bohurst
1 post
Nov 26, 2007
5:41 AM
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We are evaluating our Infection Control/Employee Health Program in light of this standard. We do not have respiratory isolation/negative pressure rooms at our facility. Please share any experiences you have had with a surveyor in regards to this standard. Thank You.
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APIQI
6 posts
Jan 03, 2008
11:43 AM
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We do have a negative pressure room that is used for basic labs and meeting with staff regarding employee health. It is not intended for patient care so it is not part of our plan for managing respiratory isolation in patient care.
We refer anyone with an airborne communicable illness to a medical provider who is equipped for isolative respiratory care. So we would seek medical hospitalization until that respiratory risk resolved. We do have respiratory mask available that are capable of meeting requirements for respiratory isolation to limit exposure if the risk becomes apparent while hospitalized with us.
If we experience a pandemic level event, it will be necessary to sequester the ill in a quarantine area in an attempt to isolate the pathogen as much as possible. That will mean conversion of a unit into an infirmary of sorts. While negative pressure would be advantageous under this scenario, this capability was not required as part of the EOC standards for behavior health when the building was designed and built in 2006. The design team was aware of this issue and made an informed decision not to build this capability into the facility design.
Our plan is to refer out significant communicable diseases such as T.B. and isolate any major out breaks to our best ability. Being able to show you have a plan for dealing with the need for respiratory isolation should work. This did not come out as an issue in our O7 JC survey or O7 CMS survey.
Last Edited on 3-Jan-2008 11:50 AM
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SueO
11 posts
Jan 21, 2008
10:26 AM
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I would echo your thoughts until we had a patient in respiratory AFB cultures came back - our plan (at a different psychiatric hospital) was to transfer these patients to acute care. They sent the patient back to us knowing we had no negative pressure room because the patient wasn't 'sick enough for acute care.'
We had the N-95 masks and the patient wore hers at all times out of her room - groups, etc., she did not have to wear in her room, staff did. The licensing officer chose to make an unannounced visit 3 days after this occurred and asked appropriate questions, identified that we followed ours and the CDC protocols and also was surprised we couldn't ransfer the patient. After 4 days her AFB came back negative but because she a positive, we reswabbed and waited until the 2nd report came back before we lifted the iso, moved her to a clean private room and terminal cleaning per the 'TB' protocol. We really felt we had dodged the bullet but I am sure it is still lurking out there.
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SueO
18 posts
Sep 16, 2008
10:17 AM
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A couple of months ago the hold on the n-95 masks was lifted in Michigan. What are you doing in your facilities for fit testing? sue.offenbecker@pinerest.org
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KathyA
4 posts
Apr 09, 2009
11:49 AM
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We don't fit test at our facility. Our building is over 100 years old and we don't have a negative air pressure room. That is identified in our TB Exposure Control Plan as well as a plan to transfer the suspect patient to one of the two medical hospitals in our city. We recently had a patient (chronic smoker, emphysema) with a CXR and CT scan that was highly suspect for "reactivation" of TB disease (had TB 20 years ago after being in prison). He was transferred to the medical hospital for further evaluation. We wouldn't consider taking him back until he had 3 negative AFB's. We just said NO but they were pushing the whole time. Turned out it wasn't TB disease but it was bad news for the patient after all.
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APYoung
Guest
Jun 10, 2009
9:49 AM
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What is the stance of CDC and CMS on not fit testing employees for the N-95?
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Pam W
10 posts
Jun 11, 2009
12:09 PM
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Joint Commission cited one of our facilities (indirect) for not fit testing the employees with the N-95 masks we had. The surveyor cited IC.01.0501 EP 1.
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