36C25819B0033-003.pdf

Attachment B – Infection Control Risk Assessment

Infection Control Risk Assessment Guidelines – VA San Diego Healthcare System

Identify the Type of Construction Project Activity (Types A-D) A Non-invasive activities, including, but not limited to:

a. Removal of ceiling tiles where no dust or asbestos is expected

b. Painting, but not sanding

c. 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 B Small scale, short duration activities which create minimal dust, including but not limited to:

a. Installation of electrical, plumbing, HVAC, telephone and computer cabling

b. Access to chase spaces where asbestos is not present

c. Cutting of walls or ceiling where dust migration can be controlled.

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

a. Sanding of surfaces for painting or wall covering

b. Removal of floor coverings, ceiling tiles, and casework

c. New wall construction

d. Minor duct work or electrical work above ceilings

e. Major cabling activities

f. Any type A, B or C activity that cannot be completed within a single work shift.

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

a. Activities requiring heavy demolition or removal of a complete utility or cabling system

b. New construction and renovation.

c. Friable asbestos and mold abatement projects.

Identify the Patient Risk Group that will be affected. If more than one risk group will be affected, select the higher group. For all construction classes, patients must be removed from the room while work is performed.

Low Medium High Highest Risk

All outpatient clinics, offices areas, administrative and industrial spaces.

All non-critical inpatient areas.

cardiology, echocardiography, endoscopy, nuclear medicine, rehabilitation medicine, radiology, MRI, respiratory therapy, dry research labs.

DOU, emergency room, clinical laboratory, wet lab research, ambulatory surgery, pharmacy, surgical and medical inpatient beds, procedure center.

Immunocompromised patient area, cath lab, SPD, ICU, occupied, negative pressure rooms, PACU operating rooms.

Match the Patient Risk Group with the Construction Project Type (A, B, C, D) to find the Class of Precautions (I – V) Construction Project Type Patient Risk Group Type A Type B Type C Type D Low Risk I II III V Medium Risk I II IV V High Risk I II IV V Highest Risk II III V V

Description of Required Infection Control Precautions by Class Class During Construction Project Upon Completion of Project

Class I 1. Execute work by methods to minimize raising dust from construction operations.

2. Immediately replace ceiling tile if displaced.

Class II 1. High Risk patients must remain out of room for one hour after completion of work and cleanup.

2. Execute work by methods to minimize raising dust.

3. Immediately replace ceiling tile if displaced.

1. Remove all visible debris with a wet towel and/or mop.

2. Housekeeping to wipe work surfaces and floors with disinfectant.

Class III 1. Execute work by methods to minimize raising dust.

2. Immediately replace ceiling tile if displaced

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

4. Water-mist work surfaces to control dust while cutting.

5. Seal unused doors with duct tape.

6. Isolate HVAC system in areas where work is being performed to prevent contamination of duct system.

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

8. Cover construction waste before transport in covered containers

1. Cover construction waste before transport in covered containers.

2. Wet mop and/or vacuum with HEPA filtered vacuum before leaving work area.

3. Open previously sealed HVAC registers and grills.

4. Housekeeping to wipe work surfaces and floors with disinfectant.

Class IV 1. Install plastic dust barriers to seal area from non-work area or implement control cube method (cart with plastic covering and sealed connection to work site with HEPA vacuum for vacuuming prior to exit) before construction begins.

2. Isolate HVAC system in areas where work is being performed to prevent contamination of duct system.

3. Maintain negative pressure (0.01) general construction and (0.20) asbestos working condition within work site utilizing HEPA equipped air filtration units.

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

5. Cover construction waste before transport in covered containers.

6. All work associated with a major project that has an approved

ICRA authorization form will be assessed on an individual basis.

1. Cover construction waste before transport in covered containers.

2. Wet mop and vacuum with HEPA filtered vacuum.

3. Do not remove barriers from work area until a Health System responsible person inspects completed project.

4. Remove barrier materials carefully to minimize spread of dirt and debris associated with construction.

5. Wet mop and vacuum with HEPA filtered vacuum before leaving work area.

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

7. Housekeeping to wipe work surfaces and floors with disinfectant.

Class V 1. Construct gypsum board/metal stud dust partition, extend and seal to ceiling.

2. Isolate HVAC system within work areas to prevent contamination of duct system.

3. Seal doors opening to adjacent areas with duct tape.

4. Block off and seal HVAC registers, grills and any openings in ductwork to remain.

5. Maintain negative pressure (0.01) general construction and

(0.20) asbestos working condition within work site utilizing HEPA equipped air filtration units.

