According to a Center for Disease Control and Prevention (CDC) research article, it is estimated that in 2002 there were 1.7 million Hospital Acquired Infections (HAIs) in the U.S. This resulted in an estimated nearly 99,000 deaths, costing up to $45 billion that year. It is estimated that the cost to treat each HAI is now $40,000 to $60,000, with the costs of treatment falling on the hospital or facility where the infection occurred. And now, Medicaid will not reimburse hospitals for certain HAIs. Airborne Infectious Diseases are believed to be a contributor HAIs, and a comprehensive environmental plan to address HAIs must include controlling the source and spread of airborne infectious disease.
Within Hospitals, Protective Environment (PEs) rooms are designed to protect those patients most vulnerable to Airborne Infectious diseases. PEs include operating rooms, rooms for premature infants, bone marrow transplant patients, and other immunocompromised patients. They are designed to have clean, filtered air, with positive air pressure (relative to surrounding areas) to mitigate the ingress of particulates, nuclei, spores and other pathogens. According to the CDC and the Facilities Guidelines Institute (FGI), these areas should be monitored continuously to verify that the positive air pressure differential is maintained, and air filtration is adequate.
Similarly, Airborne Infection Isolation (AIIs) areas are designed to protect hospital staff, other patients, and the general public from potentially infectious patients. AIIs are designed to have negative air pressure relative to surrounded areas, and the air from the AII is exhausted in a controlled manner. Again the CDC specifies that these areas are monitored to maintain the negative air pressure relationship.
It is widely believed that dust and spores dispersed by construction, renovation, and maintenance activities may contribute to HAIs. Again, a comprehensive environmental plan, including Infection Control Risk Assessment (ICRA) and Infection Control Risk Mitigation (ICRMRs) procedures, will mitigate the spread of Airborne Infectious Diseases. Construction and renovation areas are to be isolated from surrounding areas with barriers providing negative air pressure and HEPA air filters to remove particles. These areas should be monitored to verify the effectiveness of the barrier and HEPA air filters.
What should Environmental Quality, Infection Control and Facilities Personnel do about Airborne Infectious Disease?
According to the CDC Environmental Control Guidelines, 2003, Environmental quality personnel should monitor PEs and AIIS; construction, renovation, and maintenance activities; and perhaps entire facilities, to develop short and long-term, continuous metrics of environmental factors which may contribute to airborne infectious disease. These metrics include facility-wide indoor air quality (IAQ) factors such as airborne particle count (including mold and fungal spores and other nuclei), differential air pressure, humidity, CO2, and sound and light levels.
How can IC Sentinel® help?
Facility environmental monitoring has historically been performed with discrete sensors plugged into the wall or with handheld meters. The wall-mounted sensors invariably lead to power outlet congestion and unsightly cabling to multiple devices in already congested patient areas. The handheld meters are expensive and require a technician for operation, and thereby do not provide real-time, 24/7 monitoring.
IC Sentinel® is a real-time environmental quality monitoring solution, comprised of facility-wide, low-cost, compact, multi-sensor modules. IC Sentinel® is the only purpose built, distributed, networked solution available for measuring indoor air quality (IAQ) and other indoor environmental quality metrics such as sound and light levels. IC Sentinel® sensor modules are powered by Power over Ethernet (PoE), thereby reducing demand on power outlets.
IC Sentinel® sensors can be placed just about anywhere in the facility to allow immediate real-time and 24/7 monitoring and long-term profiling. The sensors can also be conveniently moved around the facility to construction, renovation, maintenance, or problem areas. There is no limit to the number of IC Sentinel® units that can be deployed within a facility to ensure adequate coverage. See the IC Sentinel® Applications Guide for installation tips.
IC Sentinel® BENEFITS
• Detect lapses or changes in differential air pressure in Protective Environments (PEs) and Airborne Infection Isolation (AII) rooms.
• Detect short and long term changes in particle count, which may signal degradation in HVAC operation or maintenance, or emergence of fungal or mold spores.
• Identify problems with barriers and ICRA compliance in construction, renovation, and maintenance areas
• Generate long term metrics related to other environmental quality metrics including sound, light, CO2 and humidity levels
• Create alerts when parameters exceed predetermined thresholds
• Remotely monitor patient sites
Who can benefit from using IC Sentinel?
INFECTION CONTROL PROFESSIONALS
Infection Control Professionals are concerned with compliance to Infection Control Risk Assessment (ICRA), and Infection Control Risk Mitigation (ICRMRs) procedures.
Both ICRA and ICRMRs are required by the Joint Commission, which provides hospital accreditation. They are included in the FGI guidelines, and recommended by the CDC Environmental Guideline. Every hospital in the United States must use them. The ICRA and ICRMRs are used during every phase of hospital design, construction, operation, maintenance, and renovation. Compliance to these processes must be demonstrated. IC Sentinel® can help to verify that ICRA and ICRMR procedures and processes are being observed by monitoring and reporting on the following:
• Monitor airborne particulate count in targeted areas or facility-wide
• Monitor differential room pressure
• Verify performance of Protective Environment (PE) rooms
• Verify performance of Airborne Infection Isolation (AII) rooms
Facilities personnel need to ensure that PEs and AIIs are provided with the proper HVAC control, and they need to monitor Construction, Renovation, and Maintenance activities for compliance with ICRA procedures. IC Sentinel® to can help Facilities personnel monitor the following:
• Verify performance of HVAC systems to provide desired differential air pressure in Protective Environment (PE) rooms and Airborne Infection Isolation (AII) rooms
• Monitor construction and renovation areas for differential air pressure and particulates, to verify compliance with ICRA procedures
• Verify temporary soft and hard barrier and air filtration effectiveness
• Monitor indoor air quality (IAQ), including CO2 and Humidity to verify performance of HVAC
• Generate real-time alerts for deviations
Patient satisfaction is increasingly becoming an important factor in hospital operations. Noise, light, and dust associated with construction, renovation, maintenance and normal operations activities can adversely affect patient satisfaction. IC Sentinel® will collect sound light, and dust levels in each location the sensor is placed. This information can be used to generate objective metrics on environmental conditions to which patients are exposed.
• Profile sound levels
• Monitor light levels
• Monitor air quality and humidity
• Gather long-term metrics