IC Risk Assessment.pdf

Frequent Occassional Uncommon Remote E H H M E H M L H M L L M L L L

RAC

L M M

M

H

Summary of Risk Assessment :

Limit removal of ceiling tiles to no more than 2 at a time. Do not leave open ceiling tiles or ladders unattended. Do NOT open ceiling tiles in patient space while patient in room. Coordinate with COR for unoccupied space as needed. Cover surfaces with plastic prior to opening ceiling tiles in the following areas: 3W, Same Day Surgery, 4N Chemo, 5S Endo, 5N Dental, Nuc MEd, SPS and OR/IR. Terminal clean areas mentioned in prior statement before reopening.

Signature of Authority: Shawn Donald, Infection Preventionist.

Team Members: Karen Ainsworth, George Porter and Virgilea Hamm

Strategies/Actions to Achieve Goals Responsible Department See Mitigating measures FMS and Contractor

Working in patient care areas with removal of up to 2 ceiling tiles

Contamination of environment Limit removal of ceiling tiles to no more that 2 at any given time

No open ceiling tiles or ladders left unattended ‐ clean up dust or debris after work

Terminal Clean must be done in the above locations prior to reopening.

Do not open ceiling tiles in patient space while patient in room. Coordinate with NM

Cover surfaces with plastic prior to opening ceiling tiles in: 3W/Same Day Surgery, 4N Chemo, 5S Endo, 5N Denta;, Nuc Med, SPS and OR/IR

Identified Risk Potential Impact Mitigating Measures

Lifting of ceiling tiles to locate and plot Fire Smoke Dampers. Start date TBD.

Will take 3 months to perform.

Minor Step 1: Review each "Hazard" with identified safety “Controls” and determine RAC (See above).

“Probability” = likelihood to cause an incident, near miss, or accident and identified as: Frequent, Likely, Occasional, Seldom or Unlikely. RAC Chart “Severity” = outcome/degree if incident, near miss, or accident did occur and identified as: Catastrophic, Critical, Marginal, or Negligible.

E= Extremely High Risk H= High Risk

Step 2: Identify the RAC (Probability/Severity) as E, H, M, or L for each “Hazard” on AHA. Annotate the overall highest RAC at the top of AHA.

M= Moderate Risk L= Low Risk

Proactive Risk Assessment Tool Activity Work

Task:

Locating Fire Smoke Dampers above Ceilings Overall Risk Assessment Code (RAC) (Use highest code) =

Project Location: Facility Wide Risk Assessment Code (RAC) Matrix Contract Number: TBD

Severity Probability Date Prepared: 5/9/2022 Prepared by (Name/ Title):

Virgilea Hamm/MDRO Catastrophic Major

Notes: (Field Notes, Review Comment, etc.) Moderate