Attachment 05 - ICRA EHRM - 554-21-700.pdf

Completing the Infection Control Risk Assessment (ICRA) Step 1: Determine type of construction based on amount of demolition and duration.

Step 2: Determine location of construction and patient risk level.

Step 3: Use graph to determine class of Infection Control containment for the ICRA.

CONSTRUCTION ACTIVITY

Type A: Inspection and Non-Invasive Activities. No ICRA needed unless in a high risk area.

Includes, but is not limited to:

1. Small scale removal of ceiling tiles for visual inspection or minor installation.

2. Painting (but not sanding).

3. Wall covering, electrical trim work, minor plumbing, and activities that do not generate dust or require cutting of walls.

Type B: Small scale, short duration activities that create minimal dust. No ICRA needed unless high risk area.

Includes, but is not limited to:

1. Installation of telephone & computer cables

2. Access to chase spaces.

3. 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 and assemblies or new construction.

Includes, but is not limited to:

1. Sanding of walls for painting or wall covering.

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

3. New wall construction.

4. Minor, uncontained duct, HVAC or electrical work above ceiling

5. Major cabling activities.

6. Any other project that cannot be completed within a single work shift.

7. Any work involving modifications to the domestic water system.

Type D: Major demolition & construction projects.

1. Activities requiring consecutive work shifts

2. Activities requiring heavy demolition/removal of complete cabling system

3. New construction Exterior Construction: Activities such as excavation within close proximity of healthcare building that may produce dust or other infection control concerns. Requires case by case review by ICRA team.

LOW RISK MEDIUM RISK HIGH RISK

Administrative Offices Lobbies Public Corridors Public Restrooms Elevators Day Rooms Retail Store File Rooms Med Records Coffee Shop Warehouse

CBS: MH Outpatient CBC: Podiatry

CBN: PT/OT

DAT-S: Radiology, Dental, Bronchoscopy, GI DAT-N: Sleep Lab IBN: SCI Outpatient IBS: Mental Health Inpatient Research: Lab Areas F/NS Patient Kitchen All Outpatient Clinics Canteen Morgue All Sterile Storage

CBC: Infusion CBN: Dialysis DAT-S: Lab, ED, Pre-op, PACU, Minor Procedure, OR (use OR-specific ICRA), Oral Surgery DAT-N: Pharmacy, Pulmonary, Cath Lab, SPS IBS: ICU, SCI Inpatient IBN: Med/Surg Units (K2 and K3) Research: Vivarium

TYPE A TYPE B TYPE C TYPE D

LOW Risk

I II II III/IV

MEDIUM Risk

I II III IV

HIGH Risk

II III/IV III/IV IV

INFECTION CONTROL RISK ASSESSMENT (ICRA)

PROJECT:

Location of Construction: Project Start Date:

Contractor Performing Work and Phone Extension: Estimated Duration:

CONSTRUCTION ACTIVITY IC RISK GROUP

Type A: Inspection, non-invasive, minor x Low Risk

Type B: Small scale, short duration, moderate levels. Medium Risk x Type C: Major activity generates moderate to high levels of dust. High Risk

Type D: Major activity–large area, major relocation of staff/pts

A pre-construction risk assessment for tuberculosis (TB) has been completed. Patient population, site location and hospital layout have been reviewed and there is no increased risk for TB.

INFECTION CONTROL PRECAUTIONS INFECTION CONTROL COMMENTS

Class I

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

2. Immediately replace any ceiling tile displaced for visual inspection (open ceiling tiles will not be abandoned).

3. Replace any stained/soiled or damaged ceiling tile with new tile.

Class II

In addition to Class I Precautions above:

1. Provides 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 painter’s tape.

4. Block off and seal air vents.

5. Place sticky mat at entrance and exit of work area—change frequently.

6. Contain construction waste before transport in tightly covered containers. Wipe down equipment before removing from the worksite.

7. Upon completion, wipe work surfaces with disinfectant, wet mop and/or vacuum and remove isolation of HVAC system.

8. Properly flush and disinfect any newly installed domestic water piping systems prior to placing in service.

Class III

In addition to Class I & II Precautions above:

1. Obtain Infection Control involvement before construction begins.

2. Complete all critical barriers or implement control cube method before construction begins.

3. Control airflow: Isolate HVAC system in areas where work is being performed and maintain negative air pressure within work site.

4. Cover transport receptacles or carts. Wipe down equipment before removing from the worksite.

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

6. Use appropriate protective clothing.

7. Upon completion, do not remove barriers until inspected by Safety and Infection Control and thoroughly cleaned by housekeeping. Remove barrier materials carefully, roll plastic on to itself and clean hard walls, to minimize spreading of dirt and debris.

Class IV

In addition to Class I, II & III Precautions above:

1. Relocate vulnerable patients or

2. Relocate all patients and staff

Exterior Requires case-by-case assessment by the ICRA team: May include more frequent air handler / filter checks if near patient care air intakes or other measures as noted to the right.

OTHER COMMENTS: Call EMS for terminal clean before taking down containment: 720-470-2492

Permit Requested By:. Infection Control: ext. Date: