AttC_Med Center Requirements-VAPHS 18 May 2017.pdf

SECTION 01 01 10

VA Pittsburgh Healthcare System (VAPHS) Medical Center Requirements

1.0 GENERAL INTENTION: This section pertains to station policy for construction projects performed at the VA Pittsburgh Health Care System. Safety and health concerns are taken seriously. Both our staff and yours are expected to strictly adhere to the regulations and requirements. This is exceedingly important, since we must be primarily concerned for the safety of our patients. In this regard, OSHA Standards may protect worker safety and health, but they have minimal benefit for protecting the safety and health of our patients, due primarily to their differing medical conditions.

Review this information as orientation with your personnel performing work on site. Where the requirements as outlined in this and other specification sections are differing, the more stringent and beneficial to the VA Pittsburgh Healthcare System shall apply.

2.0 REQUIREMENTS

A. Security:

1. Secure all construction areas, especially mechanical and electrical rooms against entry of unauthorized individuals including patients.

2. Notify the COR for permission to work after hours and weekends. Standard work hours for the medical center are Monday – Friday, 7:00 a.m. to 4:30 p.m.

3. All contractors will wear and display VA contractor badges provided by the VA Police

Department.

B. Patient Privacy

1. Before entering a patient care room, receive permission and instructions from the nurse in charge. Respect the privacy of all patients. Remember, the patients at VAPHS are veterans who have served to protect our country.

C. Key Security:

1. Only a limited number of keys will be issued to the contractor.

2. If the Contractor loses a key, all areas that are keyed to that key will be re-keyed at the

Contractor's expense at a charge of $50 per key and $50 per change, and all new keys required to be issued will be completed at the Contractor's expense.

3. Ensure all doors leading to and from the construction areas are locked at all times to prevent access to the area from unauthorized persons.

D. General Safety:

1. Follow all federal, state and local safety and health regulations.

2. Maintain safety in the construction site/area in accordance with the provisions of the contract, which includes the OSHA Regulations, National Electrical Codes. NFPA 70, National Electric Code and NFPA 101, Life Safety Code. Work in a safe manner and take all proper precautions while performing your work. Extra precautions shall be taken when working around persons occupying the building during construction.

3. Provide Personal Preventive Equipment (PPE) for your employees.

4. Post appropriate signs in specific hazardous areas. Contractor to post construction warning signs at each entrance to area.

5. Keep tools, ladders, etc. away from patients to prevent injuries.

E. Safety Inspections: The professional Occupational Safety & Health staff at this facility will perform Safety inspections of all contract operations. Written reports of unsafe practices or conditions will be reported to the Contracting Officers Representative (COR) and Contracting Officer for immediate attention and resolution.

1. Review of the Contract Workers Safety Information (Attachment A) as well as any other location-specific information which should be disseminated to all contractor personnel who will work onsite.

F. Fire Alarms:

1. The fire alarm system connects all buildings at this facility, and is activated by various heat, duct, manual pull stations, and smoke sensors. Manual pull stations are provided at each entrance. Please survey the area in which you are working to locate the manual pull stations.

2. If in the event of a fire alarm sounding, you are to remain in your area, unless medical center personnel (Safety, Nursing or Engineering) instruct otherwise or unless a fire situation is in your area, in which case you should immediately evacuate.

3. Any work involving the fire protection systems will require written permission to proceed from the COR. DO NOT tamper with or otherwise disturb any fire alarm system components without prior written permission. To do so without written permission will result in an adverse action.

G. Hazardous Materials:

1. Many of the operations you are scheduled to perform may involve the use of hazardous materials prior to bringing hazardous materials on site, all Material Safety Data Sheets will be submitted through the COR for evaluation by the facilities Industrial Hygienist/Safety Representative.

2. Storage of hazardous materials within buildings will be minimal with only enough on hand to perform daily work tasks. Flammable materials will either be removed from buildings at the end of the work shift or stored in approved flammable storage containers.

3. Care must be taken to assure adequate ventilation to remove vapors of hazardous materials in use. Many of the patients being cared for in the facility are susceptible to environmental contaminants, even when odors seem minimal. You will isolate those areas where vapors are produced and ventilate to the most extent possible to reduce the number of complaints.

4. When chemicals become odorous, the Safety Office should be contacted immediately, i.e., adhesive remover used to remove glue, so employees in adjacent areas can be notified.

H. Airborne Dust Control During Construction:

1. In order to protect patients, visitors, staff, and contractors from safety and health hazards associated with construction activities, this policy is established for the VA Pittsburgh Healthcare System (VAPHS) and for all VAPHS-affiliated/owned/leased property where construction activities are undertaken.

2. Generation of dust is of major concern within the medical center. Where operations involve the generation of dust, all efforts will be directed at eliminating airborne generated dust associated with construction.

