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Prevention of Emerging Airborne Infectious Diseases-Evaluation of Negative Pressure Isolation Rooms

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  • Design
  • Economics


In the spring of 2003, the epidemic outbreak of Severe Acute Respiratory Syndrome (SARS) in Taiwan was very severe. To prevent the spread of SARS, many hospitals reconstructed their normal patient rooms and converted them into negative pressure isolation rooms. To make sure these negative pressure isolation rooms are well functioned, it is necessary to do some post-occupancy evaluation (POE) studies for the negative pressure isolation rooms. Very few studies have been published on post-occupancy evaluations (POEs) in the field of healthcare. Furthermore, there is no published literature related to POE of negativepressure isolation rooms. This study is the first POE study of negativepressure isolation rooms, using a balanced scorecard approach. From the viewpoint of evidence-based design, Taiwanese experience in the 2003 SARS outbreak can provide very valuable lessons and may help in constructing negative-pressure isolation rooms in a cost-effective way. The sampled hospital was a major hospital treating SARS patients in Taipei in 2003. Two sessions of focus group discussions (FGDs) were conducted in fall 2005. There were six participants in each session. The purpose of the FGD is to explore the deep opinions of users, include physicians, nurses, and other staff of the SARS isolation rooms. The researchers also visited the sampled hospital for field observations in the design and operations of the negative pressure isolation rooms. The results of this study can be used to modify existing guidelines for negative- pressure isolation rooms. This study also proved that POEs using the balanced scorecard approach provide a balanced viewpoint for facility evaluation. The guidelines for negative pressure isolation rooms of USA, Canada, Australia and related literature were also reviewed. The results of the research provided valuable opinions in establishing or amending the guideline of negative pressure isolation rooms. The results were listed as follows: 1. Due to the limited space, from the economic perspective, the anteroom can be waived provided that there is a high quality negative pressure room with robust ventilation system and good pressure differential. 2. If possible, single-bed room is preferable to reduce nosocomial infection. However, during an outbreak, if there is a shortage of single-bed rooms, overflow patients infected by the same microorganism may share a room. 3. To cope with the emergence need of patients, many participants of the focus group discussions suggested it’s better to have an operating room located in the isolation area. 4. In terms of air change rates per hour and conditions of negative pressure (pressure differentials), existing Taiwanese standards should be sufficient. 5. Filtering exhaust air through HEPA filter is required in those countries with extremely high population densities like Taiwan. 6. Generally speaking, from the perspective of care outcomes, participants thought the existed negative pressure isolation rooms successfully prevent the spread of SARS. About 90% to 95% of the patients admitted to the negative pressure isolation rooms recovered finally. 7. The flow for transporting patients and suspected infected materials should be separated from the flow of staff. An elevator exclusively for transporting patients and suspected infected materials is preferable to reduce possible infection.

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