Infection Control During Construction

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Infection Control During Construction
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The Goal
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Construction Team

• The construction teams goal is to get the job
  done!
• Contracts have to be followed.
• Deadlines have to be met.
• Coordinate sub contractors.
• Supply management.
• Follow Safety standards.

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Objectives

1. Role of Infection Control
2. What infections have occurred related to
   infection?
3. Infection Control Risk Assessment.
4. The 5 priorities of Infection Prevention in
   Construction

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Infection Controls role

• The main goal of infection control is to protect
  patients, staff and visitors from healthcare
  associated infections. (HAIs)

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Why do we need Infection Control?

• There are many documented cases of healthcare
  associated infections traced back to
  construction.
• When those construction projects were going on it
  was never the plan to cause someone to get an
  infection.
• All construction projects bring risk.

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Documented Aspergillus Infections
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Documented Aspergillus Infections
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Documented Aspergillus Infections
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Documented Aspergillus Infections
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It Takes us all to Do the Job Well

• Construction Team
• Construction Lead
• COR
• Construction Safety
• Team

• Infection Control is part of the Safety Team.
• Dont wait for IC to fix the deficiency.
• Safety requires all of us to be attentive to
  areas of risk.

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Its mostly about the Dust
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Aspergillus

• Asperillus is a fungi.
• The spores can live for extended periods.
• Some of the places it is found in during
  construction
• Improperly functioning HVAC
• False Ceilings
• Acoustic Ceiling tiles
• Damp wood building materials
• Elevator shafts

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Who is at Risk?

• For healthy individuals you will see allergic
  reactions, sinusitis and mild bronchitis.
• For high risk patients that are immune
  compromised, It can be pneumonia or abscesses of
  lung, brain, liver, and skin and wound infections
• Patients have died from these infections.
• We have high risk patients in our hospital every
  day!

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Aspergillus infections
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It can be about the water too

• Legionella bacteria have been isolated from soil
  and dust but are typically associated with
  aquatic environments.
• Typical water sources in hospitals supporting
  colonization with Legionella bacteria are cooling
  towers, evaporative condensers, heated potable
  water systems, and heating and air conditioning
  systems.
• During construction and renovation processes,
  water systems are often disrupted.

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What needs to be Done?

• ICRA Infection Control Risk Assessment
• The ICRA should be completed by Infection
  Control, the COR and Construction lead before any
  work starts!
• It is signed and posted at each worksite.

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Start with the Project
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ICRA Step Two
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ICRA Step Three
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Guidelines are listed by class
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Guidelines listed by Class
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Guidelines Listed BY class
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Other Considerations

• Are there other risks like patient/visitor
  traffic nearby?
• Waste removal route?
• Potential for water damage concerns?
• Utility outages
• Types of barriers and containment measures need
  to be clearly discussed.

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Five areas of Concern
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Containment of the Job Site
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Containment of the Job Site
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Containment of THE JOB site

• Type of Barrier decided by
  It must be sealed to the deck.
• Length of time of project.
  Dust travels!

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Construction Breaches in our Facility

• Patient consult room only protected by a drop
  ceiling while major demo was going on.

• Opened to ceiling of our new Cardiology area

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Construction Breaches in our facility

• Construction Dust was found in a dental supply
  storage room adjacent to the construction site.
• Barriers were applied after the breach was
  discovered but it was not completely sealed.

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Exterior Construction Containment
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Containment of the Job Site
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Entry and Egress
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Class IV projects require an anteroom

• Aa
• 
  

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Containment and Transport

• The cover must be taped if it is not solid.
• It is important to clean the outside of the cart
  to prevent contamination outside of the job site.

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Containment and Transport
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Decontamination for the Crew

• It is for the safety of the patients that you do
  not carry construction dust on your clothing or
  equipment out into the hospital.

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Decontamination for the Crew
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Clean Up the Work Site

• Garbage must be taken out at the end of the work
  day.

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Our Patients and Families Thank You!
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References

• http//www.ashe.org/advocacy/organizations/CDC/pdf
  s/assessment_icra.pdf
• http//www.hpsc.ie/A-Z/Respiratory/Aspergillosis/G
  uidance/File,896,en.pdf
• http//r.search.yahoo.com/_yltA2KIo9RpADtVEzwAVPO
  RnIlQ_yluX3oDMTByM2Jic2xkBHNlYwNjZC10aHVtYgRzbGs
  Dc25vYgR2dGlkAw--/RV2/RE1429958889/RO10/RUhttp
  3a2f2fwww.veoh.com2fwatch2fyapi-R2xd5JW1thE/R
  K0/RSBSANcTHG524oXFGVnJcgKdRmWyc-
• https//www.emlab.com/s/sampling/env-report-02-201
  2.html