Gormley Thomas, Markel Troy A, Jones Howard, Greeley Damon, Ostojic John, Clarke James H, Abkowitz Mark, Wagner Jennifer
Department of Civil and Environmental Engineering, Vanderbilt University, Nashville, TN.
Department of Surgery, Riley Hospital for Children at Indiana University Health, Indianapolis, IN.
Am J Infect Control. 2017 Dec 1;45(12):1318-1323. doi: 10.1016/j.ajic.2017.07.024. Epub 2017 Oct 12.
Hospitals face growing pressure to meet the dual but often competing goals of providing a safe environment while controlling operating costs. Evidence-based data are needed to provide insight for facility management practices to support these goals.
The quality of the air in 3 operating rooms was measured at different ventilation rates. The energy cost to provide the heating, ventilation, and air conditioning to the rooms was estimated to provide a cost-benefit comparison of the effectiveness of different ventilation rates currently used in the health care industry.
Simply increasing air change rates in the operating rooms tested did not necessarily provide an overall cleaner environment, but did substantially increase energy consumption and costs. Additionally, and unexpectedly, significant differences in microbial load and air velocity were detected between the sterile fields and back instrument tables.
Increasing the ventilation rates in operating rooms in an effort to improve clinical outcomes and potentially reduce surgical site infections does not necessarily provide cleaner air, but does typically increase operating costs. Efficient distribution or management of the air can improve quality indicators and potentially reduce the number of air changes required. Measurable environmental quality indicators could be used in lieu of or in addition to air change rate requirements to optimize cost and quality for an operating room and other critical environments.
医院在实现提供安全环境与控制运营成本这两个双重但往往相互冲突的目标上面临着越来越大的压力。需要基于证据的数据来为设施管理实践提供见解，以支持这些目标。
在不同通风率下测量了3间手术室的空气质量。估算了为这些房间提供供暖、通风和空调的能源成本，以便对医疗行业目前使用的不同通风率的有效性进行成本效益比较。
单纯提高测试手术室的换气率不一定能提供更清洁的整体环境，但确实大幅增加了能源消耗和成本。此外，出乎意料的是，在无菌区域和器械台后部之间检测到微生物负荷和空气流速存在显著差异。
提高手术室通风率以改善临床结果并可能减少手术部位感染，不一定能提供更清洁的空气，但通常会增加运营成本。空气的高效分布或管理可以改善质量指标，并可能减少所需的换气次数。可测量的环境质量指标可以替代换气率要求或与之结合使用，以优化手术室和其他关键环境的成本和质量。
