36C25624R0109 - ICRA - Inpatient Wards isolation Rooms Exhaust System ICRA FINAL .pdf

Overton Brooks VA Medical Center Infection Prevention & Control

Step One: Circle the Construction Project Activity Type (A-D). PROJECT: Upgrade Inpatient Wards Isolation

Rooms Exhaust System 667-25-125

Type A

Inspection and non-invasive activities. Includes but is not limited to:

• Removal of ceiling tile for visual inspection-limited to 1 tile/50 square feet with limited exposure time.

• Limited building system maintenance (e.g., pneumatic tube station, HVAC, fire suppression system, electrical and carpentry work to include painting without sanding) that does not create dust or debris.

• Clean plumbing activity limited in nature.

Type B

Small-scale, short duration activities; minimal dust and debris. Includes but not limited to:

• Work conducted above the ceiling (e.g., prolonged inspection/repair of firewalls and barriers, install conduit/cabling, & access to mechanical and/or electrical chase spaces).

• Fan shutdown/startup.

• Installation of electrical devices or new flooring that produces minimal dust and debris.

• The removal of drywall where minimal dust and debris is created.

• Controlled sanding activities (e.g., wet or dry sanding) that produce minimal dust and debris.

Type C

Large-scale, long duration activities; moderate amount of dust and debris. Includes but not limited to:

• Removal of preexisting floor covering, walls, casework, or other building components.

• New drywall placement.

• Renovation work in a single room.

• Non-existing cable pathway or invasive electrical work above ceilings.

• The removal of drywall where a moderate amount of dust and debris is created.

• Dry sanding where a moderate amount of dust and debris is created.

• Work creating significant vibration and/or noise.

• Any activity that cannot be completed in a single work shift.

Type D

Major demolition and construction activities. Includes but is not limited to:

• Removal or replacement of building system component(s).

• Removal/installation of drywall partitions.

• Invasive large-scale new building construction.

• Renovation work in two or more rooms.

Step Two: Circle the Risk Group(s) affected. Select the higher group, when more than one group will be affected.

Low Risk* Medium Risk High Risk Highest Risk

*Not in patient care areas

• Public hallways & gathering areas

• Office areas

• Breakrooms

• Bathrooms or locker rooms

• Mechanical rooms

• EMS closets

• Waiting areas

• Clinical engineering

• Materials management.

• SPS Decon area

• Kitchen, cafeteria, gift shop, coffee shop, food kiosks.

• Patient care rooms/clinics

• All acute inpatient units

• Emergency department

• Occupation Health

• Pharmacy general areas

• Medication, clean utility & sterile supply rooms

• Imaging/diagnostic suites

• Laboratory.

• All transplant & ICUs

• All oncology units.

• OR suites & restricted areas.

• Procedural suites.

• Pharmacy compounding areas

• SPS: Prep and HLD areas

• Transfusion services.

• Dedicated isolation wards/units.

• Invasive imaging suites:

Step Three: Using the IC Matrix CIRCLE the Class of Precautions as determined by Construction Type and Patient Risk.

Construction Project Type

Patient Risk Group Type A Type B Type C Type D

IC

M a tr ix LOW Risk Group1 I II II III

MEDIUM Risk Group1 I II III2 IV2

HIGH Risk Group1 I III IV2 V2

HIGHEST Risk Group1 III IV2 V2 V2

1. Amend as follows for environmental conditions that could affect human health (i.e., sewage, mold, asbestos, gray water, and black water). Class IV Precautions for LOW and MEDIUM Risk Groups and Class V Precautions for HIGH and HIGHEST Risk Groups.

2. Infection Control documents required for Class III Precautions in Type C projects and all Class IV & V Precautions.

Carol Phillips, RN, CIC

MDRO Prevention Coordinator

Preliminary ICRA: ________________

DATE

Final ICRA: _

DATE