3. All employees of contractor and subcontractors are required to have Infection Control Risk Assessment (ICRA) 8-hour Certification Class. The ICRA 8-hour course is an awareness training class covering basic procedures and policies to reduce infection contamination, communication and documentation necessary for the topic and the various responsibilities to ensure facility construction meets the organization’s contamination protocols. Contractor will submit these certificates of compliance within 30 days of project commencement.

4. Contractor and subcontractors that are building the infection control barriers must have an ICRA 24-hour certificate course. The ICRA 24-hour course is a best practices class covering the proper methods to erect, maintain and dismantle ICRA barriers. Contractor to submit employee compliance to COR before any Infection Control barrier is built or within 30 days of project commencement (whichever is first).

5. No Plastic will be used in separating construction area from Medical Center.

6. The Infection Control staff will work to assist the COR in identifying and specifying all infectious control requirements that will be in effect and required during the construction activities. This includes completion of an anticipated Infection Control Risk Assessment (ICRA) permit.

7. Pre-Construction. A meeting of the COR, safety, infection control, contractor (including sub-contractors), and other identified parties performing the construction activities must be held prior to beginning of any work (or work phase) onsite. This meeting will be held to review the construction activity plans, and how they address the concerns identified during the development of the construction project including the concerns included in the construction document packages and scopes of work. Pre-Construction meetings may be held once for small projects or projects involving only one phase as well as more than once for projects employing multiple phases of work. General items for discussion during the Pre-Construction meeting(s) are identified on the Pre-Construction Meeting Checklist (Attachment B). The meeting will also discuss the following information at a minimum as well as ensure that everyone present is familiar with their role for the following:

i. Identification of the Site Safety and Health Officer (SSHO) and all other project competent person(s) (CP) as defined in VA Master Specification 01 35 26 and 29

CFR 1926.

ii. Identification of current applicable local, state, and federal safety and environmental regulations that are in effect and applicable during the construction activities; e.g., Occupational Safety and Health Administration (OSHA), US Environmental Protection Agency (EPA), National Fire Protection Association (NFPA), etc.

iii. Identification of current applicable local and national VA safety and environmental regulations.

iv. Review of the Contract Workers Safety Information (Attachment B) as well as any other location-specific information which should be disseminated to all contractor personnel who will work onsite.

v. Review of the Pre-Construction Risk Assessment (PCRA) requirements for construction activities and completion of the permit for the project and/or project phase. The general contractor, or in the case of work performed by VA staff the work supervisor, is responsible for identifying all potential construction risks as outlined in the PCRA permit (Attachment C).

vi. Review of the Infectious Control Risk Assessment (ICRA) policy requirements for construction activities and completion of the permit for the project and/or project phase. The COR/RE/PM in conjunction with the infectious control staff, director or manager of the unit(s) affected, and the contractor are responsible for identifying and reviewing all potential construction risks and requirements as outlined in the ICRA permit (Attachment D).

vii. Review of all contract worker Tuberculosis (TB) screening requirements and options (reference VHA Directive 2011-036 Safety and Health during Construction). The contractor shall also be notified that anyone failing to meet these requirements is not permitted to work onsite and/or may be removed at any time without notice until these requirements are met.

viii. Review of the medical center’s Hot Work Policy and permit process (Attachment

E).

ix. Review of the medical center’s Confined Space Policy (reference EC-042).

x. Review of the medical center’s Firewall/Smoke Wall Penetration Policy and permit process (reference EC-061).

xi. Review of the medical center’s Fire Alarm/Fire Sprinkler Impairment, Utility

Outage and Lock-Out/Tag-Out Policies and processes as applicable (reference FMS-007, FMS-014, and FMS-010 respectively).

xii. Review of the medical center’s current contract staff credentialing and badging requirements, and what steps must be taken before contract staff are permitted to work onsite (reference FMS-039).

xiii. Review of the medical center’s current contract staff information safety and security requirements (Attachment F).

I. Environmental Protection: (See Environmental Compliance: PG-18-17)

1. It may help you to be aware of the seriousness, which the environmental protection requirements of each contract are regarded. Adherence to these requirements is subject to continuing scrutiny from the community and backed by severe penalties, such as fines and incarceration. These environmental requirements will be strictly enforced.

2. No hazardous materials will be disposed of on Government property during and after completion of the project. All waste will be hauled off-site or disposed of in contractor-owned and operated waste removal containers.

3. A copy of all waste manifests for special or hazardous wastes will be forwarded to the COR and the Industrial Hygienist. Environmental requirements will be strictly enforced.

K. Housekeeping:

1. Protect patients and VA personnel in occupied areas from the hazards of dust, noise, construction debris and material associated with a construction environment. Keep work area clear, clean and free of loose debris, construction materials and partially installed work which would create a safety hazard or interfere with VA personnel duties and traffic.

2. Wet mop occupied areas clean and remove any accumulation of dust/debris from cutting or drilling from any surface at the end of each workday. Mops and buckets will not be provided.

3. Make every effort to keep dust and noise to a minimum at all times. Take special precautions to protect VA equipment from damage including excessive dust.

