Infection Control Construction Spec.pdf

INFECTION CONTROL MANUAL CONSTRUCTION SPECIFICATIONS

VAMC, PROVIDENCE, RI FOR INFECTION CONTROL-1

1. PURPOSE

To minimize the risk of infection during construction by maintaining the integrity of the environment.

2. APPLICATION

Will be determined by Chief of Facilities Management Service and Nurse Epidemiologist.

3. EQUIPMENT REQUIRED

Sheet fire retardant polyethylene, or other impervious barrier material, “air moving and filtration devices”, duct tape, clips, framing, and other materials or devices as needed. Sanders, power saws, etc. will have and will use built in dust collections systems as outlined in the construction specifications.

4. COMMUNICATIONS

a. The manager of the department where the work will take place, Facilities Management Services, Police and Security Service, Office of Safety and Infection Control Department will be notified of and /or involved in (as appropriate) the project prior to the start of work, including pre-construction meetings.

b. Problems relating to infection control that arise, at any time, will be reported to the coordinator or to the department manager, as soon as possible.

5. PROCEDURE

The area in which the construction will occur shall be isolated from the adjacent areas in the following manner unless an exception is authorized by the service chief of the area under construction.

a. Determine if the HVAC system includes return air from the construction area. If so, divert to exhaust, if possible, add filtering to remove dust before it enters the return air system, or block off supply and exhaust grills (closed and covered).

b. Install impervious barriers from floor slab above and wall to wall using framing, clips, and duct tape, as required, to maintain and secure the barrier seal.

VAMC, PROVIDENCE, RI FOR INFECTION CONTROL-2

c. When work is in an extremely sensitive area such as the OR, double impervious barriers may be used.

d. When ceiling envelopes, chases, and/or spaces are penetrated; barriers will be installed to contain movement of air and debris.

e. Windows must be closed and air ducts shut down or capped, when appropriate.

f. Anterooms (consisting of confined space beyond the barrier) will be provided at entrances to work areas to contain debris and provide workers an area to remove protective clothing or vacuum off clothing except when workers exit directly to the outside of the building. Compressed air will not be used to remove dust from clothing.

g. Walk-off mats will be at the entrance to work areas during construction.

h. Traffic will be minimized to and from the construction site. Alternative travel routes will be planned, as necessary.

i. If elevators or stairways are within the field of construction, they must have proper barriers installed.

j. Water damaged areas should be demolitioned first. This will be done under HEPA filter exhaust and containment. Waste will be bagged. This will reduce aerosol of microbial agent/fungi/spore escaping during the demolition and transport of this material out of constructions site.

k. The “air moving and filtration device” will be placed into the construction/containment area and will operate to remove dust particles from air and exhaust to the outside.

l. Negative pressure may be maintained in the construction site, and a daily record maintained during construction.

m. Before any construction begins, workers will receive a mandatory infection control handout for training and instructions.

n. Daily inspections will be conducted and documented during construction activities, by construction management, for contractor compliance with infection control requirements.

VAMC, PROVIDENCE, RI FOR INFECTION CONTROL-3

o. Disruption, violation of barrier integrity, or loss of negative air must be reported to the project manager immediately.

The following are examples of other methods which may be requested as appropriate to specific tasks and circumstances:

1. Water misting of work surfaces to control dust during cutting, sweeping, and tasks which generate dust.

2. Shutting down or covering air vents to construction areas during demolition activities prior to the beginning of construction and for the duration of the project.

3. Using a ceiling access procedure with a mini-enclosure around the work area when construction activities are required in patient care areas outside of the construction site.

4. Sealing all construction, holes, pipes, conduits, punctures, and/or exposures appropriately.

5. Vacuum off clothes with a filtered vacuum cleaner prior to exiting the work site.

6. Requiring workers to wear clean shoe covers each time they exit the work site when they travel to another area of the facility is necessary.

7. When appropriate, construction barricade entrances will have gasketed doors with self-closing, latching hardware, and dampened wall-off mats.

Environmental Cleaning

1. Any dust tracked outside of the barrier must be removed immediately and as it accumulates.

2. Cleaning in construction areas will be accomplished so as to minimize aerosolizing dust particles and may include use of resin control, damp mop, moist broom and /or HEPA filtered vacuum cleaner. Shovels and broader methods may be used to remove large debris.

3. Debris removal from construction sites must be by a pre-determined route.

4. Debris will be transported in clean containers with tight fitting covers.

5. When construction is complete, a thorough clean up of the area is to be done by construction personnel prior to turnover to Facilities Management Services for final cleaning and dust barrier removal.

VAMC, PROVIDENCE, RI FOR INFECTION CONTROL-4

6. The contractor will ensure that gross soiling is removed prior to removal of barriers.

7. Facilities Management Services will treat barriers as debris (above) and remove them in a manner designed to minimize distribution of particles.

