IPSOP14 SOP for use of Portable fans and ACU by Provide Community

Standard Operating Procedure (SOP)

for

use of Portable fans and ACU’s

Version: V1

Ratified by: Infection Prevention Group

Date ratified: 17/01/2024

Job Title of author: Specialist Infection Prevention Nurse

Reviewed by Committee or Expert Group Quality and Safety Group

1. Introduction

Portable fans and air conditioning units are an important consideration in maintaining a comfortable environment for service users, staff, and visitors.  However, Portable fans have been linked to cross infection in health and social care facilities. Dust and debris can accumulate on the surface of fans particularly on the internal blades which provides a reservoir for microorganisms and increases the risk of transmission. Therefore, any device for air cooling must be carefully considered and have been subject to a risk assessment approach.

2. Purpose

This SOP aims to ensure clinical and non-clinical staff and services use the correct choice of air-cooling device, how they must be used, and the cleaning required when used.

3. Definitions

ACUs - Air Conditioning units

IPG - Infection Prevention Group

Portable fans - a cord-connected or a battery-operated small desk top fan that can be easily moved from one place to another

PAT- Portable Appliance testing

PPM - Planned preventative maintenance

4. Duties

All Provide staff MUST ensure:

• Ensure only portable fans which are compliant with this SOP are used

• Ensure portable fans are only used in accordance with guidance in this SOP

• Ensure portable fans are cleaned and decontaminated after each use and stored appropriately.

• Ensure a visual safety check of the fan or ACU is performed prior to use and PAT label is in date.

• Ensure any non-compliant fans are removed from the clinical area and sent for disposal

• In clinical area a risk assessment is completed prior to the use of a Portable fan

Risk Assessment

In response to the alert Estates & Facilities Alert (EFA) 2019/001 (2) and using the SBAR (Situation, Background, Assessment, Recommendation), the use of bladeless fans were indicated as a contributory factor in an outbreak of infection, therefore these are not permitted for any clinical or patient use across the Provide Group

Non clinical services

The purchase of any portable bladeless fans in non-clinical areas must be authorised and approved by Estates and recorded on asset register with confirmation of the manufacturer guidance on decontamination It is the responsibility of services in non-clinical areas where bladeless fans are used that they are not at risk of misuse or being displaced to a clinical area.

5. Consultation and Communication

This SOP has been developed following advice from safety alert Estates & Facilities Alert (EFA) 2019/001 (2) and using the SBAR (Situation, Background, Assessment, Recommendation) as the evidence-base.

6. Monitoring

Monitoring of fans/ACUs will be incorporated into IPC audit schedules and results reported via IPCG.  Initially all services will be requested to submit details of all fans/ACUs currently in their possession so that an asset register can be compiled.  Devices purchased by individual services in future should be notified to Estates to include in the asset register.  Where necessary, manufacturer’s instructions can be obtained, and appropriate maintenance can be undertaken to provide assurance that devices are safe and fit for purpose.

7. Acceptable Portable fans and ACU’s

Portable fans

• Desktop – 12” white desk fan with push button control and adjustable tilt

• All fans purchased for use should be purchased via procurement and include manufacturers’ information and advice on how to decontaminate the fan.

• Bladeless or floor fans are not recommended and must not be used in clinical areas.

• The fan guard should have quick release clips (not screws) to allow for easy removal for decontamination.

How to use/Positioning:

• Bladed electric fans must be positioned so airflow is directed upwards towards the ceiling, indirectly towards the patient.

• Position the fan on a clean surface at the patient’s bed level or higher.

• Airflow must not be directed towards the door.

• Ensure airflow is not blowing directly on dressings, open wounds or onto the patients face.

• In communal non-patient areas e.g., staff rooms and offices ensure the airflow is directed within the area.

Portable ACU’s

• The hose type AC unit is the preferred option and must be vented outside e.g. through a window ensuring the hose is not vented onto a walkway e.g. a footpath

• Units must not be vented into internal spaces e.g. corridors or ceiling voids

• Emptying of the water reservoir (if in situ) remains the responsibility of the clinical team responsible for the equipment and must be undertaken routinely as instructed by the manufacturer.

8. When to use

• The use of the fan is considered to be of benefit to the patient/patient’s clinical condition and/or comfort.

• All other cooling methods have been attempted with no success and a risk assessment completed.

When NOT to use

• In areas where there are immunocompromised patients

• kitchens or in food preparation areas

• Areas where sterile supplies are stored.

• Areas where the reprocessing of medical devices takes place e.g., endoscopy, sterile services.

• In a room where a patient is managed with respiratory (airborne) precautions TB, Measles, Chicken Pox etc.

• In a room where a patient is managed with droplet or contact precautions, for example, Clostridioides difficile, MRSA, norovirus, COVID19, Influenza.

• During outbreaks of infection – this applies to all areas associated with the affected unit/ward inc. staff rooms, offices etc.

• In rooms were Aerosol-Generating Procedures (AGPs) are undertaken.

• High risk areas, Haematology/Oncology, operating rooms or where directed airflow e.g. positive or negative pressure rooms.

9. Cleaning and Decontamination

Portable fans

• Ensure a local cleaning schedule (and instructions) is available for use

• Fans in clinical areas are medical devices and are the responsibility of clinical staff to clean in the dirty utility/decontamination room

• fans (including blades) in a clinical area should be decontaminated each week as part of the cleaning schedule to prevent build-up of dust and debris and to minimise the risk of cross contamination.

• Fans in non-clinical areas inc. offices are the responsibility of the user to clean and should be included in workstation cleaning.

• Wear appropriate PPE to perform the task – disposable apron and gloves

• Remove guard prior to cleaning and clean before replacing

• Clean the fan after each individual use (and prior to storage), and when visibly contaminated (with dust and/or body fluids) – refer to manufacturer’s instructions if these are available

• Clean with detergent or universal (combined) wipes and discard into black (household/domestic) waste bags

• Ensure hands are washed following PPE removal and disposal.

Decontamination / maintenance of ACUs

• Clean exterior with a damp cloth weekly whilst in use

• Affix green “I am clean” sticker for ACUs in use in clinical areas

• DO NOT empty reservoir water into clinical handwash basins due to the contamination risk from splashback.  Empty directly into toilets, sinks or slop hoppers in dirty utility rooms

10.Storage

ACUs

• When not in use, store clean and covered in a location away from direct sunlight and with a constant ambient temperature.

11.References

Estates & Facilities Alert (EFA) 2019/001: Portable fans in health and social care facilities: risk of cross-infection

Health Protection Scotland (HPS) 2018 SBAR: Portable cooling fans (bladed & bladeless) for use in clinical areas

Health Technical Memorandum (HTM) 03-01 Part A: Specialised ventilation for healthcare premises (2021)

Health Technical Memorandum (HTM) 04-01 Part B (5) 2016