Basic Documentation

Technology Report
May, 2008
Siemens Industry, Inc. Page 1 of 12
Healthcare Isolation Rooms
Architectural and Mechanical Design Considerations
Industry Guidelines and
Preventing the Spread of Disease
WARNING:
The 2006 American Institute of Architects
(AIA) Guidelines for Design and
Construction of Hospital and Health Care
Facilities do not permit the construction of
variable pressure rooms (such as, rooms
in which the ventilation can be switched
from positive to negative pressure) in new
facilities or in renovated areas of the
facility. 2001 AIA guidelines first identified
that the use variable pressure rooms was
not acceptable for protective environments
and AII functions.
The 2006 AIA Guidelines state “…Rooms with
reversible airflow provisions for the purpose of
switching between protective environment and
airborne infection isolation functions are not
acceptable.” (AIA 2006 Guidelines, section
10.2.2.1(3), P 120) Also, variable pressure
rooms in existing facilities are discouraged.
The Centers for Disease Control (CDC)
Guidelines for Environmental Infection Control
in Health-Care Facilities state “Older health-
care facilities may have variable pressure
rooms (i.e., rooms in which the ventilation can
be manually switched between positive and
negative pressure). These rooms are no
longer permitted in the construction of new
facilities or in renovated areas of the facility,
and their use in existing facilities have been
discouraged because of difficulties in assuring
the proper pressure differential, especially for
the negative pressure setting, and because of
the potential for error associated with
switching the pressure differentials for the
room. Continued use of existing variable
pressure rooms depends on a partnership
between engineering and infection control.
Both positive-pressure and negative-pressure
rooms should be maintained according to
specific engineering specifications (Table 6)."
(2003 CDC Guidelines, p. 19.)
Who Enforces the Guidelines?
The American Institute of Architects (AIA) and Centers for
Disease Control (CDC) cannot write standards and codes;
they write guidelines. However, once the authority having
jurisdiction adopts their guidelines in whole or in part, they
become law. Most states have adopted the infection
control guidelines; check with your state department of
health. The Joint Commission on Accreditation of
Healthcare Organizations (JCAHO) has also adopted the
Guidelines as part of their standards, which means that
hospitals seeking accreditation through JCAHO must meet
the CDC and AIA Guidelines. The CDC Guidelines have
become the standard of care in the healthcare industry.
When is this Effective?
Any newly constructed room or major modification of a
room after December 2003 should not have variable
pressure rooms. In states that adopt the AIA Guidelines,
the effective date can be as early as January 2001. Again,
check with your state department of health to identify the
edition of the Guidelines that has been adopted.
Are Existing Rooms Grandfathered?
The CDC Guidelines state “…These (variable
pressure) rooms are no longer permitted in the
construction of new facilities or in renovated areas of
the facility, and their use in existing facilities has
been discourage because of difficulties in assuring
the proper pressure differential, especially for the
negative pressure setting, and because of the
potential for error associated with switching the
pressure differentials for the room. Continued use of
existing variable pressure rooms depends on a
partnership between engineering and infection
control. Both positive-and negative-pressure rooms
should be maintained according to specific
engineering specifications.”
Document No. 1
49-903