8. Thorough final cleaning of all surfaces will be done by Facilities Management Services before the area is used to provide patient care.

2/15/00 Reviewed 08/18/03, 3/22/04 Revised- 3/15/01, 4/25/05

VA MEDICAL CENTER

Infection Control Program

INFECTION CONTROL FOR CONSTRUCTION WORKERS

WHY INFECTION CONTROL IS IMPORTANT

Hospital-acquired infections (nosocomial) affect 5 percent of all patients admitted to hospitals in the United States and can cause significant illness or even death. Not all of these infections are preventable; however, studies show that up to 32 percent of hospital acquired infections can be prevented when hospitals employ an active and effective infections control program. Hospitals patients are at risk for infection because the stresses of illness and invasive treatments weaken their immune system. In general, healthy adults who are to be at work do not have the same risk for acquiring infections.

Our Infection Control Program is designed to identify and control situations that carry an increased risk for infection and to provide for a safe and healthful environment for patients and staff. During the construction project, you may be asked to do some things a bit differently to ensure that the environment is maintained as safe as possible for all. This information was developed through collaboration with the Infection Control Coordinator, Chief FMS, Safety Officer and Industrial Hygienist to help in explaining infection control aspects of construction in the hospital setting.

DUST CONTROL POLICY

Determine if the HVAC system includes return air from the construction area. If so, divert to exhaust if possible, add filtering to remove dust before it enters the return air system, or blocking supply and return vents.

Install impervious barriers from floor to floor slab above and wall to wall using framing, clips and duct tape as required to maintain and secure the barrier seal.

Report disruptions such as holes in the barrier and interruptions in the seal to the project manager immediately.

Place the “air moving and filtration device” into the containment area and operate to remove dust particles from the air.

Negative air pressure will always be maintained in the construction site at all times during construction.

If work is in an extremely sensitive area such as the Operating Room, double barriers may be required.

Project site must be completely contained before work begins and all penetrations into the construction site must be sealed. Windows must be closed and air ducts shut down or taped.

Anterooms (consisting of confined space beyond the barriers) will be provided at entrances to the work area to contain debris and provide an area where workers can remove protective clothing or vacuum off personal clothing except when exiting directly to the outside of the building.

Walk-off mats will be at entrances to work areas during construction.

Traffic routes will be pre-determine and traffic to and from the construction site will be minimized.

ENVIRONMENTAL CLEANING POLICY

Any dust tracked outside the barriers must be removed immediately as it accumulates.

All cleaning in the construction area will be by damp method or HEPA filtered vacuum.

Debris will be removed by a pre-determined route and transported in clean, covered containers.

At the end of each construction shift, construction personnel will do a thorough clean up of the area.

After inspection, the contractor will remove barriers.

Environmental Services will do a thorough final cleaning.

Thank you for participating in our effort to provide a safe hospital environment. If you have concerns or questions about infection control, please call the Infection Control Office at extension 3608.

VA MEDICAL CENTER

INFECTION CONTROL PROGRAM

INFECTION CONTROL COMPLIANCE CHECKLIST

Project: ______________________________ Date: ____________________

Time Start: ___________________________ Time End: ________________

The following are checked at least daily during demolition and/or construction:

1. Barrier containment competed before construction began.

2. Negative air pressure at construction site was monitored and recorded, at least daily, during construction work.

3. Construction area air exhausted directly outside or HEPA filtered to remove dust before the return to the HVAC system.

4. Air moving and HEPA filtration device placed into the construction area to remove and prevent the escape of dust and fungal particles.

5. All construction holes, pipes, conduits, punctures and/or exposures appropriately sealed.

6. Construction workers put on coveralls for entering the work site or vacuum off work clothes with a HEPA vacuum cleaner prior to exiting the work area.

7. Work surfaces water-misted to control dust while cutting.

8. Dust mats placed at entrance to work area at all times.

9. Workers wore clean shoe covers each time they exited the work area to travel to other areas of the facility (or no travel to other areas was necessary).

10. Dust tracked outside the barrier was removed immediately by damp-mop method or with

HEPA filtered vacuum cleaners.

11. Debris was transported from the construction area by the pre-determined route in clean containers with tight-fitting covers.

12. Designated debris routes were cleaned by damp-mop method or with HEPA filtered vacuum cleaners prior to being returned to patient or staff use.

13. Any disruption or violation of the containment barrier integrity was immediately reported to the Project Manager.

14. The freight elevator should not transport supplies or contractors to the 7th floor. All contractors will exit on the 6th floor to minimize traffic going to the 7th floor.

Above items checked (by initials) at the following times:

Compliance Checklist Submitted By:________________________________________

COMMENTS: ___________________________________________________________