4. Maintain clear access to mechanical, electrical devices, equipment and main corridors.

This will ensure access to existing systems in the event of an emergency.

5. Clean area of all construction debris and dust upon completion of demolition and/or renovation at the end of each workday.

6. During construction operations, keep existing finishes protected from damage. Cover and protect all carpets during construction. Any carpets or surfaces damaged as a result of construction activities will be replaced by the contractor and at the contractor’s expense.

M. Emergency Medical Services: Emergency medical services for stabilization purposes are available for contractors at this facility. For medical emergencies, dial 911 when inside any building at the University Drive and Aspinwall divisions. Report the nature of the emergency and location. The operator will dispatch in-house personnel or coordinate an outside emergency assistance based on the nature of the emergency.

N. Use of Government Owned Material and Equipment: Use of Government owned material and equipment is prohibited. This includes flatbeds, etc. for delivery of materials.

O. Superintendent Communications: At all times during the performance of this contract, the Contractors Superintendent is to be available by telephone. At the beginning of the contract and prior to beginning any construction, supply the COR with the telephone number for the superintendent.

P. Parking: There will be no on-site Contractor parking. There will be no contractor staging outside of construction area.

Q. Contractor's Trailers: Not authorized. Contractor is only authorized one dumpster location, regardless of how may projects they have onsite, which will be assigned by COR after Notice to Proceed.

R. Traffic:

1. Traffic hazards are minimal at this facility. Drivers should be particularly concerned with pedestrian traffic.

2. Seat belt use is mandatory on the station.

3. Federal police officers maintain a 24-hour patrol of the area.

4. No parking/driving on sidewalks and/or grass unless authorized.

S. Smoking: No smoking is permitted in buildings or around hazardous areas. Any smoking inside a government building is subject to a fine without warning. Smoking is authorized in designated smoking areas. The COR can provide locations.

T. Delivery of Materials: All materials to be delivered to VA loading docks will be coordinated by the contractor. VA personnel will not receive any contractor material and the contractor will meet all deliveries at the dock to ensure receipt, custody, and removal of items from the dock so not to impact hospital function. If contractor is not present on the site to receive materials in a timely manner, the delivery will be refused and sent away to free the dock space.

Extension of construction time will not be granted for refusal to receive contractor materials.

U. Fluorescent (PCB Containing) Fixtures: All fluorescent lighting fixtures being removed as part of this project are to have their ballasts removed and turned over to the VAMC Environmental Protection Specialist for disposal. All other components of the lighting fixture are to be disposed of by the Contractor.

V. Phasing: Contractor shall submit a schedule of approximate phasing dates on which the

Contractor intends to accomplish work in each specific area of site, building or portion thereof. Contractor shall notify the COR two weeks in advance of the proposed date of starting work in each specific area of site, building or portion thereof. Arrange such phasing dates to insure accomplishment of this work in successive phases. The Medical Center Director, COR and the Contractor, prior to any work being completed, must mutually agree to this phasing schedule. Failure to comply with the dates agreed to on the phasing schedule without approved justification may result in a contract modification that benefits the government.

W. Recycling: It is the contractors’ responsibility to recycle as much of the construction by-products as possible. This would include but not be limited to steel, copper, etc. The contractor will keep a manifest of the items recycled and approximate amounts. The contractor will also make every effort to use recycled materials during the construction of the project. This will be monitored through the submittal process, but will require that the contractor manifest all recycled materials used during the course of the project.

1. Recycled content products shall be used in execution of this contract wherever such products are available.

2. The contractor shall keep a record of all recycled content products used in execution of this contract. The record shall identify recycled content products used in execution of the work with approximate quantities.

3. Contractor shall also keep a record of all wastes and by products recycled as a result of the execution of this contract. The record shall identify products recycled along with approximate quantities.

4. Contractor shall submit copies of record reflecting all recycled products used in the contract with each application for progress payment. The record shall include the types and quantities of products used. Negative reports are required.

3.0 ENVIRONMENTAL PROTECTION:

A. Contractors shall abide by the facilities Green Environmental Management System (GEMS) policies and procedures. Contractors shall use recycled content products and bio-based materials when possible and provide an estimate of the percentage of materials with recycled content that will be used on the awarded projects. Contractors are required to certify that all personnel and subcontractors have received Resource Conservation and Recovery ACT (RCRA) training. Contractors shall recycle all possible recyclable materials and report the total quantity of recycled and total quantity or waste removed during the projects. Reporting frequency will be set by the Contracting Officer.

B. Hazardous Material Storage & Use

1. The contractor shall establish hazardous material (HM) storage and distribution system when HM is to be used. All HM required to support the contract shall be reported to the Green Environmental Management System (GEMS) Coordinator using the Contractor HM Identification Form. The Contractor HM Identification Form will be provided to the Contractor at or prior to the Pre-Construction meeting. Additional HM needed by the contractor shall be identified to the Contracting Officer's Representative for approval by the HMP.

