36C25625R0126 667-25-190 Class IV Precautions - ISO Valves .pdf

Overton Brooks VA Medical Center Infection Prevention & Control Class IV Precautions

Minimum Required Infection Control Precautions Required for Install Isolation Valves on Domestic Water System Building 1

Date: February 6, 2025

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Before and During Work Upon Completion

1. Construct NFPA 241 compliant barriers extending to the ceiling or if ceiling tile is removed, to the deck above.

2. Perform plastic/hard barrier construction with minimal dust release. Affix plastic barriers without gaps to the floor, walls, & ceiling using tape that will not leave a residue.

3. Seal all penetrations in barriers, including floors and ceiling, using approved materials (i.e., UL schedule firestop).

4. Containment units/environmental containment units (ECUs) with HEPA filtered exhaust are approved for Class IV precautions in small areas that can be totally contained.

5. Remove/isolate return air diffusers.

6. Remove/isolate supply air diffusers to prevent positive pressure of the space.

7. Maintain negative pressure and airflow for the area:

A. Airflow from entry → anteroom → construction area.

B. HEPA filter outdoor exhaust UNLESS the exhaust is >25 feet from entrances, air intakes, or open windows then HEPA filtration of exhaust is not required.

C. HEPA filter indoor exhaust AND prior to start of work, conduct particulate measurement to verify > 99.97% efficiency and confirm no change of airflow/pressure relationships in adjacent areas.

D. DO NOT exhaust into shared or recirculating HVAC systems, or other systems (e.g., bathroom exhaust).

E. Install device (e.g., magnehelic, manometer, or digital monitoring) outside the work site to continually monitor negative pressure. DO NOT use “ball in the wall” or similar apparatus.

8. Construction Waste:

A. Contain all trash and debris in the work area.

B. Transport container should be nonporous/smooth, cleanable and have a hard lid.

C. Containers must be damp-wiped clean and free of visible dust/debris before leaving the work area.

D. Use the designated route to the outside waste area.

E. If an exterior debris/trash chute is used, the receptacle must be covered to minimize dust generation. Cover any air intakes <25 feet from the chute or receptacle.

1. Construction areas must be inspected by an infection preventionist or designee and engineering representative for discontinuation or downgrading of ICRA precautions.

2. Work Area Cleaning:

A. Clean work areas including all environmental surfaces, high horizontal surfaces and flooring materials.

B. Check all supply and return air registers for dust accumulation on upper surfaces as well as air diffuser surfaces.

3. Removal of Critical Barriers:

A. Critical barriers must remain in place during all work involving drywall removal, creation of dust and activities beyond simple touch-up work. The barrier may NOT be removed until a work area cleaning has been performed.

B. All (plastic or hard) barrier removal activities below must be completed in a manner that prevents dust release.

1) Remove screws & painter tape.

Use hand-held HEPA vacuum if there is dust.

2) No drywall cutting during removal process.

3) Clean all stud tracks with HEPA vacuum before removing outer hard barrier.

4) Erect a plastic barrier if dust could be generated.

4. Negative Air Requirements:

A. The use of negative air must be designed to remove contaminates from the work area.

B. Negative air devices must always remain operational and in place for a period after completion of dust creating activities to remove contaminants from the work area and before removal of critical barriers.

Overton Brooks VA Medical Center Infection Prevention & Control Class IV Precautions

9. Install a sticky (dust collection) mat at the entrance of the work area. Change mat routinely and when visibly soiled.

10. Worker activities and clothing:

A. Clothing must be clean and visibly dust free before leaving the work area. HEPA vacuuming or use of cover suites is acceptable.

B. Shoe covers are required when entering the work area, changed prior to exiting the anteroom into the non-work area, and change damaged shoe covers immediately.

11. Consider collection of particulate data during work to monitor and ensure that contaminates do not enter the occupied spaces. Routine collection of particulate samples may be used to verify HEPA filtration efficiencies.

5. HVAC systems:

A. Upon removal of critical barriers, remove isolation of HVAC system in areas where work is being performed.

B. Verify that HVAC systems are clean and operational.

C. Verify the HVAC systems meets original airflow and air exchange design specifications.