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Negative-Pressure
Rooms Found To Increase TB Risk
Stress reduction techniques ineffective in
preventing spread
NEW YORK, NY--Clinicians at St. Joseph's
Medical Center announced Tuesday that the "negative-pressure"
isolation rooms which are currently utilized there in the care of patients
with active tuberculosis are "extremely" ineffective in preventing
spread of the disease to healthcare workers.
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St. Joseph's Medical Center,
New York, NY
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Based on the hypothesis that rooms with
"positive pressure," that is, rooms where air flows towards
the outside environment due to a positive pressure gradient, may be associated
with the outward spread of tuberculous droplets, most modern hospitals
are equipped with "negative-pressure" respiratory isolation
rooms, where airflow is reversed into the room, preventing airborne spread.
In what was at the time seen as a stunning
and humiliating planning error, the "negative-pressure" rooms
at St. Joseph's were, in 1986, erroneously designed by a team of misguided
hospital administrators and engineers as areas of decreased psychosocial
pressure, where patients with tuberculosis could "relax their mycobacteria
away."
Each room was generously equipped with
a Zen rock fountain, Patchouli incense lit 'round-the-clock, six to eight
"Amazing Affirmation" posters, an interactive I-Ching oracle,
and several copies of "The Tao Of Pooh."
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Yanni
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The soothing melodies of Yanni were
prescribed for extensive extrapulmonary disease; patients intolerant of
Yanni (up to 40% of all patients) were given second-line Enya / George
Winston combination therapy.
For patients with multi-drug resistant
(MDR) tuberculosis, treatment also included wrist magnets, thrice-weekly
foot massages, daily sessions with the Nature & Harmony chimemaster,
and meditation in front of a 17" jade Buddha acquired by St. Joseph's
from Sri Lanka in 1989.
Though the unorthodox treatment methods
were widely derided as inappropriate and possibly hazardous for patients
with such a serious and potentially fatal illness, records kept by Public
Health officials from 1990 through 1999 showed an above-average response
to the unorthodox treatment, with patients staying in negative-pressure
rooms found to have a 60% chance of being "satisfied" or "extremely
satisfied" with their care.
Improvement in actual signs or symptoms
of tuberculosis, however, was not noted in any of the 256 patients followed,
and further care in a "real hospital" was eventually necessary
for the entire cohort.
Moreover, a recent epidemiologic study
of TB spread in New York City completed suggests that St. Joseph's Medical
Center was at the center of the great majority (>76%, p<.005) of
new tuberculosis cases presenting to all major metropolitan hospitals
during the same period.
At Tuesday's press conference, St. Joseph's
spokesman Dr. Germaine Belfore admitted the negative-pressure rooms were
"a huge mistake right from the get-go," and added that "we're
[extremely] sorry for any damage the Yanni may have done."
Plans are underway to convert the hospital
into a Zen Garden.
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