IBSI provides a full range of services for hospitals and health care facilities including nosocomial infection control, surgical site infection control, air and surface disinfection system design and installation, air & surface sampling and nosocomial infection investigation support. Mold problems in hospitals can also be investigated and remediated. Air and surface disinfection systems can be provided for General Areas, Procedure Rooms, Intensive Care Units (ICUs), NICUs, and Operating Suites. Dental offices, Laboratories, and Veterinary clinics can also be supported with such services.

All such services are implicitly confidential and no undue access is required to hospital records, although it is necessary for IBSI to coordinate any investigations with the resident Infection Control Professional (ICP) or Infection Control Coordinator (ICC).

IBSI can tailor a plan for resolving nosocomial infection issues that meets the needs and budgets of any facility.

A complete program for investigating nosocomial infection etiology would typically proceed in the following stages:

1. Inspection of Hospital Facilities and ventilation systems. Pressurization and airflow directions will be established in critical areas and correlated with the original building design specifications. Existing filter assemblies may be inspected or tested for leakage. Zone isolation will be verified.

2. Evaluation of Epidemiological Data from the Hospital to identify the possible airborne agents of infection, areas affected, and the potential etiology.

3. Air and Surface Sampling in the affected areas of the hospital to identify air quality problems, surface contamination problems, and to speciate the possible causes and thereby connect them with the epidemiological data. Samples will be taken by IBSI and delivered to an independent laboratory for counting and speciation. In some cases, Hospitals prefer to perform their own analysis of the sample plates using their own laboratory facilities, which can reduce the costs of the investigation. Some hospitals even perform their own air sampling although this is not recommended unless the hospital uses IBSI sampling protocols and IBSI personnel are present to observe the sampling procedures.

4. Evaluation of Air Sampling Data. IBSI will evaluate the laboratory data from air and surface sampling, comparing it with other facilities for which IBSI has collected data or for which data has been previously published by other sources. Airborne levels will be assessed according to suggested guidelines from the literature. Problem areas will be identified and solutions will be proposed.

5. Engineered Solutions will be offered and these may include any or all of the following: Air Disinfection Systems, Surface Disinfection Systems, Remediation of mold problems or water damage, rebalancing or upgrading of existing ventilation systems, replacement of doors, removal of contaminated furnishings or carpets, or installation of stand-alone local air cleaning units.

6. Engineering Analysis of facilities can be provided, and such evaluation may include modeling of the entire building using volumes and airflows to establish the overall pattern of air purging and air mixing. Such analysis can establish the Risk of any zone or of an entire building (see articles on Building Protection Factors).

7. Bioweapons concerns can also be addressed (see main page for information).

8. Follow-up Air and Surface Sampling will verify that any installed systems are performing according to design specifications. Air sampling results will be compared with data collected prior to any engineering modifications to demonstrate improvements in air quality, and the absence or reduction of problems that previously existed.

9. Follow-up Review of Epidemiological Data. Collection of epidemiological data in nosocomial infections is recommended for at least one year (depending on facility size) in order to establish that the subject nosocomial infection problem has been reduced or eliminated. At least one year’s worth of data may be required to achieve statistical significance. The client may opt to perform this evaluation by themselves in order to assure themselves of the effectiveness of the engineered solutions.

Any or all of the above stages may be included in a package for the Client. IBSI recommends that all of the above functions be performed for any facility, but the Client has the option of eliminating one or more of the stages as their budget or concerns dictate. For example, IBSI can conduct an investigation without implementing any engineering changes, or we can design and install an air disinfection system without any prior or follow-up investigations. As is often the case, the Client’s concerns may be unique, and so the above program does not necessarily reflect any limitations or constraints on the services or systems that IBSI can provide to Hospitals and Health care Facilities.

For more information, see the articles and publications listed at right, especially;
Air - Treatment Systems for Controlling Hospital-Acquired Infections
The epidemiology and aero biological pathways of airborne nosocomial infections and methods of air and surface disinfection,

or contact IBSI via email with any questions.

Articles and Publications: Download .pdf files here