2. The contractor planning to use HM for the work must register with the GEMS prior to start of work in order to support the installation’s compliance with Executive Order 12856, Federal Compliance with Right-to-Know Laws and Pollution Prevention Requirements.

3. The contractor shall maintain Contractor HM Identification Form for HM on the job site for inspection/verification.

4. Contracting Officer's Representative (COR) will verify that the HM identified to (GEMS) Coordinator is the only HM in use on the job site.

5. Contractors shall provide the (GEMS) Coordinator:

i. A list of each material and quantity of material for all proposed HM. Hazardous

Material (HM) shall mean any item that is:

ii. A health hazard or physical hazard as defined in 29 CFR, 19 10.1200(c).

iii. Regulated in its disposal by EPA under 40 CFR.

iv. Hazardous as defined by DOT regulations under 49 CFR.

v. Hazardous as defined by the Dangerous Goods Regulations of the International

Air Transport Association.

vi. A safety data sheet (SDS) for each item on the list.

6. The contractor shall establish his/her own HM storage and issue location that complies with federal, state and local environmental regulations. Materials issued shall be tracked for quantities used. Unused materials shall be inventoried and removed from the VAMC Facilities prior to close out of the contract or expiration date of the HM. Reports of materials delivered, used and removed from the installation shall be submitted to the Contracting Officer monthly and prior to contract close out.

7. The contractor shall comply with all federal, state and local environmental standards.

8. The Facility (GEMS) coordinator shall be notified and accompany the Contracting Officer, Facility Engineer and other responsible parties i.e., COR, etc., on all project close out inspection to ensure all used/unused HM was removed from the installation.

C. HAZARDOUS WASTE REQUIREMENTS:

1. General: This section includes the handling of all hazardous waste (HW) as generated by the contractor or government hazardous waste encountered by the contractor during the course of this contract.

2. Non-Hazardous Waste: The contractor is responsible for the disposal of all non-hazardous waste.

3. Contractor Hazardous Waste: This shall include any hazardous waste that is a result of the use of hazardous materials (HM) and through leakage or spills. Pennsylvania regulations define any spills or leakage of oils (fuel) as hazardous waste. Contractor shall be fully responsible for the use, reporting and disposal of this material or waste, in accordance with all Federal, State and local regulations. The contractor shall provide a copy of his/her registration with the state Department of Environmental Protection (DEP) for the Northwest region/Environmental Protection Agency (EPA)ID number; hazardous waste transporter’ s name and copy of their license or permit to transport hazardous waste; and the Treatment, Storage, and Disposal Facility (TSDF) name and copy of their license, permit, or interim status from EPA to receive hazardous waste.

4. Notification Requirements: The contractor shall notify the Green Environmental Management System (GEMS) Office before the start of work, if he will be generating HW and when he actually starts generating HW.

5. While the EPA and the Commonwealth of Pennsylvania permit the use of accumulation sites (Ref: 40 CFR 262.34) local authorization is required prior to establishing such a site.

This approval is obtained from the Green Environmental Management System Office after a favorable joint review conducted by the (GEMS) Coordinator, The Safety Manager, The COR, and the Contracting Officer.

ATTACHMENT A

Contract Worker's Safety Information Contract Reference No.:

The VA Pittsburgh Healthcare System is a full service medical center with inpatients, outpatients, visitors, and staff who can be affected by what you do while working here. Many of these patients may have health problems that make them more susceptible to materials used or generated in your work.

In the event of a fire, remember RACE. Rescue persons in immediate danger, pull the fire Alarm and contain the fire by closing any doors. If it is safe to do so, and you have been trained, try to extinguish the fire with a portable fire extinguisher. If you do not hear the alarm sound, call ext. 333 to report the location. Know the location of the fire alarm and extinguisher in your work area.

Keep all dust and odors within the construction or maintenance site. All Material Safety Data Sheets (MSDS) for materials must be posted. Provide MSDS to the Contracting Officer’s Representative (COR).

A. Asbestos

1. Assume that any sprayed-on fireproofing and thermal insulation contains asbestos. Ceiling tiles provide the barrier between the asbestos in the interstitial and the occupied areas below. Interior walls provide a similar barrier to asbestos fireproofing on vertical columns.

2. Ceiling tiles cannot be moved or displaced without proper containment and personal protective equipment. Wall penetrations cannot be made without proper containment and personal protective equipment. Immediately report all disturbances of asbestos-containing materials to your supervisor and the COR.

B. Hazardous Waste

1. The VA Pittsburgh Healthcare System indicates waste that is hazardous with different colored bags:

a. RED for infectious or biohazardous waste.

b. YELLOW for chemo waste.

c. CLEAR & BLACK for general waste.

d. Signs on containers also indicate whether the contents are biohazardous, radioactive or cytotoxic.

e. Do not touch the contents of any of these containers

C. Hazardous Spills

1. Locate the MSDS and contact the Facility Management Service at extension 412-360-6138 during normal business hours for assistance. Alternately you can contact the VA’s Industrial Hygienist at 412-360-3705 during normal business hours. In the event of no answer, or after hours contact the VA Operator at 412-688-6000 for assistance.

