S02 ICRA Radiology HVAC .pdf

ATTACHMENT A

VAMC MEMORANDUM 517-2018-138-23, Construction Hazard Recognition Control Program

RISK ASSESSMENT MATRIX: IC GUIDELINES FOR CONSTRUCTION

CLASS CONSTRUCTION ACTIVITY RISK PRECAUTIONS REQUIRED

CLASS

I

Type A: Inspection and Non-Invasive Activities.

Includes, but not limited to:

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

2. Painting (but not sanding).

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

Low or Moderate

Risk Patients

Only High Risk Requires Class II

Precautions

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

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

CLASS

II

Type B: Small scale, short duration activities that create minimal dust.

Includes, but not limited to:

1. Access to chase spaces.

2. Cutting of walls or ceiling where dust migration can be controlled.

Low or Moderate

Risk Patients

Only High Risk Requires Class III

Precautions

1. Notify staff in the immediate area.

2. Provide active means to prevent airborne dust from dispersing into air.

3. Water mist work surfaces while cutting.

4. Seal unused doors with duct tape.

5. Block off and seal air vents.

6. Place dust mat at entrance/exit of area.

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

8. Upon completion, wipe work surfaces with disinfectant, wet mop and/or vacuum and remove isolation of the Heating, Ventilation and Air Conditioning (HVAC) system.

CLASS

III

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 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. Uncontained duct, HVAC or electrical work above ceiling.

5. Major cabling activities.

6. Any other project where high levels of dust are generated.

Moderate or High Risk Patients only Low Risk Requires Class II

Precautions

In addition to Class II Precautions above,

1. Obtain IC concurrence before construction begins.

2. Complete all critical barriers, i.e., sheetrock, plywood, plastic, to seal from non-work area or implement control cube method (cart with plastic covering/sealed connection to work site with vacuuming prior to exit) before construction begins.

3. Isolate HVAC system in area and maintain negative air pressure within work site.

4. Cover transport receptacles or carts.

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

6. Personnel are required to ensure shoes are not tracking when leaving the work site.

7. Upon completion, do not remove barriers until inspected by Safety and IC and thoroughly cleaned by FMS. Remove barrier materials carefully to minimize spreading of dirt and debris.

Attachment A, VAMC MEMORANDUM 517-2018-138-23, Construction Hazard Recognition Control Program

PATIENT RISK GROUP

Low Risk Group Medium Risk Group High Risk Group

Administrative Offices Lobbies Public Corridors Elevators Day Rooms Canteen Retail Store

Outpatient, Urgent Care and Primary Care Clinics Laboratory, Radiology and Nuclear Medicine Physical Therapy Respiratory Therapy Pharmacy Food Services Interim Care and Medical Units

SPD Storage/Sterilization Intensive Care Units TB Negative Pressure isolation rooms Operating Room

ATTACHMENT A1

ICRA Project Determination: _____________________________________________

CONSTRUCTION RISK REDUCTION PLAN

Location of Construction: Project Start Date:

Contractor Performing Work: Estimated Duration:

√ CONSTRUCTION ACTIVITY √ IC RISK GROUP

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

Type B: Small scale, short duration, moderate levels. Medium Risk

Type C: Major activity generates moderate to high levels of dust. High Risk

INFECTION CONTROL PRECAUTIONS

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

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

3. Seal unused doors with duct tape.

4. Block off and seal air vents.

5. Place dust mat at entrance and exit of work area.

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

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

CLASS

III

In addition to Class II Precautions above,

1. Obtain IC concurrence 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.

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

6. Personnel are required to ensure shoes are not tracking dust and soil when leaving the work site.

7. Upon completion, do not remove barriers until inspected by Safety and Infection Control and thoroughly cleaned by FMS. Remove barrier materials carefully to minimize spreading of dirt and debris.

Signatures:

Project Coordinator____________________________________ Date___________

FMSL Chief___________________________________________ Date___________

Signatures:

Safety Manager___________________________________ Date___________

Infection Control_________________________________ Date___________

Select Number

ATTACHMENT A2

INTERIM LIFE SAFETY MEASURES (ILSM)

√ CLASS ACTIVITY ILSM PRECAUTIONS

CLASS

I

Minor: No breech of fire detection, alarm or fighting systems. No egress or access blockage.

None required beyond routine general safety precautions.

Ensure egress. Ensure access for Emergency forces.

Ensure operational Life Safety Systems.

Prohibit smoking.

CLASS

II

Moderate: Short-term breech of fire detection, alarm or fighting systems < a single work shift. Blockage of egress or access but second means available.

In addition to Class I ILSMs, apply at-the-site measures.

Notify staff in the immediate area.

Control combustible loads.

Repair/construction staff immediately available at the site.

Compensate for compartmentalization deficiencies.

Each single breech of fire barrier immediately replaced.

CLASS

III

Major: Multiple or continuous breech of fire detection, alarm or fighting systems. Blockage of egress or access. Work > a single shift.

In addition to Class I and II ILSMs, obtain Safety Manager concurrence before construction begins.

Construct temporary smoke tight barriers of non-combustible materials.

Provide additional fire fighting equipment.

Designate alternative exit/access routes.

Increase Hazard Surveillance.

Provide additional education to applicable Medical Center Staff/Incident Response Team Conduct 2 fire drills per shift in local areas vs. all areas.

Notify Emergency Forces.

Utility failure issues:

Emergency procedures:

Additional Requirements (yes/no/NA,comments):

Air quality:

Noise:

Vibration:

Other issues not addressed above:

______________________________________________________________________________________________________ Signatures:

Project Coordinator________________________________ Date___________

FMSL Chief_______________________________________ Date___________

Signatures:

Safety Manager___________________________________ Date___________

Infection Control_________________________________ Date___________