ATTACHMENT 5 - ICRA-PCRA Risk Assessment.pdf

PRE-CONSTRUCTION RISK ASSESSMENT (PCRA)

Project # 568A4-21-703

Project Title: EHRM Infrastructure Upgrades - Pine Ridge, SD Est. Start Date: 10-1-2022

Area of Construction: Est. End Date: 1-1-2023

Contractor/Supervisor: Pending

PCRA Completed by: Russ Skovlund, Gene Ensor

SAFETY/ENGINEERING

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

Y Will exits or exit egress routes from occupied areas change? A, E, H, J, L

N Will the construction area have less than two remote exits? A, E, H, J, L

N Will there be excessive distance to exit? A, E, H, J, L

N Will access to Emergency Services become blocked or obstructed? A, B, I, J, L

Y 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?

C, E, H, I, K

Y Will smoke or firewalls be breached? A, E, G, H

Will any temporary construction partitions be built? D, day only

Y Will the project result in the accumulation of construction debris? E, F, G, H

Y Will construction affect grounds safety (pits, storage, equipment, etc.)? H

Y Will construction present other life safety hazards? H, J

N Will protection of hazardous areas be compromised? H

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

Y Will there be any anticipated utility shutdowns? (Communications, electrical, heating/cooling, HVAC, medical gases, vacuum, water, server) Coordination with station chiefs.

Y Will noise levels be excessive? Coordination with station chiefs.

Y Will vibration levels be excessive? Coordination with station chiefs.

Y Will additional security measures be implemented? In support of IT closet access

Additional Requirements:

See attached document as guidance for the entire campus. It may become a living document to support patient and hospital needs.

PATIENT SAFETY COORDINATOR

Y N CONSTRUCTION ACTIVITY

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

List: All

Y Do areas involved have knowledge of construction?

List: Yes

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

If YES, indicate intervention:

Access

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

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

3. The access path should be smooth, without tripping hazards.

4. The access path should be handicap accessible.

Constructi on Area/

Materials

1. Construction areas should not be accessible by unauthorized personnel.

2. Construction areas should be visually identified.

3. Construction materials and tools should be moved and stored appropriately to preclude unauthorized access?

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:

INFECTION CONTROL RISK ASSESSMENT

INFECTION CONTROL COORDINATOR

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

A: Inspection, non-invasive activity-includes, not limited to removal of ceiling tiles for inspection (1/50 sq ft), painting (not sanding), wall covering, electrical trim work, minor plumbing, activities which do not generate dust or require cutting of walls or access to ceilings other than for visual inspection.

Low Risk- (ex Office Areas)

Y

B: Small scale, short duration, moderate to high levels-includes but not limited to installation of telephone/computer cabling, access to chase spaces, cutting of walls or ceiling where dust migration can be controlled.

Y

Medium Risk-(ex Cardiology, ECHO, Endoscopy, Nuclear Medicine, Physical Therapy, Radiology/MRI, Respiratory Therapy)

C: Work that generates a moderate to high level of dust or requires demolition or removal of any fixed building components or assemblies. Includes but not limited to sanding of walls for painting or wall covering; removal of floor coverings, ceiling tiles, and casework; new wall construction; minor duct work or electrical work above the ceilings; major cabling activity; any activity which cannot be completed in a single work shift.

High Risk-(ex CCU, ER, Labor & Delivery, Laboratories

(specimen), Newborn Nursery, Outpatient Surgery, Pediatrics, Pharmacy, Post Anesthesia care, Surgical Units)

D: Major duration and construction activities-Includes, but not limited to:

activities that require consecutive work shifts; requires heavy demolition or removal of a complete cabling system; new construction.

Highest Risk-(ex Any area caring for Immunocompromised patients, Burn Unit, Cardiac Cath

Lab, Central Sterile Supply, ICU, Medical Unit, Negative pressure isolation rooms, Oncology, Operating rooms including C-section)

Project Class

Patient Risk Group TYPE A TYPE B TYPE C TYPE D

LOW Risk I II II III/IV

MEDIUM Risk I II III IV

HIGH Risk I II III/IV IV

HIGHEST Risk II III/IV III/IV IV

During Construction Project Upon Completion of Project

CLASS

I

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

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

CLASS

II

1. Include all items from Class I above

2. Provides active means to prevent air-borne dust from dispersing into atmosphere

3. Water mist work surfaces to control dust while cutting.

4. Seal unused doors with duct tape.

5. Block off and seal air vents.

6. Place dust mat at access points of work area.

7. Contain construction waste before transport in tightly covered containers.

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

1. Wipe surfaces with disinfectant.

2. Contain construction waste before transport in tightly covered containers.

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

4. Remove isolation of HVAC system in areas where work is being performed.

CLASS

III

1. Include all items from Class I/II above

2. Involve Infection Control in design/planning before construction begins.

3. Complete all critical barriers i.e. sheetrock, plywood, plastic, 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.

4. Maintain negative air pressure within work site utilizing HEPA equipped air filtration units.

5. Cover transport receptacles or carts. Tape covering unless solid lid.

1. Include all items from Class I/II above

2. Do not remove barriers from work area until completed project is thoroughly cleaned as required by Chief, EMS and Infection Control

Coordinator.

3. Remove barrier materials carefully to minimize spreading of dirt and debris associated with construction.

4. Vacuum work area with HEPA filtered vacuums.

5. Wet mop area with disinfectant.

CLASS

IV

1. Include all items from Class I/II/III above

2. Involve Infection Control in design/planning before construction begins.

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

4. If exiting to a patient care area, construct anteroom and require all personnel to pass through this room so they can be vacuumed using a HEPA vacuum cleaner before leaving work site or they can wear cloth or paper coveralls that are removed each time they leave the work site.

5. Walk-off mats are recommended to minimize tracking of heavy dirt and dust from construction areas. Shoe covers may be considered in certain areas.

1. Include all items from Class I/II/III above

ICRA PROJECT CLASS:

Y N RISK OF TB EXPOSURE TYPE OF RISK:

If yes, describe intervention:

Additional Requirements:

Patient Safety Coordinator/Date Infection Control Coordinator/Date

IH/Safety Date Project Engineer/Date