D. Utility Shutdown

1. You must notify your supervisor and COR for approval: (advance approval is required for all utility shutdowns in accordance with your contract requirements)

a. Prior to lock out/tag out of any utility system.

b. If a utility failure occurs.

c. Prior to restoring a system.

E. Smoking

1. Smoking is not allowed in any building and only in designated outdoor areas.

F. Patient Care Areas

1. Before entering a patient care room, receive permission and instructions from the nurse in charge.

Respect the privacy of all patients. Remember, the patients at VAPHS are veterans who have served to protect our country.

Your Project Manager (COR) is , ext.

The Safety Officer is_______________________, ext. xxxx, Police and Security can be reached at extension 412-360-6911

Employee Name/ Signature _______________________

ATTACHMENT B

Pre-Construction Meeting Checklist

Items of Discussion:

1. Which bid alternates were accepted? Verify that there is an agreement between the contractor and the VA regarding which of the alternates were accepted.

2. Labor Disputes (FAR 52.222-1).

3. Monthly Progress Payments (FAR 52.232-5).

4. Differing Site Conditions (FAR 52.236-2).

5. Superintendence by the Contractor (FAR 52.236-6). Superintendent must be employed by the contractor and must have full authority to act for the contractor.

6. Completion of Infection Control Risk Assessment (ICRA) Matrix of Precautions for Construction.

7. Completion of IC Permit and issuance (or procedures). All smoke and/or dust barriers will be in place and approved by infection control and safety prior to beginning any demolition or construction work.

8. Cleaning Up (FAR 52.236-12).

9. Accident Prevention (FAR 52.236-13).

10. Specifications and Drawings for Construction (FAR 52.236-21).

a. Specifications govern over drawings.

b. Work done without approved submittals shall be at contractor's risk.

11. Changes (APR 1984). No oral order shall be considered as a change.

12. Inspection of Construction (FAR 52.246-12).

13. Specifications and Drawings for Construction (VAAR 852.236-71). Drawings are not to be scaled.

14. Daily Report of Workers and Materials (VAAR 852.236-80). Weekly pay statement.

Documentation required for apprentices.

15. Schedule of Work Progress (VAAR 852.236-84).

16. Workman's Compensation (VAAR 852.236-86).

17. Parking Regulations/Restrictions.

18. Hauling Demolition Material. Loads must be covered. Trucks must be equipped with a tailgate.

19. Receiving of Contractor Shipments by Government Employees.

20. Asbestos removal.

21. Use of Government Ladders. Under no condition is the contractor authorized to use government ladders.

22. Smoking. No smoking in any building on station. Mechanical rooms and contractor occupied areas are no exception.

23. Material Safety Data Sheets. Contractor must provide MSDSs for all applicable materials that are brought onto the job site.

ATTACHMENT B

24. Safety. Safety of the contractor's personnel is the contractor's responsibility. VA will not intervene except when the safety of VA personnel or property is at risk.

25. Fire Stopping shall be provided for all penetrations in vertical and horizontal smoke partitions.

26. Hot Work Permits are required for all hot work.

27. Fire Safety During Construction.

a. The contractor shall manage the work and schedule material arrival in a manner to result in a minimum of combustible material stored in the building at any one time.

b. Under no condition will fire exits or other means of egress be blocked or partially blocked.

c. Housekeeping/cleanup requirements shall be rigorously adhered to. All construction debris shall be removed from the building prior to the end of each shift.

d. Smoking rules shall be strictly observed.

e. The fire alarm system may not be disarmed or disabled in any way unless an equally effective alternative fire alarm system is provided.

f. All construction partitions shall be constructed and sealed in accordance with VAPHS ILSM

Policy Safety-001 and NFPA 241.

28. Lock Out/Tag Out Energy Control Program shall be observed by all contractor personnel.

Contractor is to submit a copy of their policy for approval.

29. Working in Confined Space shall be observed by all contractor personnel. Contractor is to submit a copy of their policy for approval. Contractor must obtain a permit prior to conducting any confined space work.

ATTACHMENT C

Pre-Construction Risk Assessment

Safety Construction Permit

Location of

Construction:

Project Start Date:

Project

Coordinator:

Estimated Duration:

Contractor

Performing Work:

Permit Expiration Date:

Supervisor: Telephone:

Description of project:

Construction Activities

This PRCA form ins intended to be used for construction and renovation projects. It is not intended to be used for non-destructive building maintenance task performed within a single room such as:

• Painting or wall papering

• Installation of soap dispenser/needle box/paper towel holder in patient room

• Repair of window blind.

• Ceiling tile replacement for areas o less than 50% of the total square footage of business occupancies and non-patient areas o less than five 2 X 2 tiles in a unoccupied patient rooms

• Minimum repair of nurse call system/TV/Bed/Telephone.

