MAINTENANCE AND COMPLIANCE
Take no chances with ventilation systems
With a number of NHS Trusts hitting the headlines for being placed in ‘special measures’, and the ongoing attention of regulators such as the Care Quality Commission on all aspects of the quality of the care environment, estates and facilities managers’ efforts to keep their buildings ‘safe, clean, and fit-for-purpose’ are in the spotlight to an unprecedented degree. Here, Jerry Slann, director of Occupational Hygiene at the Institute of Occupational Medicine (IOM), explains how patient and staff safety could be compromised by a lack of knowledge and investment in hospital estate management, and highlights the integral role that hospital ventilation plays in maintaining high standards of care.
In recent years, public trust in hospital care has been severely shaken, and it is easy to understand why. Headline news stories highlighting often serious failings are becoming increasingly frequent, and point to seemingly widening cracks in a system that is reportedly already under strain. The pressure to meet targets and achieve certain standards is felt by NHS Trusts of all shapes and sizes, and the damage caused by failing to comply can have far-reaching consequences. The Care Quality Commission (CQC) has a responsibility to ensure that minimum standards are met, and the power to place an NHS Trust or Foundation Trust in ‘special measures’ if the findings from inspections are inadequate, or if hospitals fail to comply. Failings can be highlighted from a wide range of areas, including a high
mortality rate, poor hospital management, or insufficiently maintained buildings and facilities.
Estates managers have a lot of responsibility to ensure that this does not happen to their Trust, and therefore have an incredibly important job to do to ensure that patients, staff, and their organisation’s reputation, are protected.
Effective hospital ventilation A key form of defence for a hospital is its ventilation system, as an effective one will maintain a high standard of air quality and help to prevent the spread of infections. Hospital ventilation is vitally important in operating theatres, and is a crucial tool in reducing surgical site infections. In conventional theatres, the bacteria level is reduced by dilution to a level that
the body’s own immune system can handle, reducing the risk of infections to wounds. For more invasive surgery, such as orthopaedic procedures, or for patients with an auto-immune disorder, the risk of infection is significantly increased, and there is a need for ‘ultraclean’ theatres in hospitals to reduce the risk of potentially life-threatening infections following surgery. An ultraclean ventilation (UCV) system includes the use of High-Efficiency Particulate Arrestance (HEPA) filters that ensure that only optimum quality air flows directly over the open wound. HEPA air filters are highly efficient in reducing the occurrence of microorganisms, and can remove 99.97% of bacteria particles from the air that passes through them.
Critical ventilation systems HEPA filters are highly effective in critical ventilation systems, and can also be used in extract systems for areas that could contain pathogens, such as isolation rooms, mortuaries, and Category 3 laboratories. Additionally, operating theatre ventilation plays an equally important role in protecting the surgical team and hospital employees. Effective ventilation will reduce the workplace risks associated with exposure to hazardous substances, such as anaesthetic gases.
The Institute of Occupational Medicine says its team can provide ‘a wealth of expert knowledge and support’ on ventilation systems, including reviewing validation and verification documentation and methods, auditing ventilation systems, and reviewing training requirements.
Dangers of sub-standard ventilation Hospital ventilation is an integral tool to protect patients and employees, and estates and facilities teams and their engineers cannot afford for it to be compromised. Estates managers have to be acutely aware of the many problems that could arise if the system is not properly installed or maintained. Potentially hazardous faults can include incorrect and low airflow rates; a poor hierarchy of cleanliness – where the air should flow from the most to least clean areas in theatres suites, and inadequate
March 2017 Health Estate Journal 43
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