• Journal of The Korea Institute of Healthcare Architecture
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• v.24 no.1
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• pp.51-58
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• 2018

Purpose: In this study, through the comparison of the pressure fluctuation and air exchange volume in negative isolation room according to the type of the door and door opening/closing speeds, which is one of the main factors causing the cross contamination of the negative pressure isolation room, establishes standard operating procedures to prevent cross contamination in high risk infectious diseases and isolation room design. Methods: In this study, the air flow each of the room is analyzed using ANASYS CFX CODE for flow analysis. In addition, the grid configuration of the door is constructed by applying Immersed Solid Methods. Results: The pressure fluctuation due to the opening and closing of the hinged door was very large when the moment of the hinged door opened and closed. Especially, at the moment when the door is closed, a pressure reversal phenomenon occurs in which the pressure in the isolation room is larger than the pressure in the anteroom. On the other hand, the pressure fluctuation due to the opening and closing of the sliding door appeared only when the door was closed, but the pressure reversal phenomenon not occurred at the moment when the sliding door was closed, unlike the hinged door. As the opening and closing speed of the hinged door increases, the air exchange volume is increased. However, as the opening and closing speed of the sliding door is decreased, the air exchange volume is increased. Implications: According to the results of this study, it can be concluded that the pressure fluctuation due to the opening and closing of the hinged door is greater than the pressure fluctuation due to the opening and closing of the sliding door. In addition, it can be confirmed that the pressure reversal phenomenon, which may cause to reduce the containment effect in negative pressure isolation room, is caused by the closing of the hinged door. Therefore, it is recommended to install a sliding door to maintain a stable differential pressure in the negative isolation room. Also, as the opening and closing speed of the hinged door is slower and the opening and closing speed of the sliding door is faster, the possibility of cross contamination of the room can be reduced. It is therefore necessary to establish standard operating procedures for negative isolation room for door opening and closing speeds.

• Journal of The Korea Institute of Healthcare Architecture
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• v.29 no.4
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• pp.29-35
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• 2023

Purpose: The 2015 Middle East Respiratory Syndrome (MERS) outbreak and the recent COVID-19 pandemic have highlighted the lack of negative pressure isolation rooms and the fragility of the healthcare system. The need for healthcare facility transformation for respiratory infectious diseases has become more prominent due to COVID-19, and the purpose of this study is to provide a foundation for the rapid, economical, and safe construction of negative pressure isolation wards. Methods: This study analyzes the current status of hospitals that have been converted to negative pressure isolation rooms, and provides architectural plans and examples to provide a reference for bedroom change. Research data of this study have been obtained by analyzing the drawings of negative pressure isolation wards of nationally designated inpatient treatment beds and urgent isolation beds. In addition, the relevant literature of urgent isolation beds has been analyzed to derive bedroom change type. Result: In this study, a total of 21 isolation bed conversion methods have been presented. Implications: In order to change efficiently from a general ward to an isolation ward, it is necessary to consider the actual hospital's infectious disease transmission patterns and facility conditions.

• Journal of the Architectural Institute of Korea Planning & Design
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• v.33 no.12
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• pp.19-28
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• 2017

The purpose of this study is to propose a design methodology to build temporary isolation rooms when infectious diseases suddenly occur in a certain region, such as the case of MERS-Cov in South Korea in 2015. Although most big hospitals usually have isolation rooms, they are expensive and dangerous to run such facilities on normal and typical days. To deal with these problems in this research, shipping containers are chosen as devices used to build the temporary isolation rooms near the original hospital. To do so, firstly, a prototype for the temporary isolation room was designed with the three part modules. The first part is for the medical team; the second part including the isolation rooms is for patients; the third part is for medical selection rooms to test the specimens. Secondly, the plan was compared with the MERS-Cov infection control guidelines. Finally this prototype is applied into the Yong-in Yon-sei severance hospital and then evaluated through a CFD simulation using STAR-CCM+(ver.9.06) for checking infectious bacterium movement in this prototype. The result showed that the prototype is effectively safe for patients tested as negative, patients waiting to be tested, and the medical team.

• Journal of The Korea Institute of Healthcare Architecture
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• v.24 no.2
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• pp.37-44
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• 2018

Purpose: This study investigates the influences of coughing direction and healthcare worker's location on the transport characteristics of coughed particles in airborne infection isolation room (AIIR), which is commonly called negative pressure isolation room, with a downward ventilation system. Methods: Computational Fluid Dynamics (CFD) was used to simulate the airflow and for tracing the behavior of particles. Results: The results show that the airflow pattern and coughing direction have a significant influence on the characteristics of particle dispersion and deposition. When healthcare workers are in the isolation room with the patient who is lying on the bed, it is recommended to be located far from the anteroom to reduce the exposures from infectious particles. And when the patient is lying, it is more effective in removing particles than when the patient is in Fowler's position. Although it is an isolation room that produces unidirectional flow, coughing particles can spread to the whole room and a large number of particles can be deposited onto patient, bed, side rails, healthcare worker, ceiling, floor, and sidewall. Implications: Following the patients' discharge or transfer, terminal cleaning of the vacated room, furniture, and all clinical equipment is essential. Also, it is necessary to establish detailed standard operating procedure (SOP) in order to reduce the risk of cross-contamination.

• Journal of The Korea Institute of Healthcare Architecture
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• v.29 no.3
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• pp.37-44
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• 2023

Purpose: To decrease cross-infection, it's essential to analyze the spatial composition of the 'PPE doffing area'. Instead of solely relying on manpower standards, we should focus on responding to infectious diseases within the context of space planning. By doing so, we can lower the risk for healthcare workers' infection and ensure a level of safety in various environmental changes or new manpower input situations. Methods: This analysis is conducted specifically for facilities with negative pressure isolation wards. Additionally, interview surveys to obtain feedback from healthcare workers and incorporate their expertise into the design of the 'PPE doffing area' have been carried. Results: In a PPE doffing area, the standard spaces include a PPE doffing room, a shower room, and a clothing room. Depending on the facility environment or the level of infectious diseases, a Decontamination room or Anteroom can be optionally added. Healthcare workers who remove their PPE in the PPE doffing room should avoid re-entering the Negative pressure room. The shower room is often underutilized. When planning for a future PPE doffing area, an aisle space or passageway must be included even if a shower room is planned. Implications: This study examined the space used by healthcare workers rather than patients, with a focus on infection prevention through architectural planning rather than individual efforts. However, the investigation was limited to facilities that have been converted from general wards to negative pressure isolation wards, so it cannot be generalized to all infectious disease facilities.

• Journal of The Korea Institute of Healthcare Architecture
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• v.28 no.4
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• pp.61-69
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• 2022

Purpose: In response to the rapid spread of COVID-19 in 2020, the government supported facilities and equipment through the 'Urgent Isolation Ward Expansion Project'. Design and remodeling of efficient negative pressure isolation facilities had to be done in a short period of time, and the performance gap between facilities was very large because the types of hospitals and wards of existing medical facilities were diverse. In order to secure the stability of isolation wards between medical facilities and reduce the facility gap, guidelines for planning isolation wards considering the diversity of each hospital should be appropriately presented. In consideration of these points, this study aims to provide basic data for future remodeling guidelines for each plan type of the negative pressure isolation ward first. Methods: We analyzed the plans before and after the change of 13 case hospitals that performed the urgent care bed expansion project for COVID-19 confirmed patients. Before the remodeling, the current status of the facility was analyzed according to the type of corridor, the location of the nursing station, and the location of the elevator. After remodeling, the flow of medical staff and patients, the flow of entry and exit of clean and contaminated items, and the space of negative pressure and non-negative pressure areas. Results: The ward type was divided into three types according to the corridor type and room arrangement: double loaded corridor type with two side wards, race track type with one side ward, and race track type with two side wards. Based on these three types, the standard floor plan type of the isolation ward was proposed in terms of the location of the elevator bank and Nurse station. Implications: When the existing general ward is converted into a negative pressure isolation ward, this study can be a basic data to present customized guidelines for each ward type.

• Journal of The Korea Institute of Healthcare Architecture
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• v.29 no.4
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• pp.69-77
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• 2023

Purpose: During the COVID-19 pandemic, there have been many cases of converting regular hospital wards into temporary negative pressure isolation wards. The purpose of this study is to evaluate the minimum airflow differences that satisfies the pressure difference criteria(-2.5 Pa) according to airtightness of switching type wards, in preparation for utilization of aging regular wards as negative pressure isolation wards. Methods: Visual inspection and field measurements were conducted using blower door to evaluate airtightness of 5 hospital wards. CONTAM simulation was used to assess the airflow differences when pressure difference between the corridor and wards met the criteria at various levels of airtightness. Results: The ACH₅₀ of evaluated wards ranged from 19.3 to 50.1 h^-1 with an average of 37.0 h^-1, indicating more than four times leakier than other building types. The minimum airflow differences increased as the airtightness of the wards decreased and the size of the wards increased. Implications: When operating rapidly converted negative pressure isolation wards, understanding airtightness is crucial for determining the minimum airflow differences to maintain the pressure differences. The analysis of this study suggests that improving the airtightness of aging rooms is essential and the minimum airflow differences should be suggested considering both the airtightness and size of rooms.

• Journal of The Korea Institute of Healthcare Architecture
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• v.27 no.3
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• pp.39-49
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• 2021

Purpose: The negative pressure isolation ward is a key facility in preparedness and response to infectious diseases. For the sustainable operation of the facility, appropriate facility improvement is required. The experience of medical staff responding to infectious diseases in the COVID-19 pandemic provides effective informations for facility planning. Methods: The post occupancy evaluation (POE) was conducted by interviewing medical staff who is working on Nationally designated negative pressure isolation ward in general hospital. Floor plan analysis was conducted before field surveys for identifying facility characteristic and spatial composition. After that, field surveys were conducted at 3 hospitals, and interviews and fieldwork were conducted together. Results: It is necessary to increase the standard size of ward area from 15m² to 20m². The size of the doffing room has to be planned for accommodation of two or more people. Equipment storage, clean storage and waste storage also should be properly planned. There were almost no problems with the circulation in the ward. There was not enough space for medical staff. Implications: For a sustainable and safe negative pressure isolation ward planning, it is necessary to exploit learning from the medical staffs who have many experiences of coping with infectious diseases.

• Korean Journal of Air-Conditioning and Refrigeration Engineering
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• v.23 no.7
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• pp.520-527
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• 2011

Recently, Influenza(AI, PI) patients have been increasing rapidly. But, there is a lack of isolation hospitals. In particular, according to increase the rate of patients with airborne infection, in order to prevent the spread of pathogens, design of layout plan and air conditioning system of isolation hospitals becomes more important to maintain patient's room as negative pressure. In this study, the spread of pathogens are analyzed as room differential pressure, moving time of medical staff and patients, and moving way in isolation hospitals by multizone simulation; CONTAM 2.4. Through the analysis, the ways to improve isolation hospital considered at the design step are reached to prevent the spread of pathogens effectively. Also, it verifies that HVAC system for isolation hospital is suitably designed as standard.

• Journal of The Korea Institute of Healthcare Architecture
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• v.29 no.3
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• pp.17-28
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• 2023

Purpose: This study aims to provide basic data for the future construction plans of the Infectious Disease Hospitals by analyzing the area composition and required room ratios in the wards and ICU of currently under-construction infectious disease hospitals. Methods: 3 Methods have been used in this paper. 1) This study conducted a literature review on major considerations and related guidelines for hospitals specializing in infectious diseases using existing data. 2) Based on the objects and activities of the hospital space, zones and areas were set for each department according to infection control. 3) Based on the established zones and areas, basic plan drawings of three hospitals specializing in infectious diseases currently under construction were collected and architectural drawing analysis was performed. Results: 1) Infectious Diseases Hospital must have a spatial organization that can accommodate patient isolation, infection control, efficiency of medical service, and changes. 2) Zones for infection control are divided into negative pressure and non-negative pressure zones based on airborne precaution isolation. It is divided into clean and contaminated zone according to class of cleanliness by Aseptic technique. Areas are classified by objects (patients, healthcare workers, supplies) and activities (access, medical treatment, support), and a system for organizing space is established based on this. 3) By analyzing the area composition of each departmental area, each required room, and each required space in the wards and intensive care units, it provides basic data for the spatial organization for architectural planning of the infectious disease hospital. Implication: It can be used as basic data when planning related facilities by analyzing the characteristics of the space plan of the required room according to the relationship between activities, movement lines, and operation plans based on user behavior.