• Testing, maintenance, or replacement of electric outlets, switched, or light bulbs Non-destructive

• Routine plumbing maintenance to repair or unstop sinks or commodes

• Repair medical gas outlet. (Front Body)

• Air balance readings.

• Routine checks and maintenance of HVAC systems

The following must be completed prior to any construction activities

1. A construction barrier shall be constructed prior to starting any work.

• No exits shall be directed to go through a construction area.

• Doors shall be locked to prevent unauthorized entry

• Put signs on doors into construction area "Construction Area – Do Not Enter".

• Place tacky mats at doors exiting construction area.

• Negative air shall be maintained in construction area (24/7) the duration of project.

• Exhaust air from construction projects cannot be returned through the building HVAC system

• Post a copy of this PCRA and a copy of the ICRA permit at the entrance to the construction area

2. Emergency contact information and procedures for accidents/events that could impact Patient

Care or Life Safety must be in place and posted at each job site. Included in these procedures are such things as:

• Emergency telephone numbers of key departments.

• A plan that describes where main valves, switches, and controls are for the area in case of an emergency.

• A plan for unexpected outages.

3. Maintain clean, safe, and orderly work area.

• All debris removal must be by covered cart.

• Comply with all OSHA and VA Safety requirements

• Daily safety checks shall be documented by the contractor.

Yes No Will there be any work that will require activation of the Interim Life Safety Measures during this project?

a. Some things that trigger ILSM's to be implemented are but not limited to:

• Any construction that impacts an EXIT or stairs, exit routes from occupied areas adjacent to construction site

• Any construction that impacts major breaches in a fire or smoke wall, (penetration permit required)

• Taking the main fire protection system (sprinkler) out of service

• Taking the main fire alarm system out of service

b. ILSM determination will be made by VAPHS Safety Department

Yes No Have Life Safety Drawings been reviewed to identify all hazardous areas, smoke partitions/barriers, and fire barrier walls?

a. If so, are these walls clearly marked on construction drawings?

Yes No Will any penetrations be made in smoke or fire barrier walls?

a. If so, Penetration Permits must be obtained and a copy of the fire stop/sealant material specification sheet(s) must be provided to the COR and VA Safety Office prior to making any penetrations in existing smoke partitions/barriers, and fire barrier walls

Yes No Will the functional or operational use of any rooms in the construction area be changed which could impact Life Safety Requirements? Examples could include converting offices into storage space or mechanical spaces or changes to exits routes or exit access, or adding new fire/smoke walls.

a. If so, who conducted the Life Safety assessment? _________________________

b. Have all Life Safety review comments and concerns been addressed in the design?

Yes No Will there be hot work done on this project?

a. If yes, a Hot Work notification must be made and a Hot Work Permit must be posted at the job site.

b. An additional fire extinguisher must be on hand and a dedicated fire watch must be assigned to each hot work location while the hot work is being performed.

Yes No Will there be noise or vibrations generated that will impact a department adjacent to, above, or below the construction area? All impacted departments must be notified

ATTACHMENT C

a. If so, how will noise or vibrations be reduced to an acceptable level?

Yes No Will hazardous chemicals be used on this project? If so, an MSDS Sheet is required to be onsite for all chemicals used on site

a. If yes, how will fumes, odors, and spills be controlled?

Yes No Will any internal combustion tools or equipment be used on this project?

NOTE: If used they are only authorized to be used outdoor in well ventilated areas and not near air handler, air compressor, or other equipment air intakes. For example gas powered saw or similar tools shall not be used inside buildings or near air intakes.

Vehicles and equipment shall not be left unattended while running and shall not be allowed to idle when not in use.

For example, trucks shall not be allowed to idle while being unloaded or loaded .

Yes No Has the VAPHS Asbestos Survey been reviewed to determine if there is Asbestos Containing Material (ACM) within the project area?

Yes No Is there known or presumed ACM within the construction area?

a. What measures will be taken to prevent ACM within the construction area from being disturbed or abated during the project?

b. If abatement is planned VAPHS Safety, Asbestos O&M Program Manager, AFGE Representatives , and departments in areas adjacent to abatement area must be notified of planned abetment action.

c. If abatement is planned, provide name and License # of contracted Abatement Company

d. If abatement is planned list Allegheny County Abatement Permit #______________________

Yes No Will there be any removal of lead building materials?

a. If yes, list procedures contractor will follow to control employees and patients’ exposure.

b. If bulk lead material is removed disposition documents must be provided to VAPHS GEMS Coordinator.

Yes No Will there be any hoisting or crane use during the project?

a. If so has a hoisting plan been provided by the contractor and reviewed by Safety and COR?

Yes No Will there be a Confined Space Entry required on this project? If yes Contractor must

a. Review VAPHS confined space hazards identified on VAPHS confined space list

b. Submit proof of confined space training qualifications for all workers who will enter a confined space on VAPHS property

c. Submit a copy of their Confined Space Program and permit to COR which will be reviewed by VAPHS Safety

Office

d. Provide all required confined space entry and monitoring equipment and rescue service for their workers.

e. VAPHS does not provide rescue service.

