NICU Standard 9: Airborne Infection Isolation Room(s)

An airborne infection isolation room shall be available for NICU infants, and shall provide a minimum of 180 square feet (16.7 square meters) of clear floor space, excluding the entry work area. A hands-free handwashing station for hand hygiene and areas for gowning and storage of clean and soiled materials shall be provided near the entrance to the room. Ventilation systems for isolation rooms shall be engineered to have negative air pressure with air 100% exhausted to the outside, and shall meet acoustic standards for infant rooms (see Standard 29 for specifics). Airborne infection isolation room perimeter walls, ceilings, and floors, including penetrations, shall be sealed tightly so that air does not infiltrate the environment from the outside or from other airspaces.

Airborne infection isolation rooms shall have self-closing devices on all room exit doors. An emergency communication system and remote patient monitoring capability shall be provided within the airborne infection isolation room.

Airborne infection isolation rooms shall have observation windows with internal blinds or “smart” glass for privacy. Placement of windows and other structural items shall allow for ease of operation and cleaning.

Airborne infection isolation rooms shall have a permanently installed visual mechanism to constantly monitor the pressure status of the room when occupied by a patient with an airborne infectious disease. The mechanism shall continuously monitor the direction of the airflow.

Interpretation: An airborne infection isolation room adequately designed to care for ill newborns should be available in any hospital with an NICU. In most cases, this is ideally situated within the NICU, but in some circumstances, utilization of an airborne infection isolation room elsewhere in the hospital (e.g., in a pediatric ICU) would be suitable. 

At least one single-occupancy isolation room should be available for any infant with a suspected airborne infection. A space within the NICU should also be available to safely cohort a group of infants infected with or exposed to a common airborne pathogen.

When not used for isolation, these rooms may be used for care of non-infectious infants and other clinical purposes.

Turbulence attendant to high air-exchange rates can result in unacceptable levels of background noise in airborne infection isolation rooms. Such levels result in speech interference, annoyance, and physiologic responses typical of noise exposure for adults and infants. Specific attention is required, therefore, to the design of the heating/ventilation/air-conditioning ductwork and to washable acoustic surfaces on the walls and ceilings to ensure that sound levels meet the Standard in these rooms. Glass partitions should be limited to that which is actually necessary for safe visualization. Proportional amounts of acoustically absorptive and acoustically reflective surfaces should be appropriate to achieve greater than 25% sound absorption.

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