performance of our HVAC and make changes to its settings.”

Keeping Dangers at Bay When any of an HVAC’s components are not configured optimally or fal- ter, the risk of infection increases, says Michael Altree, co-founder of and vice president of business development for American Pharma Technologies in Boise, Idaho. For example, he says, a challenge

Role of HVAC in Infection Prevention

Implement a system that monitors and logs temperature, humidity and pressure of your unit BY ROBERT KURTZ


hile most components of an ASC’s heating, ventilation

and air-conditioning (HVAC) system are typically out of sight, they should never be out of mind. A properly func- tioning HVAC system is vital to keep- ing patients safe, says Donald Smith, vice president of Agnew Associates in Austin, Texas. “An HVAC system is essentially the respiratory system of a building— exhausting contaminated air, bringing in outside air and circulating air in the building while providing the necessary levels of filtration, temperature con- trol and humidity control,” he says. “In short, it is responsible for maintain- ing the indoor air quality of a building. This is a very important role in pre- venting infections.” The primary

components of an

HVAC system provide the heating, cool- ing and air-moving capacity required

for the building, Smith says. These may include boilers, chillers, pumps and air handlers. Secondary components include piping, ductwork and air dis- tribution devices that aid in the transfer of energy and delivery of air to specific locations. There are individual compo- nents, he says, that serve a single func- tion, such as humidifiers that maintain a minimum humidity level in a space. Smaller facilities, like some ASCs, may rely upon “packaged equipment” that combines components and functions into individual units, he adds. Enabling all these mechanical com-

ponents to work together properly is a computer-based building automation system, says Karen Reiter, RN, CASC, administrator of DISC Surgery Center at Newport Beach in Newport Beach, California. “This is a sophisticated system that interfaces with our HVAC. It provides the ability to monitor the


that ASCs might face is properly con- trolling humidity. When the percent of relative humidity in a room goes outside an optimal operating range, it can create a ripe environment for harmful bacte- ria to survive and thrive. “In the middle of the summer, an ASC may think it is wise to dial back its HVAC over a week- end with the good intention of reducing energy usage” but this can be problem- atic, Altree says. If temperatures in an ASC’s sterile areas are allowed to rise when the facility is closed and then expe- rience a rapid reduction in preparation for the surgical team’s arrival, humid- ity management can become a problem. “These areas may have so much warm air and humidity that an HVAC system can struggle to keep humidity within range,” he says. “If an HVAC system is unable to handle the humidity, the high humidity can lead to increased infection risk in operating rooms (ORs) and ster- ile storage areas.”

Reiter says she checks the perfor-

mance of her HVAC system when the ASC opens and then throughout the day. “In the morning, before we open an OR, I will pull up our computer system. It provides a layout of our entire facility and every temperature and humidity in our rooms.” She reviews this informa- tion to ensure nothing appears unusual. Prior to each procedure, the staff pulls up this data on a screen outside the OR and checks the figures for the room. “We may decide to modify the temper- ature to ensure surgical team comfort and optimal performance of the tech- nology used during the procedure.”

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