S02 - PCRA ICRA Risk Assessment v2.pdf

PRE-CONSTRUCTION RISK ASSESSMENT (PCRA)

Project # 568A4-21-702

Project Title: EHRM Infrastructure Upgrades – Hot Springs, SD Est. Start Date: 10-1-2022

Area of Construction: Est. End Date: 10-1-2023

Contractor/Supervisor: Pending

PCRA Completed by: Russ Skovlund, Gene Ensor, and Mark Tupper.

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

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

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

Y 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

Y Will any temporary construction partitions be built? D

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:

Y Do areas involved have knowledge of construction?

List:

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:

Coordination with biomed will be needed.

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)

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.

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: The whole campus is affected. See attached spreadsheet

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

HOT SPRINGS VA MEDICAL CENTER

HOT SPRINGS, SOUTH DAKOTA

3/30/2022

Building Floor Area Description ICRA Hours Hours NOTES

Class Occupied G.C. Work

1 Basement Offices II 0800-1630 No restrictions

First Offices II 0800-1630 No restrictions

Second Offices II 0800-1630 No restrictions

Second Mental Health II 0800-1630 After 1700 hrs Area noted on drawings

Third Offices II 0800-1600 No restrictions

2 Sub-basment Offices II 0800-1600 No restrictions

Basement Offices II 0800-1600 No restrictions

First Dining II

Breakfast, lunch, diner After hours Work to be conducted after dining hours, coordinate with C.O.R.

First Kitchen III 0600-1800 After 1800 hrs After dining hours, coordinate with C.O.R.

Second Clinic II 0800-1630 After 1700 hrs

3 Basement Volunteers II No restrictions

First Nat. Call Center II No restrictions

Second Nat. Call Center II No restrictions

4 Basement Nat. Call Center II No restrictions

First Nat. Call Center II No restrictions

Second Nat. Call Center II No restrictions

5 Basement Kitchen III 0700-1430 After 1500 hrs After dining hours, coordinate with C.O.R.

Basement Retail II No restrictions

First Resident floor III 0-2400 0800-1630 hrs Patient area

Second Isolation Ward III 0-2400 0800-1630 hrs Occupancy may vary at time of construction, coordinate with C.O.R.

6 Basement DOM Quarters II 0700-1530 0700-1530 hrs Work cannot occur after hours.

First DOM Quarters II No restrictions

Second Patient Activities II Work around schedule of use, coordinate with C.O.R.

7 Basement Patient Activities II Work around schedule of use, coordinate with C.O.R.

First Resident floor III 0-2400 0800-1630 hrs Patient area

Second Resident floor III 0-2400 0800-1630 hrs Patient area

8 Basement Storage II 0800-1600 No restrictions

First Resident floor III 0-2400 0800-1630 hrs Patient area

Second Resident floor III 0-2400 0800-1630 hrs Patient area

9 Basement Storage II No restrictions

First Chapel II Sundays No restrictions No work on Sundays and religious holidays

10 Basement II No restrictions

First Chapel II Sundays No restrictions No work on Sundays and religious holidays

11 Basement Call Center II 0800-1630 After 1700 hrs Connector corridor work: no restrictions

First II No restrictions

Second II No restrictions

12 Basement Sector A: Clinic III 0800-1630 After 1700 hrs Area noted on drawings

Basement Sector A: Files II 0800-1630 No restrictions

Basement Sector C, D: Central

Sterile IV 0800-1630 After 1700 hrs

Area noted on drawings

Basement Sector C, D: Offices II No restrictions Area noted on drawings

Ground Sector A: Urgent Care III 0700-2000 After 2000 hours Area noted on drawings

Ground Sector A: Clinic III 0700-1630 After 1700 hrs Area noted on drawings

Ground Sector B: Imaging III 0800-1630 After 1700 hrs

Ground Sector B: Clinic III No restrictions

Ground Sector C, D: Comp. Rx IV 0800-1630 0800-1630 hrs Compounding Pharmacy; area noted on drawings

Ground Sector C, D: Rx IV 0800-1630 No restrictions Pharmacy

First Sector A: Acute Care IV 0-2400 0800-1630 hrs

First Sector B: Eye Clinic III 0800-1630 After 1700 hrs

First Sector C, D: Dental III 0800-1630 After 1700 hrs

First Sector C, D: Offices II No restrictions

Second Sector A: Sterile Strg IV 0800-1630 0800-1630 hrs Note area to be be coordinated indicated in drawings

Second Sector B: Dialysis IV High use Weekends Saturday after 1600 hrs to Monday 0500 hrs

Second Sector B: Offices II 0800-1630 0800-1630 hrs

Second Sector C, D: Sp. Clinic III 0800-1630 After 1700 hrs Area noted on drawings

Second Sector C, D: Dialysis IV High use Weekends Saturday after 1600 hrs to Monday 0500 hrs

Second Sector C, D: Offices II 0800-1630 0800-1630 hrs

Third Sector B: Offices II No restrictions

Third Sector C, D: Biomed II No restrictions

Third Sector C, D: Sleep Lab III 2000-0800 0800-1630 hrs

Third Sector C, D:Respiratory III 0800-1630 After 1700 hrs Area noted on drawings

Third Sector C, D: Admin II 0800-1630 After 1700 hrs Area noted on drawings

Fourth Lab Admin II No restrictions

Fourth Laboratory IV 0800-1630 0800-1630 hrs

Electronic Health Records Management (EHRM) Infrastructure Upgrades

Project No. 568A4-21-702

HOT SPRINGS VA MEDICAL CENTER

HOT SPRINGS, SOUTH DAKOTA

3/30/2022

Building Floor Area Description ICRA Hours Hours NOTES

Class Occupied G.C. Work

13 First Painter/pipefitter I No restrictions

14 First Engineering II No restrictions

17 First Garage I No restrictions

18 First Engineering I No restrictions

20 Basement Residence II No restrictions

First Residence II No restrictions

23 Basement Residence II No restrictions

29 Basement Residence III 0800-1630 0800-1630 hrs

43 Basement Laundry I 0800-1630 0800-1630 hrs

53 Basement II 0800-1630 0800-1630 hrs

Ground Kitchen III 0700-1430 After 1500 hrs After dining hours, coordinate with C.O.R.

First Call Center II 0800-1630 After 1700 hrs

First Library II No restrictions Coordinate with C.O.R.

65 Ground MCR III No restrictions

Ground Offices II 0800-1630 0800-1630 hrs

66 Ground Police, FD II 0800-1630 0800-1630 hrs

Electronic Health Records Management (EHRM) Infrastructure Upgrades

Project No. 568A4-21-702