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

7. Cover construction waste before transport in covered and sealed containers. Biohazards to be double bagged.

8. All work associated with a major project that has an approved

1. Cover construction waste before transport in covered containers.

2. Wet mop and vacuum with HEPA filtered vacuum.

3. Do not remove barriers from work area until a Health System responsible person inspects completed project.

4. Remove barrier materials carefully to minimize spread of dirt and debris associated with construction.

5. Wet mop and vacuum with HEPA filtered vacuum before leaving work area.

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

7. Housekeeping to wipe work surfaces and floors with disinfectant.

ICRA authorization form will be assessed on an individual basis.

9. Provide monitoring and clearance samples for mold/asbestos.

Infection Control Construction Permit For Class IV and V Precautions

Class I 1. Execute work by methods to minimize raising dust from construction operations.

2. Immediately replace ceiling tile if displaced.

3. Clean work area upon completion of task.

Class II 1. High Risk patients must remain out of room for one hour after completion of work and cleanup.

2. Execute work by methods to minimize raising dust.

3. Immediately replace ceiling tile if displaced.

4. Remove all visible debris with a wet towel and/or mop.

5. Housekeeping to wipe work surfaces and floors with disinfectant.

Class III 1. Execute work by methods to minimize raising dust.

2. Immediately replace ceiling tile if displaced

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

4. Water-mist work surfaces to control dust while cutting.

5. Seal unused doors with duct tape.

6. Isolate HVAC system in areas where work is being performed to prevent contamination of duct system.

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

8. Cover construction waste before transport in covered containers

9. Wet mop and/or vacuum with HEPA filtered vacuum before leaving work area.

10. Open previously sealed HVAC registers and grills.

11. Housekeeping to wipe work surfaces and floors with disinfectant.

Class IV 1. Obtain infection control permit before construction begins.

2. Install plastic dust barriers to seal area from non-work area or implement control cube method (cart with plastic covering and sealed connection to work site with HEPA vacuum for vacuuming prior to exit) before construction begins.

3. Isolate HVAC system in areas where work is being performed to prevent contamination of duct system.

4. Maintain negative pressure (0.01) general construction and (0.20) asbestos working condition within work site utilizing HEPA equipped air filtration units.

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

6. Cover construction waste before transport in covered containers.

7. All work associated with a major project that has an approved ICRA authorization form will be assessed on an individual basis using the Risk Assessment and Exposure Control Checklist.

8. Wet mop and vacuum with HEPA filtered vacuum.

9. Do not remove barriers from work area until a Health System responsible person inspects completed project.

10. Remove barrier materials carefully to minimize spread of dirt and debris associated with construction.

11. Wet mop and vacuum with HEPA filtered vacuum before leaving work area.

12. Remove isolation of HVAC system in areas where work was being performed.

13. Housekeeping to wipe work surfaces and floors with disinfectant.

14. Complete daily log documenting work activity and completion of remedial and preventive procedures required.

Class V 1. Obtain infection control permit before construction begins.

2. Construct gypsum board/metal stud dust partition, extend and seal to ceiling.

3. Isolate HVAC system within work areas to prevent contamination of duct system.

4. Seal doors opening to adjacent areas with duct tape.

5. Block off and seal HVAC registers, grills and any openings in ductwork to remain.

6. Maintain negative pressure (0.01) general construction and (0.20) asbestos working condition within work site utilizing HEPA equipped air filtration units.

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

8. Cover construction waste before transport in covered containers.

9. All work associated with a major project that has an approved ICRA authorization form will be assessed on an individual basis using the Risk Assessment and Exposure Control Checklist.

10. Wet mop and vacuum with HEPA filtered vacuum.

11. Cover construction waste before transport in covered and sealed containers.

Biohazards to be double bagged.

12. Provide monitoring and clearance samples for mold/asbestos.

13. Do not remove barriers from work area until a Health System responsible person inspects completed project.

14. Remove barrier materials carefully to minimize spread of dirt and debris associated with construction.

15. Wet mop and vacuum with HEPA filtered vacuum before leaving work area.

16. Remove isolation of HVAC system in areas where work was being performed.

17. Housekeeping to wipe work surfaces and floors with disinfectant.

18. Complete daily log documenting work activity and completion of remedial and preventive procedures required.