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Improving ventilation hygiene in wards for immunocompromised patients: a workflow comparison of traditional and
Pascal De Waegemaeker1, Thomas Snoeij1, Isabel Leroux-Roels1
1Ghent University Hospital, Infection Control Department, Ghent, Belgium.
Introduction:
For a vulnerable hospital population, hospital ventilation systems can pose a risk if not maintained correctly. Dust accumulation in air ducts can create environments that allow fungal spores, such as Aspergillus.spp, to thrive, potentially leading to severe infections like invasive aspergillosis. Our study aimed to develop a safe protocol for cleaning ventilation systems on an active ward in healthcare settings.
Methods:
We conducted a comparative evaluation of ventilation duct cleaning in adjacent hospital rooms. In one room, the ducts were accessed from within the room using a traditional brushing method, while in the other room, the ducts were primarily accessed from outside using a novel method including the use of newly developed low speed brushes and point extraction of debris. Air quality was monitored by counting particles every 15 minutes in 100-liter samples using a calibrated air sampler and collecting microbiological specimens before and after the cleaning process.
Results:
In-room cleaning caused a significant spike in airborne particles of all sizes, along with a modest increase in Aspergillus spp. spores, which took an hour to return to baseline levels. Conversely, external access for cleaning did not notably impact room air quality.
Conclusion:
These findings highlight the risks associated with internal duct cleaning, especially for patients who are vulnerable to airborne fungal infections. External duct access proves to be a safer alternative, ensuring minimal disruption to the air quality in patient care areas. This study supports the necessity of strategic planning in hospital ventilation maintenance to protect vulnerable populations.
Insights
Traditional hospital duct cleaning significantly increased airborne particles and fungal spores. A novel external cleaning method maintained air quality, proving safer for vulnerable patients and essential for hospital ventilation maintenance.
Area of Science:
- Healthcare-associated infections
- Environmental hygiene
- Hospital engineering
Background:
- Hospital ventilation systems require maintenance to prevent microbial growth.
- Dust in air ducts can harbor fungal spores like Aspergillus spp.
- Invasive aspergillosis poses a severe risk to immunocompromised patients.
Purpose of the Study:
- To develop a safe protocol for cleaning hospital ventilation systems.
- To compare the impact of traditional versus novel duct cleaning methods on air quality.
- To minimize risks to vulnerable hospital populations during maintenance.
Main Methods:
- Comparative evaluation of duct cleaning in adjacent hospital rooms.
- Traditional in-room brushing versus novel external access with specialized tools.
- Air quality monitoring (particle counts) and microbiological sampling before and after cleaning.
Main Results:
- In-room cleaning caused significant spikes in airborne particles and Aspergillus spores.
- External cleaning method showed no notable impact on room air quality.
- Baseline air quality returned within one hour after traditional cleaning.
Conclusions:
- Internal duct cleaning poses risks to patients susceptible to airborne fungal infections.
- External duct access is a safer alternative for ventilation system maintenance.
- Strategic planning is crucial for hospital ventilation upkeep to protect patient safety.
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