Yes No Will any of the following systems be out of service at any time during the project?

• Fire alarm

• Sprinkler

• Electrical

• Domestic water

• Oxygen

• Sewage

• HVAC

• Communications Systems

a. If so have contingency plans been developed and coordinated with all impacted departments?

Additional Safety Concerns

Yes No

Permit Requested By Safety Approval COR/Project Coordinator

Date: Date: Date:

ATTACHMENT D

Infection Control Risk Assessment Matrix of Precautions for Construction & Renovation

Step 1: Using the following table, identify the type of Construction Project Activity (A-D)

Type A Inspection and Non-Invasive Activities Includes, but is not limited to:

• Removal of ceiling tiles for visual inspection limited to 1 tile per 50 square feet.

• Painting (but not sanding)

• Wallcovering, electrical trim work, minor plumbing, and activities which do not generate dust or require cutting of walls or access to ceilings or other than for visual inspection.

Type B Small scale, short duration activities which create minimal dust Includes, but is not limited to:

• Opening of no more than one ceiling tile per 10 tiles

• Installation of telephone and computer cabling

• Access to chase spaces

• Cutting of walls or ceiling where dust migration can be controlled

• Minor renovation of existing space

• Wet sanding of walls

Type 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 is not limited to:

• Dry sanding of walls for painting or wall covering

• Cutting of walls, removal of drywall or building finish components where work is limited to one room or suite (including removal of floor coverings, ceiling tiles and casework)

• Wall demolition or new wall construction

• Minor duct work, plumbing work or electrical work above ceilings (not including system demolition or installation)

• Moderate renovation of existing space

• Major cabling activities, multiple rooms/lines where multiple access points are needed

• Any activity which cannot be completed within a single work shift

Type D Major demolition and construction projects Includes, but is not limited to:

• Activities which require consecutive work shifts the closure of a unit/wing or relocation of an entire patient area

• Requires heavy demolition or removal of a complete cabling system, HVAC, plumbing, medical gas, or electrical system

• Demolition of major fixed building components, assemblies, fit-out elements, or structural elements

• Outdoor construction of new structures located in close proximity (as determined by ICRA team) to existing patient care facility

• New construction

• Excavation activities within close proximity (as determined by ICRA team) of hospital building

Step 2: Using the following table, identify the Patient Risk Groups that will be affected. If more than one risk group will be affected, select the higher risk group:

Low Risk Medium Risk High Risk Highest Risk

• Office areas

• Public corridors and spaces not on or directly attached to patient units or treatment locations

• Admissions

• Cardiology

• Echocardiography

• Endoscopy

• Nuclear Medicine

• Physical Therapy

• Radiology/MRI

• Respiratory Therapy

• Canteen

• Emergency Room

• Laboratories

(specimen)

• Linen storage

• Outpatient Surgery

• Pharmacy

• Post-Anesthesia Care

Unit

• Surgical Units

• Outpatient clinics

• Any area caring for immunocompromised patients

• Cardiac Cath Lab

• Dialysis Clinic

• Central Sterile Supply

SPS

• Intensive Care Units

• Medical Unit

• Negative pressure isolation rooms

• Oncology

• Operating rooms

• Clinics/areas where surgical procedures are performed

• Dental

Step 3:

Match the Patient Risk Group (low, medium, high, highest) with the planned Construction Project Type (A, B, C, D) on the IC Matrix to find the Class of Precautions (I, II, III, IV) or level of infection control activities required. Classes of precautions are described in the table on the next page.

IC Matrix: Class of Precautions for Construction Projects by Patient Risk

Patient Risk Group Type A Type B Type C Type D

LOW Risk Group I II II III/IV

MEDIUM Risk Group I II III IV

HIGH Risk Group I II III/IV IV

HIGHEST Risk Group II III/IV III/IV IV

Note: Infection Control approval will be required when the Construction Activity and Risk Level indicates that Class III or Class IV control procedures are necessary.

Step 4: Identify the areas surrounding the project area, assessing potential impact

Unit Below Unit Above Lateral Lateral Behind Front

Risk Group Risk Group Risk Group Risk Group Risk Group Risk Group

Step 5: Identify specific site of activity, e.g. patient rooms, medication room, ect.

Step 6: Identify issues related to: ventilation, plumbing, electrical in terms of the occurrence of probable outages

Step 7: Identify containment measures, using prior assessment.

• Type of barrier (solid wall barrier or plastic) :

• Ante-room (yes/no) if yes type of barrier :

• HEPA filtration required and where vented to :

• HEPA Filtration Unit functioning properly with proper filter:

• HVAC, describe local or system isolation of work site :

Step 8: Consider potential risk of water damage. Is there a risk due to compromising structural integrity: (e.g. wall, ceiling, roof) Wall will be opened

Step 9: Work hours: Can or will the work be done during non-patient care hours? Duration of Project –how long will barriers be in place?

