PCRA 437-21-205 Zone 4.pdf

PRE-CONSTRUCTION and INFECTION CONTROL RISK ASSESSMENT

Project #

Project Title: Est. Start Date:

Area of Construction: Est. Duration:

Contractor/Supervisor:

SAFETY/ENGINEERING

Y N If YES, select ILSM from list below or describe other intervention:

Will exits or exit egress routes from occupied areas change?

Will the construction area have less than two remote exits?

Will there be excessive distance to exit?

Will access to Emergency Services become blocked or obstructed?

Will any part of the fire protection systems (detection, notification or suppression) be shut down or impaired for >4 hours in a 24-hour period?

Will smoke or firewalls be breached?

Will any temporary construction partitions be built?

Will the project result in the accumulation of construction debris?

Will construction affect grounds safety (pits, storage, equipment, etc.)? Is a dig permit required?

Will construction present other life safety hazards?

Will protection of hazardous areas be compromised?

INTERVENTION

A. Ensure Alternate Egress Routes B. Ensure Alternate Emergency Access C. Fire Department Notification D. Ensure Smoke-Tight Temporary Construction

E. Additional Fire Fighting Equipment F. Control Combustible Loads G. Conduct 2 Fire Drills Per Shift in All Areas H. Increase Hazard Surveillance Rounds

I. Additional Training of Emergency Personnel J. Ensure Additional Employee Education K. Institute a Fire Watch w/documentation L. Post temporary signage

Y N CONSTRUCTION ACTIVITY If YES, describe intervention:

Will there be any anticipated utility shutdowns? (Communications, electrical, heating/cooling, HVAC, medical gases, vacuum, water, server)

Will noise levels be excessive?

Will vibration levels be excessive?

Will additional security measures be implemented?

Will work require Hot Works Permit?

Will work require Above Ceiling Work Permit?

1.

PATIENT SAFETY COORDINATOR

Y N CONSTRUCTION ACTIVITY

Does this project involve a patient care area either directly or adjacent to?

List:

List:

Does this project alter patient access to building/patient care area, either temporarily or permanently?

If YES, indicate intervention:

Access

The new/temporary access path should be intuitive, i.e. easy to follow.

Signage should be adequate for decreased visual acuity and at appropriate viewing levels for both ambulating and w/c bound individuals.

The access path should be smooth, without tripping hazards.

The access path should be handicap accessible.

Construction Area/

Materials

Construction areas should not be accessible by unauthorized personnel.

Construction areas should be visually identified.

Critical Alarms

Critical clinical alarms shall be functional and audible within and adjacent to the construction zone? Including but not limited to:

a. Emergency CODE Systems

b. Medical Gas Alarms (Oxygen, Air, Suction)

c. Wander guard technology

d. Vital Sign Monitoring/Telemetry Systems

e. Medication/Nutrition Pumps

f. Nurse Call Systems

Additional Requirements:

1. Loud, sudden or unexpected noises must be avoided; if any noise louder than ambient noise is going to occur, occupants of surrounding rooms must be notified immediately prior to commencement of noise. If excessive noise is unavoidable, work must be coordinated with the AOD.

2.

A E H J L

A E H J L A E H J L

A B I J L

C E H I K

A E G H

D

E F G H

H

H J H

Are there additional considerations or precautions needed for the surrounding areas?

Tools and chemicals should be secured at the end of each work shift.

Signage posted at worksite entry to preclude unauthorized access.

INFECTION CONTROL RISK ASSESSMENT AND PERMIT

INFECTION CONTROL COORDINATOR

Y N CONSTRUCTION ACTIVITY TYPE Y N PATIENT RISK GROUP (may modify as appropriate)

A: Inspection, non-invasive activity-includes, not limited to: removal of ceiling tiles for inspection (1/50 sq ft) with limited exposure time, limited building system maintenance that does not create dust/debris, clean plumbing activity limited in nature.

Low Risk- Non patient care areas such as: walkways, gathering areas, offices, break-rooms& mechanical rooms (not on clinical units), EMS closets, bathrooms, and locker rooms.

B: Small scale, short duration, activity-includes, not limited to: work conducted above the ceiling, fan startup/shutdown. Or the following if limited dust/debris is created: new flooring, installation of electrical devices, removal of drywall, controlled sanding.

Medium Risk- Patient support areas such as: waiting areas, materials management, SPS-de-contamination side, kitchen, cafe, patriot store, coffee shop.

C: Large scale, longer duration activity-includes but not limited to: removal of flooring, walls/drywall, casework, building components; new drywall;

renovation in a single room; non-existing cable pathway; invasive electrical work; dry sanding; work not completed in a single shift; work creating significant noise or vibration.

