S02 SOL 0026 AttA-SOW.09) Infection Control Risk Assessment (ICRA).pdf

Infection Control Risk Assessment for Construction / Renovation Projects Project Name: Replace Steam Line South Leg Project or Work-Order Number: 578-17-027 Project Manager or COR: Martin Jensen Extension: 20920 Building Number: Exterior and 217/221 roof Floor(s)/Room(s): South Campus Start date: Projected completion date:

Construction Activity Infection Control Risk Group ☐ TYPE A: DUST LEVEL Low

Non-invasive activity, low noise, no vibration.

☒ GROUP 1: LOW

Office areas, FMS areas, all non-patient care areas.

☐ TYPE B: DUST LEVEL: Moderate to High Small scale, short duration, low-moderate noise, low-moderate vibration.

☐ GROUP 2: MEDIUM

All other patient care areas including general medicine floors, ultrasound, Rehab, Occupational Therapy.

☐ TYPE C: DUST LEVEL Moderate to High Requires more than one work shift (independent of working days) to complete, low-moderate noise, moderate–high vibration

☐ GROUP 3: MEDIUM/HIGH

ED, Radiology/MRI, admissions, food service areas, laboratories.

☒ TYPE D: DUST LEVEL High Major demolition and construction activities. Requires consecutive work shifts, moderate-high noise, moderate-high vibration

☐ GROUP 4: HIGHEST

Operating rooms, SPS, ICU’s, Outpatient areas, oncology, anesthesia, post anesthetic recovery, all endoscope areas, Pharmacy, Renal Dialysis

Project Class Determination Matrix Construction Activity Type Risk Group

Type “A”

Type “B”

Type “C”

Type “D”

Group 1 I II II III Group 2 I II III IV Group 3 I III III IV Group 4 III IV IV IV

Contractors Actions by Project Class All personnel will have Emergency Preparedness training/posting/ID card.

CLASS

I

1. Execute work to minimize air-borne dust dispersed into atmosphere from construction operations.

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

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

4. Clean work area upon completion of task including wiping surfaces with disinfectant.

5. Contact EMS for appropriate preparation for return to operation(s).

CLASS

II

In addition to above:

6. Post the signed ICRA at the entrance.

7. Isolate work area from patients/staff. Use appropriate temporary barriers and more permanent containment methods (i.e., seal holes in walls, tape gaps in doors, etc.)

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

9. Block off and seal supply air vents. Place filter over return/exhaust vents.

10. Place dust mat or wipe feet at entrance/exit of work area.

11. Wet mop and/or vacuum w/HEPA filtered vacuum before leaving work areas.

CLASS

III

In addition to above:

12. Install barriers to create a negative pressure ante room and/or workroom.

13. Maintain negative air pressure in work area at all times until completion utilizing HEPA-equipped air filtration units.

14. Vacuum personnel with HEPA vacuum before leaving. Or, Don-Doff coveralls each time leaving work site. All wear shoe covers changed each time exiting the area.

15. Vacuum the entire work area with HEPA vacuums or wet mop with disinfectant at the completion of project.

16. Do not remove barriers until completed project is inspected by Safety, IC-Team, EMS, and Area Manager.

17. Carefully remove barriers to minimize spread of dirt and debris. Contact EMS for final clean.

CLASS

IV

In addition to above:

18. Provide a disinfectant wipe down of any tool carts or waste transports prior to leaving the containment area.

19. Do not remove barriers until terminal clean is performed inside work zone and barriers are included in the cleaning process.

20. Perform 2nd terminal cleaning after removal of barriers. Contact EMS for final clean.

Signatures Date Contractor’s Signature:

(Projects Only)

Project Planner or Maintenance Worker Signature:

Supervisor Signature:

Infection Control:

Construction Activity