Table 4.
Strategies for healthy outcomes in daily procedures.
| Criterion | Criticism | Strategies |
|---|---|---|
| site constructions in the neighborhood—site construction | If there are some site constructions inside of the hospital, the hospital borders or in the neighborhood of the hospital, and procedures have not been taken to prevent renovation and remodeling activities from adversely affecting the building air supply | it is suggested they define healthcare strategies for good outcomes of medical practices. In any case, good performance of ventilations systems is required, with regular cleaning of the filters, and it is requested they open the windows only in the case of need, for avoiding dust concentrations. |
| room dimension and layout—window opening | If it not is possible to open the windows | it is suggested they improve the air rate changes. |
| microclimatic parameters—temperature/relative humidity/air velocity. | If the parameters are not respected | it is requested they improve or reduce the temperature/relative humidity and/or air velocity through ventilation systems and/or natural ventilation systems, for adequate air rate changes and improving the microclimatic parameters. |
| ventilation system—crowd index | If the crowd index predicted for the environmental unit is not respected | it is suggested they improve the air rate changes. |
| ventilation system—exchange rate | If the air exchange rate is not respected | it is requested they improve air exchange rate and/or improve natural ventilation strategies with window openings. |
| ventilation system—air flow | If the air flow rate between inlet and discharge is not maintained, | it is suggested they improve the adequate air rate changes |
| ventilation system—pressure | If the pressure is negative, | any action should be taken into consideration, starting from existing legislation that does not list any specific requirement. In any case, it is suggested they have air intake systems near the door and windows openings. |
| medical activity—medical activities and therapies | If there are some medical treatments that can affect the quality of the air | it is requested they dilute the pollution levels, or, in general, improve the air rate changes. |
| medical activity—medical equipment | If there is some medical equipment that can emit chemical pollutants in the breathing zone of the user, | it is requested they maintain an adequate distance from the breathing zone (at least 1 mt). |
| cleaning activity—number of cleaning activities per day/cleaned areas/floor cleaning products/furniture cleaning products/bathroom cleaning products | In general, it is expected that at least twice a day the healing spaces are cleaned. If they are not, | it is requested they do the cleaning activities at least twice a day. |
| In general, it is expected that cleaning products are differentiated. If they are not, | it is expected that the cleaning products are adequate for each surface, responding to the performance of the material. | |
| cleaning activity—air change during and after cleaning activity | If the windows are not opened enough during and after cleaning activities, | it is requested they take into consideration this best practice, especially if the cleaning products have VOC concentrations. The window can be opened manually or with smart automatization system. |
| If it is not possible to open the windows, | they is expected to improve the air rate changes. | |
| human presence—smoking activity | If smoking restrictions in the inpatient room and in the inpatient ward, as well as outside, are lacking, | smoking restriction in healing settings are suggested, and/or the introduction of some sensors for monitoring the performance of the quality of the air. |
| maintenance activity—sampling activity | If the healthcare organization does not consider the introduction of sampling activities for registering the indoor air in the inpatient ward, | it is suggested they introduce some mobile sensors (which can also be used in different healthcare environments) for monitoring the quality of the air. |