High Risk- Patient care areas such as: In-patient rooms (except ICU), ED, employee health, general pharmacy area, medication rooms, clean utility rooms, diagnostic imaging suite, laboratory.

D: Major demolition and construction activities-includes, but not limited to:

removal/replacement of building system components; removal/installation of drywall partitions; invasive large-scale new building construction;

renovation work in two or more rooms.

Highest Risk- ICU, oncology, infusion clinic, procedural areas, pharmacy compounding, SPS-clean side, interventional radiology suite, ORs and restricted areas.

Project Class

Patient Risk Group TYPE A TYPE B TYPE C TYPE D

LOW Risk I II II III

MEDIUM Risk I II III IV

HIGH Risk I III IV V HIGHEST Risk III IV V V

Class: Mitigation Activities Before and During Construction Project: Upon Completion of Project:

CLASS I

1. Perform non-invasive work activity to not interrupt patient care or create dust.

2. Immediately replace any ceiling tile displaced for visual inspection.

CLASS II

1. Perform only limited dust work and/or activities designed for basic facilities and engineering work.

2. Perform limited dust and invasive work following standing precaution procedures.

3. This class should not be used for construction or renovation activities.

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

2. Check all supply and return registers for dust accumulation on upper surfaces and air diffusers.

3. Remove isolation of HVAC system and verify it is clean and operational. (Meeting original specifications).

CLASS III

1.Provide an active means to prevent airborne dust (hand held HEPA vacuums, plastic containment, closing doors).

2.Remove or isolate return and supply air diffusers.

3.Work area must be neutrally to negatively pressured at all times.

4.Seal all doors with tape that will not leave residue.

1. Include all items from Class II above, and:

2. Construction area must be inspected by infection control, patient safety coordinator, and/or engineering representative for discontinuation of precautions.

1.Include all items from Class III above, and:

2.Construct critical barriers meeting NFPA 241 requirements, preventing dust release. Barriers must extend to the ceiling or deck above, if tiles are removed. Plastic barriers must be effectively affixed to ground & ceiling & secure from movement/damage.

3.Seal all penetrations in barriers, including ceilings & floors, using approved materials applicable to the barrier type.

4.Containment units approved for Class IV precautions are enclosed & have HEPA filtered exhaust air.

5.Negative airflow pattern must be maintained from the ante-room to the construction area.

6.Install device on exterior of work containment to continually monitor negative pressurization.

7.Maintain negative pressure for the entire workspace with HEPA exhaust systems. If directed outdoors, it must be at least 25 feet from entrances and air intakes. If directed indoors, the system must be HEPA filtered that is verified prior to start of work as no less than 99.97% effective and not altering airflow/pressure in other areas.

8.Worker clothing must be clean and free of visible dust before leaving the work area. Workers must wear shoe covers that must be changed prior to exiting the anteroom and changed immediately if damaged.

9.Consider collection of particulate data during work to monitor/ensure contaminates do not enter occupied space.

1.Include all items from Class IV above, and:

2.Construct anteroom adjacent to the entrance of the construction work area.

3.Workers are required to wear coveralls at all times, & must be removed before leaving the anteroom.

1. Include all items form Class IV.

ICRA PROJECT CLASS:

Could there be a risk of TB Exposure? Y N If yes, explain:

Could water quality be compromised? Y N If yes, Explain:

Additional Requirements for every project:•Construction signs with the Point of Contact and Emergency PoC's phone numbers will be posted.•Install sticky mat at entrance of contained work. Sticky mats must be changed routinely and when visibly soiled.•Contain all trash and debris in the work area.•Nonporous/smooth and cleanable containers (with a hard lid) must be used to transport trash and debris from the construction area. These containers must be damp-wiped cleaned and free from visible dust/debris before leaving the contained work area.•All barrier construction must be completed in a way that prevents dust release.•Maintain clean areas surrounding work location.•Exhaust into shared or recirculating HVAC systems, or other shared exhaust systems (such as bathroom exhaust) is not acceptable.•If negative pressure is required, install device (e.g. magnehelic, manometer, or digital monitoring) on the exterior of work containment to continually monitor negative pressurization. The "ball in the wall" or similar apparatus are not acceptable.

Patient Safety Coordinator/Date Infection Control Coordinator/Date

IH/Safety Date Project Engineer/Date

CLASS IV

CLASS V

1. Include all items from Class II/III above, and:

2. Critical barriers must stay in place until the work area has been cleaned and removed in a way prevents dust release.

3. When removing hard barriers, a plastic barrier should be installed and HEPA vacuum used if there will be dust creation. Drywall cutting is prohibited. Clean all stud tracks with HEPA vacuum before removing outer barrier.

4. Negative air must remain operational after completion of dust creating activities to remove containments before removal of critical barriers.

N/A-no dust generated.

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