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Patient Rooms.

When central systems are used to air condition patients’ rooms, the recommendations in for air filtration and air change rates should be followed to reduce crossinfection and to control odor.

Rooms used for isolation of infected patients should have all air exhausted directly outdoors.

A winter design temperature of 24°C with 30% rh is recommended; 24°C with 50% rh is recommended for summer. Each patient room should have individual temperature control. Air pressure in patient suites should be neutral in relation to other areas.

Most governmental design criteria and codes require that all air from toilet rooms be exhausted directly outdoors. The requirement appears to be based on odor control. Chaddock (1986) analyzed odor from central (patient) toilet exhaust systems of a hospital and found that large central exhaust systems generally have sufficient dilution to render the toilet exhaust practically odorless.

Where room unit systems are used, it is common practice to
exhaust through the adjoining toilet room an amount of air equal to the amount of outdoor air brought into the room for ventilation. The ventilation of toilets, bedpan closets, bathrooms, and all interior rooms should conform to applicable codes. Intensive Care Units. These units serve seriously ill patients,
from postoperative to coronary patients. A variable range temperature capability of 24 to 27°C, a relative humidity of 30% minimum and 60% maximum, and positive air pressure are recommended. Protective Isolation Units. Immunosuppressed patients (including bone marrow or organ transplant, leukemia, burn, and AIDS patients) are highly susceptible to diseases.

Some physicians prefer an isolated laminar airflow unit to protect the patient; others are of the opinion that the conditions of the laminar cell have a psychologically harmful effect on the patient and prefer flushing out the room and reducing spores in the air. An air distribution of 15 air changes per hour supplied through a nonaspirating diffuser is often recommended.

The sterile air is drawn across the patient and returned near the floor, at or near the door to the room. In cases where the patient is immunosuppressed but not contagious, a positive pressure should be maintained between the patient room and adjacent area.

Some jurisdictions may require an anteroom,
which maintains a negative pressure relationship with respect to the adjacent isolation room and an equal pressure relationship with respect to the corridor, nurses’ station, or common area. Exam and treatment rooms should be controlled in the same manner. A positive pressure should also be maintained between the entire unit and the adjacent areas to preserve sterile conditions.

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