Post on 08-Nov-2020
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HDR Facility Guidelines
for Patient Biocontainment
with Highly Pathogenic Infectious Diseases
2015 Eagleson Colloquium
PRESENTORS
Jon Crane, FAIA from HDR Mark Fitzgerald, Director of Biocontainment Planning from HDR Jeff Owens, from HDR
General Thoughts on Guidance
Lessons from the biocontainment world
One size does not fit all. (State & local issues, union / non-union, age & condition of infrastructure,
location of facility in hospital, etc., etc., etc.).
An incident will occur. (Infection, lack of compliance to SOP, unplanned outage, pipe leakage,
lightning strike, etc., etc., etc.)
When an incident happens, every decision you have made will be challenged.
General Thoughts on Guidance
Lessons from the biocontainment world
General Thoughts on Guidance
In some cases we don’t know the risk.
General Thoughts on Guidance
Performance based versus prescriptive.
Guidance should be based on risk
assessment.
Guidance should be performance based
versus prescriptive where possible, for
example: Floors should be slip resistant,
seamless and capable of withstanding
decontamination chemicals.
Architectural Guidance
The Containment Barrier
Consider an anteroom with two doors in
series from any space that may be
potentially contaminated.
Consider primary containment devices
(biological safety cabinets) for small scale
work, laboratory testing that requires sample
manipulation and for other procedures
where practicable.
Consider sealed interior windows and
cameras to allow viewing of staff and
patients while minimizing entering
containment space.
Architectural Guidance
The Containment Barrier
Consider sealing windows and penetrations
on the containment boundary based on risk
assessment. This does not mean a
hermetically sealed room. .
Consider finishes (floors, walls, ceilings,
doors frames, etc.) that are easily cleanable
and can withstand routine chemical
disinfection.
Consider a pass-through decontamination
autoclave with both solid and liquid waste
cycles. Place the autoclave service space
outside of containment.
Consider redundant autoclaves.
Architectural Guidance
The Containment Barrier
Consider laboratory testing space within the PBU.
Consider a VHP pass thru, dunktank or other method for
laboratory samples to be removed from the contained
patient area after surface decontamination.
HVAC System Guidance
Control Areas with Potentially Contaminated Air
Consider inward directional airflow from
areas of lower risk to areas of higher risk.
Consider a separate air supply and exhaust
system for the Patient Biocontainment Unit.
Consider a decontamination-in-place HEPA
filter system on the exhaust system with
zero leakage ductwork from room to HEPA
filter. Base on risk assessment of discharge
point of exhaust air.
HVAC System Guidance
Control Areas with Potentially Contaminated Air
Consider capability for continuous operation
of air supply and exhaust.
Consider a decontaminate-in-place
HEPA filter system on the air supply
system with zero leakage ductwork from
room to HEPA filter.
Plumbing System Guidance
Minimize Staff Handling of Infectious Waste and Control
Areas with Potential Infectious Waste
Consider a liquid effluent decontamination system.
Consider backflow prevention or filtration on liquid or gas
services when entering potentially contaminated space entering
the room.
THIS IS BAD
Plumbing System Guidance
Minimize Staff Handling of Infectious Waste and Control
Areas with Potential Infectious Waste
Consider HEPA filtration (or equivalent) on plumbing vents based
on risk assessment of discharge location.
If vacuum is provided, use a local dedicated system.
Consider a system for space decontamination.
Electrical System Guidance
The Risk is Significantly Higher in Patient Care Facilities
than in Laboratory and Animal Facilities.
Consider back-up power.
Consider UPS for power continuity
for system controls.
Consider sealing conduits passing through
the containment barrier.
Consider a means of communication
between the patient care spaces and the
support staff outside.
© 2014 HDR Architecture, Inc., all rights reserved. © 2014 HDR Architecture, Inc., all rights reserved. © 2014 HDR Architecture, Inc., all rights reserved. © 2014 HDR, Inc., all rights reserved. © 2014 HDR, Inc., all rights reserved. © 2014 HDR, Inc., all rights reserved. © 2015 HDR, Inc., all rights reserved.