of the room’s pressure. Electronic monitoring devices can be placed inside the isolation room and outside to trigger an alarm when the pressure reaches a set threshold. Regular inspection is necessary to ensure the devices are not contaminated or broken.
Contact the Experts at Air Innovations for Custom HVAC Systems
Air Innovations offers specialty environment control units to meet the needs of various critical applications. Our IsolationAir® portable contamination systems deploy quickly to isolate a sterile environment and prevent cross-contamination. These systems come equipped with UV sterilization, HEPA filtration, and ductwork connections. Whether you need to turn a room into a negative or positive pressure environment, our IsolationAir® system offers the ideal solution.
Our expertise will ensure your isolation rooms are compliant with ASHRAE, AIA, and CDC guidelines to protect patients, staff, and guests. Contact us to speak with a representative or request a quote to learn more.
At Air Innovations, we’ve designed, manufactured, and tested custom environmental control solutions for OEMs and non-OEMs for over 30 years. This extensive experience provides us with the knowledge and skills needed to deliver appropriate systems for a wide range of industries. One of the key markets we serve is the healthcare industry. Healthcare professionals know they can rely on us for products that keep their patients and personnel safe and healthy, such as hospital isolation room systems.
Below, we provide an overview of hospital isolation rooms, outlining the types available and key considerations to keep in mind when building one for a healthcare facility. Additionally, we highlight the products we offer that can be used to help build isolation rooms.
WHAT ARE HOSPITAL ISOLATION ROOMS?
In hospitals and other healthcare facilities, controlling the spread of infectious diseases is critical to keeping patients, personnel, and visitors safe and healthy. An important element of a comprehensive infection control strategy is the use of isolation rooms. These specialized rooms are designed to decrease the likelihood of cross-infection among people within the facility by controlling the flow of air within the room to reduce airborne infectious particle levels. They can achieve this goal in a number of ways, including by controlling the quantity and quality of intake or exhaust air, maintaining an air pressure differential between adjoining areas, directing airflow in a specific pattern, diluting room air with large volumes of clean air, and cleaning the air with high-efficiency particulate air (HEPA) filters.
TYPES OF HOSPITAL ISOLATION ROOMS
Isolation facilities can be configured in several ways, including the following:
Standard Rooms. These rooms utilize standard room (neutral) air pressure levels. They have normal HVAC systems and may or may not have a clinical handwash sink, en suite shower and toilet facilities, and a self-closing door. While they are generally used for patient contact isolation applications, they can be used for normal patient care when isolation is not required.
Airborne Infection Isolation (AII) Rooms. These rooms—also referred to as infectious isolation rooms—utilize a negative-pressure differential. They have lower pressure levels than adjacent rooms so air will rush inward rather than outward when the room is opened. This design prevents airborne infectious particles from escaping into other areas of the healthcare facility. They are employed as single-occupancy rooms to isolate patients with suspected or confirmed airborne-transmissible infections.
Protective Environment (PE) Rooms. These rooms utilize a positive-pressure differential. They have higher pressure levels than adjacent rooms so air will rush outward rather than inward when the room is opened. This design prevents airborne infectious particles from entering the room from other areas of the facility. They are utilized to protect immune-compromised patients from airborne-transmissible infections.
KEY CONSIDERATIONS WHEN BUILDING AN ISOLATION ROOM
Due to their critical function, isolation rooms must be designed and constructed carefully. Otherwise, there is an increased risk of cross-contamination between patients, personnel, and visitors. While there are many factors to consider to ensure an isolation room will work properly, some of the key ones include air changes per hour, HVAC, pressure control, temperature control, and supplemental controls.
AIR CHANGES PER HOUR (ACH)
As per the infectious disease control guidelines outlined by the Centers for Disease Control (CDC), isolation rooms should have a minimum of 12 air changes per hour using medical-grade HEPA filters. These filtration units are designed to remove 99.97% of airborne particles that are ≥0.3 µm in diameter. The American Institute of Architects (AIA) further specifies that a minimum of 12 air changes per hour are required for new facility constructions and renovations, while a minimum of six air changes per hour are required for existing facilities.
HVAC systems play a vital role in hospitals and other healthcare facilities. In addition to regulating airflow and maintaining comfortable temperature levels, they also help minimize the transmission of airborne diseases. When properly implemented, they can prevent the spread of contaminant-laden air through air purification, improved ventilation, and airflow control.
Standard rooms do not require a specialized HVAC system.
Negative pressure rooms require dedicated supply and exhaust systems separate from the building’s systems that do not permit any return air. A HEPA filtration should be connected to the supply system if the room will be used for isolating immunosuppressed patients. Additionally, the air conditioning system should be connected to an emergency power supply to prevent depressurization in the event of power loss.
