Northwestern McHenry Hospital negative airflow rooms keep patients, front-line workers safer

Front-line health care workers have received praise for their service in keeping our community safe during the COVID-19 pandemic. Less often recognized, however, are the many “hidden heroes” whom doctors and nurses rely on to be able to care for patients safely, said Catie Schmit, VP and chief nursing executive for Northwestern Medicine McHenry Hospital.

One example of the pandemic’s unsung heroes is the facilities department staff who played a crucial role in enacting Northwestern Medicine McHenry Hospital’s “dynamic surge plan,” Schmit said.

“They are really important to us because they ensure that we have the safe, physical environment that we need to care for this population,” she said.

Members of the McHenry facilities team worked around the clock to convert 42 of the hospital’s regular patient rooms into “negative airflow rooms,” bringing the facility’s total up to 54 of the specially ventilated rooms, Schmit said.

Negative airflow rooms or “negative pressure rooms” are used in hospital settings to contain airborne illnesses such as tuberculosis or, more recently, COVID-19, Director of Facilities Dylan Degraw said.

The team was able to change the ventilation systems in the rooms “to increase the exhaust so you’re pulling more air from the room than you’re pushing [in] so that’s really what makes the rooms negative,” Degraw said.

Recently updated guidelines from the Centers for Disease Control and Prevention recommend the use of negative airflow rooms, also known as "Airborne Infection Isolation [AII] Rooms," as one of the best ways to prevent the spread of COVID-19 within hospitals.

With the use of negative pressure rooms, “you’re basically pulling air from the nurses station area into the room and then that air gets exhausted directly outside so you’re not recirculating the air,” he said. “So you’re keeping anything that could be airborne inside that room and then it gets exhausted out.”

Degraw’s team also constructed three additional “anterooms” in the hospital’s intensive care unit, he said.

“An anteroom basically is a small room that is on the outside of the negative air rooms and really the purpose of the anteroom, is for staff to don and doff [personal protective equipment],” he said.

This brings the hospital’s total available anterooms to five. The use of anterooms further prevents the virus from spreading from isolation areas to the rest of the facility, Degraw said.

Currently, all COVID-19 patients are being isolated in a few of the hospital’s open units and are transported to an isolated area of the ICU if needed, Schmit said.

Negative airflow rooms are primarily used for COVID-19 patients who require what Schmit called “aerosol generating procedures” or procedures that cause virus particles or “droplet nuclei” to be released into the air. These are typically procedures that make patients cough or sneeze.

These kinds of procedures include the use of a nebulizer, intubation or a ventilator, she said.

By containing, removing and replacing air that has been contaminated with droplet nuclei from COVID-19 patients, the negative airflow system not only keeps other patients safer, but it also significantly reduces the chances of infection for hospital staff, Schmit said.

“I am just so extremely proud of our team,” Schmit said, suddenly at a loss for words.

“We are in challenging times right now, but the way the team has come together here for the community has been nothing short of inspirational.”

Also among the hospital’s “hidden heroes” are its biomed team, the IT department and many others, Schmit said. Each play a vital role in creating the safest possible environment for patients and staff as they prepare for further surges in COVID-19 cases, she said.

“We’ve all worked so hard and so great as a team, and it just goes to show that we’re really providing the best possible care to our patients,” Degraw said. “It feels really good to be able to help.”

Even the hospital’s cafeteria workers have banded together to stock a small store with grocery items and prepared meals so that nurses and doctors don’t have to shop for dinner after a long shift, Schmit said.

“We have nurses that work 12-hour shifts and then ... to have to go to the grocery store when they’re so tired can be really difficult,” she said.

“So, if there’s a silver lining in this, it’s that our team is stronger than ever,” she said.