Improved air quality in hospitals helps to provide a healthier environment for patients and staff and makes economic sense because of its relevance as a preventative infection control measure. Colin Hitch, director of Jasun Filtration, discusses this vital constituent of health care hygiene procedures.
THE improvement of air quality in health-care settings is a vital constituent of modern airborne hygiene procedures. It is also of importance with regard to occupational health and safety requirements in medical institutions. Improved air quality not only helps to provide a healthier and more pleasant environment for patients, staff and visitors but also makes economic sense because of its relevance as a preventative infection control measure.
Costs for health care have escalated recently. The pressures forcing such increases include growing demand for health care, rising costs of medical technology, malpractice liability and shortages of health care professionals. Health care institutions are forced to increase efficiency and contain costs.
Maintenance and operation of heating, ventilation, and air conditioning (hvac) systems is one area that can suffer budget cuts without noticeably impacting directly on patient care. One obvious way to control costs is to defer spending on 'low visibility' items that seemingly have no direct impact on patients. Such cuts are often directed at routine servicing of hvac systems, causing air quality to suffer.
Air quality in many hospitals has deteriorated to a point where airborne transmission of infectious disease has become a significant problem. Given that many infections such as tuberculosis (TB) and legionnaire's disease, are transmitted in the air, adequate ventilation is more critical than ever. New strains of antibiotic-resistant bacteria make infection control top priority. The increasing numbers of orthopaedic replacement procedures and organ transplants make air quality in sterile operating and isolation rooms critical.
In addition, if air quality is poor, health care providers can be exposed to hazardous gases and particulates. Nursing staff who routinely administer antibiotics can develop resistant strains of microbes that can hinder treatment if they are infected. Nurses involved in administering chemo-therapeutic drugs can be accidentally exposed to toxic levels of the drug if air filtration is inadequate.
Air filtration should be at the forefront when dealing with indoor air quality in hospitals. Because the vast majority of microbes are associated with particles, air filtration becomes an attractive solution to preventing the spread of infection.
The air quality requirements in health-care settings vary even from room to room. Some areas require high-efficiency filtration of airborne micro-organisms to protect patients, staff and visitors (eg in operation suites, ICUs, TB isolation rooms), whereas other areas require the filtration of gaseous contaminants, chemicals and odours to provide a safer environment (eg in laboratories, autopsy rooms, dental surgeries and pharmacies). It is, therefore, essential only very high quality filters are installed in these environments.
The NHS Purchasing and Supply Agency have specified a national framework for the supply and fitting of air filters. These include using suppliers that are able to provide an assessment of the environmental impact of its filters and how this will be managed. Filtration companies should, like Jasun Filtration, have EN14001 accreditation, which enables them to assess the life of the product including recycling and disposal. The NHS insists that when fitting filters strict procedures should be adhered to, which can only be carried out by company's working with the new BS EN ISO 9001:2000 accreditation.
It is also vital that, when fitting filters, companies make an assessment of their condition and report this to the authorities. It is therefore imperative that NHS authorities use only companies which have their own trained fitters who are able to provide this level of 'consultation'.
Finally, it is important any filtration company used by the NHS maintains a high level of R&D so their products are able to take advantage of innovations in new materials and structures. Such R&D also involves continuous product testing and improvement.
The government's recent use of electronic reverse auctions to try and make massive savings in the NHS has so far failed to live up to expectations. In the case of air filtration, companies such as my own find it uneconomic to tender for such work and have therefore decided not to enter into a 'Dutch auction'. Jasun has found the fixed price clauses in the contracts, which are normally for three years, leave little leeway for fluctuating exchange rates and raw material hikes. And this means the NHS is failing to address important factors such as quality and service.
Air filtration can play an important role in protecting staff and patients from airborne contaminants. The inescapable conclusion is that, with air balancing and proper system hygiene, it is the best means of reducing and controlling hospital-acquired infections, both from an efficiency standpoint and from a cost perspective.