S02_SOL_Att6_ICRA_676-19-107_Replace_Med_Vac_Pump.pdf

VAMC TOMAH

Infection Control Risk Assessment (ICRA)

Step 1. Use the following chart to identify the Type of Construction Project Activity (Type A-D)

Type A Inspect and Non-invasive Activities: Includes, but not limited to:

Removal of ceiling tiles for visual inspection limited to 1 tile per 50 square feet Painting (but not sanding)

Wall covering, electrical trim work, minor plumbing, and activities which do not generate dust or require cutting of walls or access to ceilings other than for visual inspection

Type B Small scale, short duration activities which create minimal dust: Includes, but not limited to:

Installation of telephone and computer cabling Access to chase spaces Cutting of walls or ceiling where dust migration can be controlled

Type C Work that generates a moderate to high level of dust or requires demolition or removal of any fixed building components or assemblies: Includes, but not limited to:

Sanding of walls for painting or wall covering Removal of floor covering, ceiling tiles and casework New wall construction Minor duct work or electrical work above ceilings Major cabling activities Any activity which cannot be completed within a single work shift

Type D Major demolition and construction projects: Includes, but not limited to:

Activities that require consecutive work shifts.

Requires heavy demolition or removal of a complete cabling system.

New construction

Is it likely the Contractor's staff will be placed at risk for infection with tuberculosis? No Is it likely there will be physical disruption of the water system/lines during activity? No Selected Type of Construction: _C__ Notes:

Step 2. Using the following table, identify the Patient Risk Group that will be affected.

If more than one group is affected, select the higher risk group.

Low Risk Medium Risk High Risk Highest Risk Office areas Cardiology

Echocardiography Endoscopy Nuclear Medicine Physical Therapy Radiology/MRI Respiratory Therapy

CCU

Emergency Room Laboratories Outpatient Surgery Pharmacy Post Anesthesia Care Unit Surgical Units

Any area caring for immunocompromised patients Cardiac Cath Lab Central Supply Intensive Care Units Medical Units Negative airflow rooms Oncology Operating Rooms

Select Patient Risk Group: Low_ __ __ Notes:

Step 3. Match the Patient Risk Group with the planned Construction Project Type (A, B, C, D) on the following matrix, to find the Class of Precautions (I, II, III, and IV) or level of infection control activities required.

Patient Risk Group Type A Type B Type C Type D

Low risk I II II III/IV

Medium risk I II III IV High risk I II III/IV IV Highest risk II III/IV III/IV IV

Select Control Procedures: __II____

676-19-107 Replace Medical Vacuum Pump

B400 6 NOV 2018

During Construction Project Upon Completion of Projects

C la ss I 1. Execute work by method to minimize raising dust from construction operations

2. Immediately replace a ceiling tile displaced for visual inspection

1. Clean work upon completion of task: major cleaning will be completed by EMS/SPS. Maintenance and contractor should remove any obvious debris generated by their work.

C la ss

II

1. Provide active means to prevent airborne dust from dispersing into atmosphere.

2. Water mist work surfaces to control dust while cutting

3. Seal unused doors with duct tape

4. Block off and seal air vents.

5. Place dust mat at entrance and exit of work area.

6. Remove or isolate HVAC system in areas where work is being performed.

7. Plastic or solid barrier before entry into attic space to restrict access and ensure stairway does not become dust covered/dirty in the removal of equipment.

1. Wipe work surfaces with disinfectant.

2. Contain construction waste before transport in tightly covered containers.

3. Wet mop &/or vacuum before leaving work area.

4. Remove isolation of HVAC system in area where work is being performed.

C la ss

II

I

1. Remove or isolate HVAC system in area where work is being done to prevent contamination of duct system.

2. Complete all critical barriers, i.e. sheetrock, plywood, plastic, to seal area from non-work area or implement control cube method (cart with plastic covering & sealed connection to work site with HEPA vacuum for vacuuming prior to exit) before construction begins.

3. Maintain negative air pressure within worksite utilizing HEPA-equipped air filtration units.

4. Contain construction waste before transportation in tightly covered containers.

5. Cover transport receptacles or carts. Tape covering unless solid lid is used.

1. Do not remove barriers from work area until completed project is inspected by Safety Management & Infection Control & thoroughly cleaned by Environmental Management. Ceiling system and tiles must be in place before barriers are removed.

2. Remove barrier materials carefully to minimize spreading of dirt & debris associated with construction.

3. Vacuum work area with HEPA-filtered vacuums.

4. Wet mop with disinfectant.

5. Remove isolation of HVAC system in areas where work is being performed.

C la ss

IV

1. Isolate HVAC system in area where work is being done to prevent contamination of duct system.

2. Complete all critical barriers, i.e., sheetrock, plywood, plastic, to seal area from non-work area or implement control cube method (cart with plastic covering & sealed connection to work site with HEPA vacuum for vacuuming prior to exit) before construction begins.

3. Maintain negative air pressure within worksite utilizing HEPA-equipped air filtration units.

4. Seal holes, pipes, conduits and punctures appropriately.

5. Construct anteroom and require all personnel to pass through this room so they can be vacuumed using a HEPA vacuum cleaner before leaving work site; or the can wear cloth or paper coveralls that are removed each time they leave the work site.

6. All personnel entering the work site are required to wear shoe covers.

Shoe covers must be changed each time the worker exits the work area.

7. Do not remove barriers from work area until completed project is inspected by Safety Management & Infection Control & thoroughly cleaned by Environmental Management.

1. Remove barrier materials carefully to minimize spreading of dirt & debris associated with construction.

2. Contain construction waste before transport in tightly covered containers.

3. Cover transport receptacles or carts. Tape covering unless solid lid.

4. Vacuum work area with HEPA-filtered vacuums.

5. Wet mop with disinfectant.

6. Remove isolation of HVAC system in areas where work is being performed.

Comments: Components removed from service will be removed from attic through roof and lowered to the ground.

Note: Infection Control approval will be required when Construction Activity and Risk Level indicate that Class III or Class IV control procedures are necessary, when disruption in the water lines is a planned part of the activity.

Project: 400 Vacuum System Replacement Class Type: II Proposed Start Date: TBD Estimated Date of Completion: TBD Project Engineer: David Martin Project Contractor: TBD Date Approved by Infection Control Officer/designee: 10/26/2018 Electronic Signature: Melissa Moore RN BSN, Infection Control Nurse

676-19-107 Replace Medical Vacuum Pump

B400 6 NOV 2018