Ventilation Quick Guides
As part of the Project Firstline initiative, ASHE, in collaboration with the American Hospital Association (AHA), has released Ventilation Guidance and Quick Guides for health care workers, staff, and facility managers so that they can confidently make knowledgeable evidence-based decisions regarding ventilation in health care settings to keep patients and staff safe and reduce chance of contamination and infection from diseases that spread through the air. One guide is designed for health care facility managers and the other is for nurse managers and clinicians.
Nurse Manager and Clinicians Quick Guide
This Quick Guide is meant to be a reference with short answers for frequently asked questions regarding ventilation and infection control in the health care environment. Detailed information for all Quick Guide FAQs can be found in Infection Control Guidance on HVAC for Nurse Managers and Clinicians.
Download the Guidance for Nurse Managers and Clinicians SPANISH Version
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What is the purpose of an HVAC system?
- Heating or cooling of spaces.
- Adjusting relative humidity of air.
- Establishing directional airflow or pressurization relationships between spaces.
- Filtering and diluting recirculated air.
- Flushing contaminants in the air from enclosed spaces.
Setting reference: Inpatient and outpatient facilities.
For more information, see “Introduction” in the Infection Control Guide on Heating, Ventilation and Air Conditioning for Nurse Managers and Clinicians.
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How can I develop an effective means of communication about an HVAC system with the facilities team?
- Develop a working knowledge of features and limitations of HVAC system.
- Understand which types of patients should be housed in certain rooms.
- Facilities team should inform clinical leaders when HVAC equipment is not operating or in need of repair.
Setting reference: Inpatient and outpatient facilities.
For more information, see “Communication” in the Infection Control Guide on Heating, Ventilation and Air Conditioning for Nurse Managers and Clinicians.
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How is fresh OSA brought into a health care facility
- Fresh OSA is brought into the building by the HVAC system.
- The HVAC system will mix fresh OSA with return air (RA) recirculated from the building.
- The mixed air is cooled and/or heated, then filtered and supplied to the building.
Setting reference: Inpatient and outpatient facilities.
For more information, see “Introduction” in the Infection Control Guide on Heating, Ventilation and Air Conditioning for Nurse Managers and Clinicians.
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What is an HVAC System's role in infection control?
- Continuous airflow through spaces to dilute contaminant levels (air change).
- Filtration of delivered air to remove contaminants.
- Exhausting air as appropriate to remove contaminants, preferably at their source.
- Using HVAC system air balance to create air pressure differentials when required from space to space.
Setting reference: Inpatient and outpatient facilities.
For more information, see “Introduction” in the Infection Control Guide on Heating, Ventilation and Air Conditioning for Nurse Managers and Clinicians.
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What is positive or negative pressure?
- Pressurization in heating ventilating and air-conditioning (HVAC) refers to the relative pressure between spaces.
- A pressure relationship is established by providing more air than would be required into a space, and return or exhausting the excess air from an adjacent space.
- This directional airflow keep contaminants out of the positive room, and inside the negative room.
View from inside negative pressure room: Tissue paper shows air flowing into room.
View from inside positive pressure room: Tissue paper shows air being sucked from the room.
Setting reference: Inpatient and outpatient facilities.
For more information, see “Pressurization” in the Infection Control Guide on Heating, Ventilation and Air Conditioning for Nurse Managers and Clinicians.
Health Care Facilities Managers Quick Guide
This Quick Guide is meant to be a reference with short answers to frequently asked questions regarding ventilation and infection control in the health care environment for Facilities staff members. Detailed information for all Quick Guide FAQs can be found in Infection Control Guidance on HVAC for Facilities Managers.
Download the Guidance for Health Care Facilities Managers SPANISH Version
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What is an HVAC system’s role in infection control?
- Continuous airflow through spaces to dilute contaminant levels (air change).
- Filtration of delivered air to remove contaminants.
- Exhausting air as appropriate to remove contaminants, preferably at their source.
- Using the HVAC system air balance to create air pressure differentials when required from space to space.
- Flushing contaminants in the air from enclosed spaces.
Setting reference: Inpatient and outpatient facilities.
For more information, see “Introduction” in the Infection Control Guide on Heating, Ventilation and Air Conditioning for Health Care Facilities Managers.
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How can I develop an effective means of communication with the clinical team about HVAC systems?
- Develop a working knowledge of functions and procedures of different departments.
- Understand which types of patients should be housed in certain rooms.
- Inform clinical leaders when HVAC equipment is not operating or in need of repair.
Setting reference: Inpatient and outpatient facilities.
For more information, see “Communication” in the Infection Control Guide on Heating, Ventilation and Air Conditioning for Health Care Facilities Managers.
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How is fresh OSA brought into a health care facility
- Fresh OSA is brought into the building by the HVAC system.
- The HVAC system will mix fresh OSA with return air (RA) recirculated from the building.
- The mixed air is cooled and/or heated, then filtered and supplied to the building.
Setting reference: Inpatient and outpatient facilities.
For more information, see “Introduction” in the Infection Control Guide on Heating, Ventilation and Air Conditioning for Health Care Facilities Managers.
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What is the best first step to take when considering HVAC system upgrades or renovations?
- Engage with reputable and experienced architects and engineers.
- Filtration of delivered air to remove contaminants.
- Always survey and perform a test and balance (TAB) prior to any upgrades.
- Note that any area renovated or upgraded must be brought up to the current code cycle.
Setting reference: Inpatient and outpatient facilities.
For more information, see “Introduction” in the Infection Control Guide on Heating, Ventilation and Air Conditioning for Health Care Facilities Managers.
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How often should ventilation systems be inspected?
- An HVAC ventilation system should be inspected at least once a year.
- System testing can be verified by using a supply air measuring hood (balometer).
- System testing and balance should be performed as required, as well as before and after any renovations.
Setting reference: Inpatient and outpatient facilities.
For more information, see “Brief Resource Review” and "System Upgrades" in the Infection Control Guide on Heating, Ventilation and Air Conditioning for Health Care Facilities Managers.
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What is positive or negative pressure?
- Pressurization in (HVAC) refers to the relative pressure between spaces.
- A pressure relationship is established by providing more air than would be required into a space, and return or exhausting the excess air from an adjacent space.
- This directional airflow keep contaminants out of the positive room and inside the negative room.
View from inside negative pressure room: Tissue paper shows air flowing into room
View from inside positive pressure room: Tissue paper shows air being sucked from the room.
Setting reference: Inpatient and outpatient facilities.
For more information, see “Pressurization” in the Infection Control Guide on Heating, Ventilation and Air Conditioning for Health Care Facilities Managers.
The Project Firstline program is a national training collaborative led by the Centers for Disease Control and Prevention (CDC) in partnership with the American Hospital Association and the Health Research & Educational Trust (HRET), an AHA 501(c)(3) nonprofit subsidiary.
Project Firstline is a national collaborative led by the U.S. Centers for Disease Control and Prevention (CDC) to provide infection control training and education to frontline healthcare workers and public health personnel. AHA is proud to partner with Project Firstline, as supported through Cooperative Agreement CDC-RFA-OT18-1802. CDC is an agency within the Department of Health and Human Services (HHS). The contents of this webpage do not necessarily represent the policies of CDC or HHS, and should not be considered an endorsement by the Federal Government.
This content was funded in part by a cooperative agreement with the Centers for Disease Control and Prevention (grant number CK20-2003). The Centers for Disease Control and Prevention is an agency within the Department of Health and Human Services (HHS). The contents of this resource do not necessarily represent the policy of CDC or HHS, and should not be considered an endorsement by the Federal Government.