From the Guidelines
The use of a fan in a patient room with a history of Multi-Drug Resistant Organism (MDRO) is generally not recommended. Fans can potentially disperse MDRO-containing particles throughout the room and surrounding areas, increasing the risk of environmental contamination and transmission to healthcare workers, visitors, and other patients. According to the guidelines for environmental infection control in health-care facilities 1, maintaining positive pressure in the patient's room and using HEPA filters to enhance filtration of spores in the room are recommended. The use of fans may compromise these measures and increase the risk of MDRO transmission. If environmental cooling is necessary, alternative methods such as adjusting the room's air conditioning system should be considered. In situations where a fan is deemed absolutely necessary for patient comfort, a thorough risk assessment should be conducted by infection prevention specialists. If approved, the fan should be thoroughly cleaned and disinfected regularly with an appropriate hospital-grade disinfectant effective against the specific MDRO, and positioned to minimize air turbulence across contaminated surfaces or wounds. The presence of the fan should be documented in the infection control plan, with clear protocols for cleaning and maintenance. This cautious approach is based on the understanding that MDROs can survive on environmental surfaces for extended periods, and air currents from fans may contribute to their dispersal beyond the immediate patient environment. Key considerations include:
- Maintaining continuous negative air pressure in relation to the air pressure in the corridor 1
- Ensuring that rooms are well-sealed by properly constructing windows, doors, and air-intake and exhaust ports 1
- Providing ventilation to ensure >12 ACH for renovated rooms and new rooms, and >6 ACH for existing AII rooms 1
- Directing exhaust air to the outside, away from air-intake and populated areas 1
From the Research
Fan Usage in Patient Rooms with MDRO History
- The use of fans in patient rooms with a history of Multi-Drug Resistant Organism (MDRO) is not directly addressed in the provided studies 2, 3, 4, 5, 6.
- However, the studies suggest that airborne transmission of infectious diseases, including MDROs, can occur through droplet nuclei that remain suspended in the air for several hours 2.
- In-room air cleaners with HEPA filters and UVGI technology can be effective in reducing the concentration of airborne pathogens, including MDROs, in patient rooms 2.
- The placement and setup of in-room air cleaners are crucial to maximize their efficiency, and consultation with ventilation engineers, infection control experts, and/or industrial hygienists is recommended 2.
- Portable negative pressure isolation systems, such as the COVIAGE™, can also be used to contain patients with respiratory illness and minimize the exposure of healthcare providers to infectious pathogens, including MDROs 3.
- Studies have shown that hospital room surfaces and patient hands can be contaminated with MDROs, highlighting the need for effective infection control measures, including hand hygiene protocols and environmental cleaning 4, 5.
- Ventilation-associated particulate matter has been identified as a potential reservoir of MDROs in health facilities, emphasizing the importance of proper ventilation and air filtration systems 6.
Key Considerations
- The use of fans in patient rooms with a history of MDRO should be carefully considered, taking into account the potential risks of airborne transmission and the effectiveness of infection control measures.
- In-room air cleaners and portable negative pressure isolation systems can be useful in reducing the concentration of airborne pathogens, but their placement and setup are crucial to maximize their efficiency.
- Effective infection control measures, including hand hygiene protocols and environmental cleaning, are essential to prevent the transmission of MDROs in healthcare settings.