Positive pressure rooms can share an air system with the building as long as the minimum outdoor air requirements meet local requirements and restrictions. However, the supply air inlet should be fitted with a HEPA filter.
The recommended minimum differential pressure between the isolation room and adjacent rooms is 2.5 Pa (0.01” water gauge) for both negative and positive rooms.
Isolation rooms must be appropriately heated or cooled to maintain an average temperature of 75°F.
Ultraviolet germicidal irradiation can be used as a supplemental air-purifying measure.
ACHIEVING CONTAMINATION CONTROL WITH AIR INNOVATIONS
We offer a broad selection of products that help control contamination in healthcare facilities. For example, our IsolationAir® portable contamination systems can be used to turn standard-sized rooms into negative-pressure or positive-pressure isolation areas for patient care or containment in as little as 30 minutes. They quickly and easily create a sterile environment in an isolated space that prevents cross-contamination, ensuring patients and personnel are better protected against infectious diseases. IsolationAir systems have several key features:
American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE)
Download our IsolationAir brochure for more details about our line of standard hospital contamination control systems.
CONTACT US FOR YOUR ISOLATION ROOM ENVIRONMENTAL CONTROL NEEDS
In medical facilities, dedicated isolation rooms are a critical tool for controlling airborne disease transmission. These spaces can be expensive to build and often require extensive airflow control measures to prevent cross-contamination with the rest of the facility effectively.
At Air Innovations, we understand the importance of airborne disease control in the healthcare industry. Our CDC, AIA, and ASHRAE-compliant IsolationAir® contamination control systems help hospitals, extended care facilities, and emergency preparedness centers improve their surge response capabilities and infectious disease preparedness. The portable units can be quickly and conveniently deployed to convert standard rooms into isolated environments for a number of applications, saving healthcare facilities time and money.
To learn more about our environmental control solutions and how they can benefit healthcare facilities, contact us today.
Effective positive and negative pressure rooms are an important part of industrial climate control systems. In medical settings, these rooms prevent the spread of infectious contaminants and maintain sterile or restricted spaces and are also referred to as ProtectiveEnvironments (positive pressure rooms) and Airborne Infection Isolation Rooms (AIIR) (negative pressure rooms). Negative or positive pressure rooms are a necessary part of a wide range of medical and research environments, as they help maintain clean conditions in the smallest clinic to the largest hospital.
Understanding Positive and Negative Pressure Rooms
Positive pressure rooms maintain a higher pressure inside the treated area than that of the surrounding environment. This means air can leave the room without circulating back in. In this way, any airborne particle that originates in the room will be filtered out. Germs, particles, and other potential contaminants in the surrounding environment will not enter the room. In medical settings, a positive pressure room (protective environment) allows staff to keep vulnerable patients safe from infections and disease.
Positive and negative pressure rooms both require a number of additional components to remain effective: Building positive and negative pressure rooms requires the use of specialized construction and climate control equipment. A minimum of 12 air-flow changes each hour must be maintained in order to sustain the desired environment and depending on the size and purpose of the room, more may be necessary.
Recirculation of air through HEPA filters to control the movement of airborne contaminants
Self-closing entryway with an adequate seal
Thoroughly sealed floors, ceiling, walls, and windows
Fans and ductwork to move air in the desired directions
A monitoring system that allows users to adjust pressure when necessary
Intermediate environment between the pressure room and outside environment for deliveries, observations, and protective gear storage
Some medical facilities additionally incorporate UV radiation into the system to help maintain a sterile environment. Using UV light in a filtration system sterilizes particles and reduces viruses (such as coronavirus) in the quarantine space, helping to protect healthcare workers who enter the room to service the quarantined patient.
Positive and Negative Pressure Rooms in Hospitals
Positive and negative pressure rooms are an essential part of controlling the spread of infectious diseases within large facilities such as hospitals. Negative pressure rooms (airborne infection isolation rooms) are a common solution in infection control efforts. Hospitals use them in inpatient rooms to ensure infectious germs don’t spread throughout the facility via the HVAC system. Hospitals usually design the following areas as negative pressure environments:
Waiting areas, especially in emergency rooms
AII (airborne infection isolation) rooms
Autopsy and dark rooms
Soiled laundry areas
Positive pressure rooms are usually used in scenarios that must continually filter harmful contaminants out of the environment. This makes them helpful when treating patients with compromised immune systems because the introduction of any harmful element will be efficiently filtered out. They’re also used in situations that must continually maintain a specific type of atmosphere in a room, such as human and animal nurseries. Other uses of positive pressure rooms include in vitro fertilization labs and operating theaters.
Installing Your Pressurized Room
Hospital managers must carefully plan their pressurized room to ensure they satisfy the following requirements: