• Title, Summary, Keyword: Patient isolation

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A CFD Simulation Study on the Isolation Performance of a Isolation Ward (CFD를 이용한 격리병동의 격리성능 검토)

  • Sohn, Deokyoung;Kwon, Soonjung;Choi, Yunho
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.20 no.1
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    • pp.7-14
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    • 2014
  • Purpose: In this study, we performed ventilation simulations for a standard isolation ward including three intensive care rooms, one anteroom(buffer room), and its recommended ventilation equipments. The purpose of this study is to predict outflow of pathogenic bacteria from patient breath to verify the reliability and the safety of the isolation ward. Methods: We suppose three scenarios of the movement of medical staff. The leakage of patient's breath to out of the ward is predicted in these scenarios using CFD simulations. Results: The patient's breath leakage rate to out of the ward in scenario 1 according to room air changes per hour(ACH : 6 and 12) is predicted to be 0.000057% and 0.00002%, respectively. The patient's breath leakage rate to out of the ward in scenario 2 according to room air changes(ACH : 6 and 12) is predicted to be 0.00063% and 0.00019%, respectively. The patient's breath leakage rate to out of the ward in scenario 3, which is the worst case(6 room air changes) is predicted to be 0.1%. Implications: Through the ventilation simulation like that in this study, the reliability and the safety on isolation performance of various plan of isolation ward are predicted quantitatively.

A Numerical Study on Coughed Particle Dispersion and Deposition in Negative Pressure Isolation Room according to Particle Size (음압격리병실에서의 기침 토출입자의 입경에 따른 확산 및 침적에 대한 수치해석 연구)

  • Jung, Minji;Hong, Jin Kwan
    • 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.

A Study on the Facility Eligibility Inspection & Effect of Environment Improvement for National Inpatient Isolation Units (국가지정 입원치료 격리병상 시설적격성 및 환경개선효과 분석에 관한 연구)

  • Lee, Du Ru Na;Kwon, Soon Jung;Sung, Min Ki;Yoon, Hyung Jin;Hong, Jin Kwan
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.23 no.4
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    • pp.67-75
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    • 2017
  • Purpose: This study is for the facility eligibility and improvement evaluation analysis for the patient care environment of 7 facilities which has national inpatient isolation units. Methods: For the evaluation, first of all, the patient care environment of national inpatient isolation units are scrutinized by the checklist which is used on from 2014 with the 4 fields of criteria : architectural planning and layout, general requirement and condition for operating the negative pressured isolated patient room, HVAC system, and waste water discharging system. Finally, the evaluation results are compared with that of 2014. Results: The result shows that the average value of facility eligibility is 89.3 percent and which is 8.9 percent higher than the value before the MERS occurred. Implications: It is clear that facility remodeling of 7 institutions is being performed continuously, and the result of facility eligibility evaluation is reflected on design of a new 21 national inpatient isolation units those are going to be constructed from 2016. Therefore, it is expected that this study is used as a practical reference to establish the criteria of patient care environment management and safety management for both infectious disease outbreak and general service condition.

Ethnography on Isolation Unit for Hematopoietic Stem Cell Transplantation: Focusing on Patients (조혈모세포이식 병동에 관한 문화기술지: 환자를 중심으로)

  • Kang, Young-Ah;Yi, Myung-Sun
    • Asian Oncology Nursing
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    • v.9 no.1
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    • pp.31-42
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    • 2009
  • Purpose: The purpose of the study was to understand how patients experience everyday life in an isolation unit for hematopoietic stem cell transplantation (HSCT). Method: The data were collected from 25 patients with HSCT at the isolation unit from January to March in 2008 in one general hospital in Korea. The data were collected by participant observations and ethnographic interviews and were analyzed using ethnographic method. Results: Four themes regarding environmental area emerged: 'barrier pulling up the drawbridge', 'very strange world', 'small and restricted space tied by IV and other treatment lines', and 'loud noise in a silent space.' Three themes regarding patients emerged: 'facing fear and anxiety', 'continuation of loneliness and lethargy', and 'compromising with a very long, dull, and boring time'. These themes describe how patients with HSCT suffer from continuous physical and psychosocial problems in a confined space, while endeavoring to control these problems and to search for hope for a new life. Conclusion: The results of the study provide an in-depth understanding of the experience and culture of patients in an isolation unit for HSCT. They would be used in developing practical programs to decrease patient's culture shock including fear and anxiety at isolation unit for HSCT.

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Optimized Serological Isolation of Lung-Cancer-associated Antigens from a Yeast Surface-expressed cDNA Library

  • Kim, Min-Soo;Choi, Hye-Young;Choi, Yong-Soo;Kim, Jhin-Gook;Kim, Yong-Sung
    • Journal of Microbiology and Biotechnology
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    • v.17 no.6
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    • pp.993-1001
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    • 2007
  • The technique of serological analysis of antigens by recombinant cDNA expression library (SEREX) uses autologous patient sera as a screening probe to isolate tumor-associated antigens for various tumor types. Isolation of tumor-associated antigens that are specifically reactive with patient sera, but not with normal sera, is important to avoid false-positive and autoimmunogenic antigens for the cancer immunotherapy. Here, we describe a selection methodology to isolate patient sera-specific antigens from a yeast surface-expressed cDNA library constructed from 15 patient lung tissues with non-small cell lung cancer (NSCLC). Several rounds of positive selection using patient sera alone as a screening probe isolated clones exhibiting comparable reactivity with both patient and normal sera. However, the combination of negative selection with allogeneic normal sera to remove antigens reactive with normal sera and subsequent positive selection with patient sera efficiently enriched patient sera-specific antigens. Using the selection methodology described here, we isolated 3 known and 5 unknown proteins, which have not been isolated previously, but and potentially associated with NSCLC.

A Study on the Design Qualification of an Isolation Hospital According to Circulation System (동선계획에 따른 격리병동의 설계검증에 관한 연구)

  • Park, Hyun-Jin;Jung, Chung-Soo;Hong, Jin-Kwan
    • 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.

Isolation Effectiveness by Progressive Space Organization in Negative Pressured Isolation Unit (음압격리병실에 있어서 단계별 공간구성의 격리효과)

  • Kwon, Soonjung;Sung, Minki
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.22 no.4
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    • pp.79-86
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    • 2016
  • Purpose: The purpose of this study is to identify the effect of Progressive Space Organization (ante-rooms) in Negative Pressured Isolation Unit(NPIU) such as National and Regional Isolation Units in Korea in order to build basic data for the evidence based design of Airborne Infection Isolation Units which should prepare and respond effectively to the public health crisis due to the hazardous airborne infectious disease. Methods: 1) Gas(SF6) test and analysis on the 23 Korean Isolation Units under operation. 2) Assessment of the isolation level of the space components by checking the Gas concentration. 3) Analysis of the Isolation Effectiveness according to Space Organizational levels. Results: 1) The higher segregation level is, the lower Gas(SF6) concentration is. 2) Too many segregations(anterooms) of Isolation Unit are not efficient for the prevention of infectious bacillus spread. For example, 4 level of segregation has similar segregation effect to the 3 level of segregation. Implications: Many anterooms in front of the isolated patient bedroom will guarantee the safe environment against the danger of hazardous airborne nosocomial infection. On the other hand, too many segregations is inefficient, expensive, inconvenient, narrow(unflexible) and so on. This study can be used as basic data for further development of design guidelines of isolation units.

A Study on the Architectural Planning of Material Handling System for the Airborne Infection Isolation Hospitals (호흡기 감염 격리병원의 물류시스템 계획에 관한 연구)

  • Choi, Kwangseok;Kwon, Soon Jung
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.23 no.2
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    • pp.63-72
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    • 2017
  • Purpose: The purpose of this study is to review the material handling system of the Airborne Infection Isolation Hospitals which is the one of the key elements of infection control and to improve the basic data for the planning and design of those facilities. Methods: Research was conducted by literature reviews and case studies for the material handling system of domestic and foreign Isolation hospitals. Results: The result of this study can be summarized into three points. First, a general isolation unit and a high level isolated unit need to be distinguished in terms of efficiency and safety. In particular, it is desirable that a high level isolated unit have to completely separate clean and soiled circulations, and soiled corridor should be installed by those means. By doing this, the medical staff can observe patient rooms and supply clean materials directly in the clean zone without wearing PPE, so that safety and work efficiency can be improved at the same time. Second, for the safe disposal of wastes, it is desirable to install a dedicated sterilizer per ward and sterilize it at least in the ward. In addition, It is desirable to install a central waste treatment room and a dedicated soiled corridor in consideration of the inadequate handling capacity and emergency situation. Third, the characteristics of material flow chart in the negative pressured isolation hospitals and the corresponding material handling system have been presented. Implications: Infection control is very important in safety, but it is necessary to respond to the symptoms of the patient.

Efficacy and Usability of Patient Isolation Transport Module for CBRN Disaster : A Manikin Simulation Study (특수재난 대응 환자 격리 이송 장비의 효율성 및 편의성 평가: 마네킹시뮬레이션 연구)

  • Kim, Ki-Hong;Hong, Ki-Jeong;Haam, Seung-Hee;Choi, Jin-Woo
    • Fire Science and Engineering
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    • v.32 no.3
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    • pp.116-122
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    • 2018
  • In Chemical, Biological, Radiological and Nuclear (CBRN) disaster, integrated and optimized equipment package including stretcher, isolation unit, patient monitoring and treatment equipment is essential to achieve proper treatment and prevent secondary contamination. The purpose of this study was to evaluate the efficiency and ease of use of integrated CBRN disaster equipment package for disaster medical response. This study was a randomized crossover study using a manikin simulation for emergency medical technitian (EMT). All participants used the existing devices and prototype of integrated CBRN disaster equipment package alternately. Efficiency was measured by time from vital sign change to detection or treatment application. Ease was use was measured by questionnaires for each patient monitor, stretcher care and isolation unit. 12 EMTs were enrolled. hypoxia-detection time of integrated equipment group was significantly shorter than existing equipment group (4.9 s (3.8-3.9) vs 3.5 s (2.5-3.9), p < 0.05). There was decreasing tendency of ECG change detection and facial mask oxygen supply but no statistical significance was observed. Overall satisfaction of patient monitoring device in integrated equipment group was significantly higher than existing devices (4(3.5-5) vs 3(3-3), p < 0.05). The use of integrated CBRN disaster equipment package shortened the hypoxia detection time and improved usability of vital sign monitor compared to existing devices.

An exploratory study on the development of a device for isolation unit in CBRNE disaster (CBRNE 재난 시 격리이송을 위한 장치 개발에 관한 탐색적 연구)

  • Ham, Seung Hee;Park, Namkwun;Yoon, Myong O
    • Journal of the Society of Disaster Information
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    • v.14 no.1
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    • pp.65-71
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    • 2018
  • In this study, it is aimed to prevent the spread of pollutants in the event of a major disaster caused by CBRNE accidents and attacks and build up system to provide optimal transport environment for each patient condition By identifying characteristics of existing products and make them immediately applicable in the field. The purpose of this study is suggesting essential consideration in both functional and performance in the development of the isolation unit. As a result of the study, it suggests (1) basic function, (2) efficient field utilization, (3) isolation unit interface and combination of modules in development of isolation unit.