Step 10: Infection control considerations

• Clean and Soiled Utility Rooms:

• Hand washing sinks

• Support services space

• Negative pressure rooms

• Positive pressure rooms

Step 11: Plan to discuss the following containment issues with the project team:

• Traffic Flow (doors for entering/exiting site, elevators supplies, removing debris)

• Housekeeping (maintaining the work site)

• Debris removal (how and time) Off Tour

ATTACHMENT DPermit

Number: Infection Control Construction Permit

Location of Construction: Project Start Date:

Project Coordinator: Estimated Duration:

Contractor Performing Work: Permit Expiration Date:

Supervisor: Telephone:

YES NO CONSTRUCTION ACTIVITY YES NO INFECTION CONTROL RISK GROUP

TYPE A: Inspection, non-invasive activity. GROUP 1: Low Risk

TYPE B: Small scale, short duration, moderate to high levels.

GROUP 2: Medium Risk

TYPE C: Activity generates moderate to high levels of dust, requires greater 1 work

Shift for completion.

GROUP 3: Medium/High Risk

TYPE D: Major duration and construction activities requiring consecutive work shifts.

GROUP 4: Highest Risk

Class 1 1. Execute work by methods to minimize raising dust from construction operations. 3. Minor demolition for remodeling.

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

Class II 1. Provides active means to prevent air-borne dust from dispensing into atmosphere. 6. Contain construction waste before transport in tightly covered containers.

2. Water mist work surfaces to control dust while cutting. 7. Wet mop and/or vacuum with HEPA filtered vacuum before leaving work area.

3. Seal unused doors with duct tape. 8. Place dust mat at entrance and exit of work area.

4. Block off and seal air vents. 9. Remove or isolate HVAC system in areas

5. Wipe surfaces with disinfectant. where work is being performed.

Class III 1. Obtain infection control permit before construction 6. Vacuum work with HEPA filtered vacuums.

begins. 7. Wet mop with disinfectant.

Date: 2. Isolate HVAC system in area where work is being 8 Remove barrier materials carefully to minimize done to prevent contamination of the duct system. spreading of dirt and debris associated with

Initials: 3. Complete all critical barriers or implement control construction.

cube method before construction begins. 9. Contain construction waste before transport in

Initials: 4. Maintain negative air pressure within work site tightly covered containers.

utilizing HEPA equipped air filtration units. 10. Cover transport receptacles or carts. Tape

5. Do not remove barriers from work area until covering.

complete project is thoroughly cleaned by 11. Remove or isolate HVAC system in areas where

Environmental Services Department. work is being performed.

Class IV 1. Obtain infection control permit before construction 7. All personnel entering work site are required to begins. wear shoe covers.

2. Isolate HVAC system in areas where work is being 8. Do not remove barriers from work area until

Date: done to prevent contamination of duct systems. completed project is thoroughly cleaned by the

3. Complete all critical barriers or implement control Environmental Services Department.

Initials: cube method before construction beings. 9. Vacuum work area with HEPA filtered vacuums.

4. Maintain negative air pressure within work site 10. Wet mop with disinfectant.

utilizing HEPA equipped air filtration units. 11. Remove barrier materials carefully to minimize

Initials: 5. Seal holes, pipes, conduits, and punctures spreading of dirt and debris associated with appropriately. construction.

6. Construct anteroom and require all personnel to 12. Contain construction waste before transport in pass through this room so they can be vacuumed tightly covered containers.

using a HEPA vacuum cleaner before leaving work 13. Cover transport receptacles or carts. Tape covering site ore they can wear cloth or paper coveralls that 14. Remove or isolate HVAC system in areas where are removed each time they leave the work site. work is being done.

15 Manometers required to visually monitor negative air flow In highest risk areas. Daily readings during construction to be manually recorded by the contractor.

COTR Date

Infection Control Nurse Date

General Contractor Date

Director/Manager of Unit Date

Pre-Construction:

Conduct initial ICRA meeting to determine Level and Barrier type and placement

______Discuss routes for removal of trash and debris and time restrictions if necessary

______Pre inspection prior to start of work for Level 3 or 4 projects

______Other information pertinent to project

During Construction:

______Maintain precautions as directed on the ICRA form

______Contact Infection Prevention for review prior to any changes to approved design are completed

______Infection Prevention to complete weekly construction rounds of all projects that are Level 3 or 4

Post Construction Check List:

______All construction activities to be completed prior to starting any of the following steps. This includes all finishes and final touch ups by contactor. No work should be completed once the terminal clean process is initiated.

Contractor should perform terminal clean of construction debris.

______Contact EMS and Infection Prevention to schedule terminal clean. Internal barriers may be taken down but all exterior barriers should remain in place, and negative air remain in place, until terminal clean completed and inspected

______After clean is completed Infection Prevention to inspect site for all Level 3 or 4 projects to approve terminal clean is satisfactory

______Exterior barriers may be removed and EMS to do clean area where barriers have been removed.

ATTACHMENT F