This in turn affects the following room ventilation characteristics: a. Negative pressure, only if the filtered air is exhausted outside the room b. ACH or equivalent ACH (eACH)10 2. HEPA filter: removes pathogens from the air and is essential if the filtered air is returned to the room. [...] The eACH is determined by calculating the ratio of the airflow rate of the unit to the room volume (22). [...] The checklists are not meant to be exhaustive, but rather address some of the key issues discovered as part of the Ontario practice survey (further details are presented in the Appendix and the following report: “In-Room Cleaners: Current and Recommended Practices” ). [...] Health care facilities should review the following recommendations from our ICEP regarding the application of in-room HEPA cleaners in the following situations: 1. Suspect a room does not meet ACH requirements in standards: It is recommended that a comprehensive engineering assessment of the room’s environmental controls be made (i.e., confirm the room ACH as well as the directional airflow) and [...] Evaluate and determine how best to position and install the unit based on the design of the technology, the client population served, and the room design and workflow.