By law, an Infection Control Risk Assessments (ICRA) is conducted before any type of construction project begins at any healthcare facility. ICRA construction protocols apply to renovation projects, additions, or even routine maintenance at hospitals or healthcare facilities. Infection prevention and control measures must be the top priority for contractors who specialize in hospital construction projects as well as for healthcare facility managers. Once established, ICRA construction protocols should make it difficult for patients and people to develop Hospital-Acquired Infections (HAIs).
It’s difficult enough to control HAIs, and ICRA construction projects only add an additional level of stress to healthcare environments already under siege by HAIs. The CDC reports that each year 2 million people will be afflicted by an HAI—that’s approximately 1 in 25 patients! Approximately 110,000 of those cases will be fatal, mostly those patients who are already immuno-compromised—the older, sicker, or weaker patients.
Add an ICRA construction project to the mix and it can bring in a host, literally and figuratively, of harmful bacteria and particulates with the flow of people and materials in and out of hospitals. Increased pedestrian traffic, debris, and dust-laden mold spores from demolition will invariably threaten the healthcare environment during construction projects. To help avoid the spread of infection during ICRA construction projects, here are 5 ways for contractors, facility managers, and infection control professionals to ensure patient safety and aid in preventing infections on job sites:
Make Implementing an ICRA Construction Strategy a Team Effort
Infection control should be a primary concern for contractors, project managers, architects, and facility and construction management teams in the developmental and planning stages of an ICRA construction project. An ICRA strategy should be agreed upon by all parties. The ICRA team works together to study risk factors, potential hazards to patients, people, and medical equipment, and ways to minimize the risk of HAIs related to the ICRA construction.
Establish an Infection Control (IC) Matrix of Precaution for the Job
Establishing an IC Matrix is recommended by ASHE (American Society for Healthcare Engineering). To start, identify the Type of Construction Project activity to be undertaken. Categorize the Types ranging from A to D. Type A activities are non-invasive. They do not stir dust, such as plumbing or painting without sanding. Type D is for major construction projects that require removal of fixtures, cabling, or demolition. Next, identify the Patient Risk Group that will be subjected to the Type of Construction Project. The grouping consists of low, medium, high, and highest risk groups.
Once a Construction Type and Patient Risk Group have been identified, cross-reference the Type of activity by Risk level to establish an IC Matrix Class of Precaution. The matrix is intended to measure the degree of infection control necessary for each type of construction project. It is measured by Class I, II, III, and IV, with IV requiring the highest level of infection control procedures in place. See the IC Matrix recommend by ASHE for an example.
Isolate the Worksite with a STARC Modular Wall Containment System
STARC Systems’ two premier temporary containment solutions, RealWall™ and LiteBarrier™, mitigate the possibility for airborne pathogens to be released from the work zone into the hospital. Our great looking, durable modular walls provide maximum containment of dust and debris on job sites and, once erected, provide visually pleasing corridors and passages for patients, hospital staff, and visitors to move around the job sites without disruption. Both RealWall™ and LiteBarrier™ exceed ICRA Class IV requirements for healthcare construction while maintaining a clean, hospital environment.
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Appoint an Infection Control Monitor
To ensure that IC is being met throughout the construction process, it is important to place a person in charge of the IC measures. It is simply not possible to control the spread of infection on an ICRA construction project if someone is not continually monitoring the job site. An infection control monitor does not work on his or her own, but coordinates with the project and facility managers, staff, and shift leaders to have infection control guidelines followed and tasks assigned and completed each day. Having an individual monitor the job site and delegate tasks will decrease the probability of the spread of infections during construction projects.
Monitor Indoor Air Quality
To prevent the spread of pathogens from construction areas and to ensure Indoor Air Quality (IAQ), negative airflow should be continually monitored and documented on the job site. Construction and demolition activities can introduce the harmful particulate matter, micro-sized dust, and fibers, into an environment. Obviously, HVAC intakes should be sealed to isolate the job site from general ventilation. Use Negative Air Machines (NAM) with High-Efficiency Particulate Air (HEPA) filters inside the enclosure. A NAM should be in place prior to construction and used throughout the duration of the project. Creating negative air pressure lowers the air pressure inside the containment area, which pulls outside air in. Both RealWall™ and LiteBarrier™ have fully integrated negative air panels that create an environment that can prevent contaminated air from escaping. The negative air panels easily integrate with exhaust systems and pressure monitors, so that once the work begins, negative air pressure can be verified.
Image above: RealWall™ negative air panel install at Brigham and Women’s Hospital