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Melinda,
I’m assuming that operating theatres are going to remain operational during the renovations that the area being renovated can be completely sealed off from the rest of the complex?
The purpose of air sampling under these circumstances is to qualitatively detect breaks in environmental infection control measures.
In terms of air sampling I would do rank order air sampling.
The objective of rank order air sampling is to monitor the efficacy of dust control measures by measuring and comparing the count of fungi in the area before, during and after the works. This approach determines the rank order of air quality from dirty (i.e. the outdoor air) to clean (i.e. air filtered through high-efficiency filters [90%-95% filtration]) to cleanest (i.e. HEPA-filtered air – the operating theatres).
As an example rank order microbiological air sampling involves a standard number of samples taken on a routine, regular basis over a specified time in specific areas such as the following:
Outdoors (dirty).
An indoor area not under construction and away from construction site(clean).
The Operating Theatre/Operating Theatre Complex(cleanest).
The more data you have before works commence (i.e. baseline data) the better.
You will need to take care in terms of interpreting the air sample results as air sampling can be problematic for the following reasons:
Lack of standards linking fungal spore levels with infection rates.
Lack of standards/protocols for testing (sampling intervals, number/location).
Resource intensive (if you are to undertake this sampling for a long or protracted period the resource implications for an ICP or a team can be significant).
Substantial laboratory support required.
Unknown incubation period of Aspergillus infection.
Variability of sampling circumstances.
In addition there should be a risk assessment undertaken before works commence and the barriers should be checked on a routine regular basis for breaches. If breaches are identified works should cease until the breaches are rectified along with the theatres being notified that unfiltered air from an adjacent construction site may be entering the theatre complex.
References
1. Centres for Disease Control and prevention. Guideline for Environmental Infection Control in Health-Care Facilities: recommendations of CDC and healthcare Infection control Practices Advisory Committee (HICPAC). MMWR 2003; 52(no.RR-10): 1-48
2. Microbiological Commissioning and Monitoring of Operating Theatre Suites, A report of a working party of the Hospital Infection Society UK, Sept 2005
Regards
Glenys
Glenys Harrington
Consultant
Infection Control Consultancy (ICC)
PO Box 5202
Middle Park
Victoria, 3206
Australia
H: +61 3 96902216
M: +61 404 816 434
infexion@ozemail.com.au
ABN 47533508426
—–Original Message—–
My Facility is currently planning to close a part of the Operating Theatre down to do some renovations. The hospital executive have asked me to devise an “air quality” program. Can anyone share their experience or steer me in the right direction.
Melinda Griffiths
CNC Infection Control
Alice Springs Hospital
08 89517737
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