Medical Construction & Design

NOV-DEC 2017

Medical Construction & Design (MCD) is the industry's leading source for news and information and reaches all disciplines involved in the healthcare construction and design process.

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M E D I C A L C O N S T R U C T I O N D E S I G N MCDM AG.COM | NOV EMBER / DECEMBER 2017 | Medical Construction & Design 21 buff er rooms, one negative for non-sterile hazardous drugs and one positive for sterile non-hazardous drugs. Detail 3: Storage Under the new standard, haz- ardous drugs should be stored separately from non-hazardous drugs, in an externally venti- lated, negative-pressure room with a minimum of 12 ACH. There is no one-size-fi ts-all approach to designing USP 800-complaint storage in an effi cient way. It will all depend on the layout of the pharmacy, the scope of its service and its growth plan. However, here are a few things to consider: > An existing storage room or offi ce can be converted into negatively pressurized storage for hazardous drugs. > Appropriately sized, the sterile-hazardous-drug buff er room can serve as storage for sterile hazardous drugs. Non- sterile hazardous drugs should not be stored in sterile areas. > Remember that local authorities may have stricter regulations than USP 800, and should be consulted. Impacts: Duct routing Building infrastructure modi- fi cations associated with USP 800 can be extensive. The ex- tent of mechanical renovations varies greatly between facili- ties due to the age of systems, spare system capacities and the location of the space for rout- ing of new services. USP 797 mandates that sterile drug processing should occur in a positive-pressure environment in which airfl ow moves from cleanest (C-PEC) to dirtiest (anteroom). USP 800 requires the opposite fl ow of air for hazardous-drug storage and compounding — a negative-pressure environ- ment — with exhaust exiting the facility a minimum of 10 feet above roof level, and 25 feet from outdoor air intakes, due to the hazardous proper- ties of the exhausted air. A pharmacy designed for non-hazardous drugs may have no exhaust system serving the compounding area, so modifi - cations to existing HVAC may include the addition of dedicat- ed exhaust systems to achieve negative pressurization. Depending on the loca- tion of the existing pharmacy within the building, the impact of routing new exhaust duct- work through the facility can be signifi cant. For example, a pharmacy located on a lower level with multiple stories above would require the rout- ing of exhaust ducts to roof level, which impacts depart- ments throughout the facility. Impacts: Fire-rated ductwork Passing hazardous exhaust ducts through fi re-rated and smoke walls presents another challenge. Per the International Mechanical Code 2015, fi re and smoke dampers are prohibited in hazardous exhaust ductwork. When a hazardous exhaust duct penetrates a rated assembly, the ductwork requires enclosure in a fi re-resistance- rated shaft. Construction of a rated shaft enclosure around a duct can add signifi cant cost to the project if the length of ductwork requiring the enclosure is extensive. A rated enclosure requires more space in an above-ceiling condition, which can be diffi cult to obtain in existing facilities with congested above-ceiling conditions. Discussions with facility staff to minimize new exhaust duct routing to a roof location will help limit the impact of new systems on existing facilities. Impacts: System capacity The new requirement for hazardous and non-hazardous drugs to be processed in separate ISO Class 7 sterile processing rooms can impact existing building mechanical systems. Class 7 requires air to be supplied at 30 ACH via HEPA fi ltration — an amount of airfl ow and system pressure that may not be attainable from the existing system. Modifi cations to meet those airfl ow requirements can include rebalancing of existing systems, increasing fan motor sizes or incorporating additional equipment such as fan fi lter units. Additional pressure- monitoring devices between buff ers and anterooms are also required to verify the correct pressure diff erentials. USP 800 will aff ect existing pharmacy departments throughout the country. For every pharmacy that handles hazardous drugs, new policies and procedures will be required. The physical building environment will need to be evaluated far in advance in order to avoid a shutdown. This planning should be done early to help identify and budget capital expenditures required for compliance. Design professionals should be ready with a working knowledge of the new code in order to help identify potential infrastructure modifi cations needed for compliance. Kim Cowman is senior associate and senior mechanical engineer at Leo A Daly. She can be reached at krcow- Spotlight Healthcare HVAC M C D MEDICAL CONSTRUCTION & DESIGN Keep up with us on the Web Follow us at mcdmag Join the Medical Construction & Design Connection at linkedin Get Your FREE subscription or renew at subscribe

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