9. When in use by SIKI TB patients, doors in negative pressure rooms must remain closed,
except for entering or exiting the room. Proper airflow and pressure differentials between areas are
difficult to control because of open doors, movement of patients and staff, temperature, and the effect of
vertical openings. Air pressure differentials can only be maintained in completely closed rooms. An open
door reduces or eliminates the desired effect of negative pressure rooms. Whether windows are needed in
doors to S/KI TB patient bedrooms is a local decision.
10. Medical Centers and outpatient clinics should consider providing emergency power to
exhaust systems serving inpatient TB rooms and to some of the ambulatory care rooms designated for
management of S/KI TB patients. The potential risks to patients and staff, available emergency power
system capacity, and relative priority of other functions covered by emergency power should be carefully
evaluated when considering costly emergency power system emergency expansion.
B. Medical, Surgical, and Neurological (MS&M) Nursing Acute Care Units
To determine the number- of TB rooms, use the following formulae to determine number of patient
bedrooms for cases of S/KI TB:
1. Current need: (Identify the maximum number of patients requiring respiratory precautions
for S/KI TB at any one time within the past 12 months,) x (change in incidence of TB in community over
the past year).
2. Projected Need: Using the estimated change in the population in the facility, Distributed
Population Planning Base (DPPB) for any Future year, calculate future needs based on current estimate
as determined above multiplied by this population change ratio.
EXAMPLE 1- All specific numbers are for illustrative purposes only.
15.0
Maximum number of patients requiring AFB precautions at one time (e.g., 15)
-
x 1. 05
-
Change in community incidence (this represents a 5% increase in community
incidence)
15.75
Need for TB beds based on changes in B incidence in community
-
T
x 10.85
-
Correct for future anticipated changes in veteran population (this represents a 15%
decrease in expected veteran population)
13.38
-
Projected no. of AFB precauton beds needed corrected for calculated changes in
i
veteran population and community incidence
C. Nursing Unit Organization
1. High Incidence Area or Referral Center:
Medical Centers with sufficient workload or those assigned the mission of referral center may choose to
concentrate all TB bedrooms on an existing MS&N nursing unit designated for TB inpatient care. Or,
they may designate bedrooms to be used for TB care throughout their facility. In establishing groups of
TB bedrooms on an MS&N nursing unit, a Medical Center should renovate a contiguous sub-set of the
bedrooms on the unit to meet HVAC and bathroom requirements; not necessarily the entire ward. The
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