VA261-17-R-1185-00004017.docx

Infection Control Risk Assessment Matrix of Precautions for Construction & Renovation STEP ONE: Using the following table, identify the Type (A-D) of Construction Project Activity.

Include, but are not limited to:

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

· Painting (but not sanding).

· Wall covering, electrical trim work, minor plumbing, and activities that do not generate dust or require cutting of walls or access to ceilings other than for visual inspection.

Include, but are not limited to:

· Installation of telephone and computer cabling.

· Access to chase spaces.

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

Includes, but is 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 ceilings.

· Major cabling activities.

· Any activity that cannot be completed within a single work shift.

Includes, but is not limited to:

· Activities that require consecutive work shifts.

· Requires heavy demolition or removal of a complete cabling system.

· New construction.

TYPE OF CONSTRUCTION PROJECT ACTIVITY: Type C (New card readers, door hardware, etc. at multiple locations throughout the facility plus running conduit to various IT spaces)

STEP TWO: 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.

· Echocardiography

· Endoscopy

· Nuclear Medicine

· Physical Therapy

· Radiology/MRI

· Respiratory Therapy

· Outpatient Clinics

· Emergency Room

· Labor & Delivery

· Clinical Laboratories

· Pediatrics

· Pharmacy

· Post Anesthesia Care Unit

· Surgical Units

· Any area caring for immuno-compromised patients

· Burn Unit

· Cardiac Cath Lab

· Supply, Processing, and Distribution

· All inpatient medical or surgical units

· Medical Unit

· Negative pressure isolation rooms

· Outpatient chemotherapy areas

· Operating Rooms

PATIENT RISK GROUP: Highest Risk (Inside all buildings, including CLC, ED, IPP, OPP, Office Areas)

STEP THREE: Match the… Patient Risk Group (Low, Medium, High, Highest) with the planned Construction Project Type (A, B, C, D) on the following matrix, to find the Class of Precautions (I, II, III, or IV) or level of infection control activities required.

(Class I-IV or Color-Coded Precautions are delineated on the following table.)

IC Matrix Class of Precautions: Construction Project by Patient Risk Construction Project Type

Note: Infection Control approval is required for all construction or renovation activities.

CLASS OF PRECAUTIONS: III/IV (pink)

Description of Required Infection Control Precautions by Class

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

Clean up any dust that may have been generated with HEPA filtered vacuum or damp mop.

2. Remove or isolate HVAC system in areas where work is being performed.

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 tacky mat at entrance and exit of work area and change frequently or when ineffective.

1. Wet mop and/or vacuum with HEPA-filtered vacuum before leaving work area and wipe work surfaces with disinfectant.

2. Contain construction waste before transport in tightly covered containers. Tape may be used to ensure a tight cover.

3. Remove isolation of HVAC system in areas when work has been completed.

1. Complete all critical barriers, i.e., sheetrock, plywood, plastic, to seal area from non-work area or implement control cube method before construction begins.

2. Maintain negative air pressure (NPV) within the work site utilizing HEPA-equipped air filtration units.

3. NPV monitoring devices should be visible from outside the worksite and readings should be documented daily or more often as needed.

4. Contain construction waste before transport in tightly covered containers. Tape covering unless solid lid.

As above and:

1. Remove barrier materials carefully to minimize spreading of dirt and debris associated with construction.

2. Do not remove barriers from work area until completed project is thoroughly cleaned by Environmental Management Services Department and inspected by FMS, Safety and Infection Control.

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

2. 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.

3. All personnel entering work site are required to wear shoe covers. Shoe covers must be changed each time the worker exits the work area.

As above

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

Risk Group Up to Highest Risk Group Up to Highest Risk Group Up to Highest Risk Group Up to Highest Risk Group Up to Highest Risk Group Up to Highest

STEP 5: Identify specific site of activity, e.g., patient rooms, medication room, etc.All areas of the facility (Bldg 12, 1D, 1, 1A, 10, 6, 15)

STEP 6: Identify issues related to: ventilation, plumbing, and electrical, in terms of the occurrence of probable outages.Some minor/small-scale outages will be required to connect to 120V power. Other than that, it is all low voltage and no outages needed.

STEP 7: Identify containment measures using prior assessment. What types of barriers (e.g. solid wall barriers)? Will HEPA filtration be required?Construction barriers will be put in place at the current location of work to ensure patient and staff safety at all times.

Note: Renovation/construction area shall be isolated from the occupied areas during construction and shall be negative with respect to surrounding areas.

STEP 8: Consider potential risk of water damage. Is there a risk due to compromising structural integrity (e.g., wall, ceiling, roof)?No risk

STEP 9: Work hours: Can or will the work be done during non-patient-care hours?All work will be done on a not-to-interfere basis with regards to patient care.

STEP 10: Do plans allow for adequate number of isolation/negative airflow rooms?Negative air machines are neither practical nor feasible for this type of work. Temporary barriers will be required at the current location of work.

STEP 11: Do the plans allow for the required number and type of hand washing sinks?Yes, hand washing sinks are available.

STEP 12: Does the infection control staff agree with the minimum number of sinks for this project? (Verify against the American Institute of Architects Guidelines for types and area.)N/A (Project does not involve installing any sinks)

STEP 13: Does the infection control staff agree with the plans relative to clean and soiled utility rooms?Yes, impact is low due to work location

STEP 14: Plan to discuss the following containment issues with the project team: traffic flow, housekeeping, and debris removal (how and when).Debris removal will be covered as part of general project cleanup

Risk for Tuberculosis (TB): HIGH X LOW

If HIGH risk, was TB test documentation received from contractor?

YES NO X NA

Comments:

The ICRA may be modified throughout the project. Revisions must be communicated to the Project Manager.

Infection Control Construction Permit

TYPE A: Inspection, non-invasive activity

GROUP 1: Low Risk

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

GROUP 2: Medium Risk

X

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 X

GROUP 4: Highest Risk

CLASS I

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

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

3. Minor Demolition for Remodeling.

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. Wipe surfaces with disinfectant.

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

7. Wet mop and/or vacuum with HEPA filtered vacuum before leaving work area.

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

9. Remove or isolate HVAC system in areas where work is being performed.

CLASS III

1. Obtain infection control permit before construction begins.

2. Isolate HVAC system in area where work is being done to prevent contamination of the duct system.

3. Complete all critical barriers or implement control cube method before construction begins.

4. Vacuum work with HEPA filtered vacuums.

5. Wet mop with disinfectant.

6. Remove barrier materials carefully to minimize spreading of dirt and debris associated with construction.

7. Contain construction waste before transport in.

8. Maintain negative air pressure within work site utilizing HEPA equipped air filtration units.

9. Do not remove barriers from work area until complete project is thoroughly cleaned by the Environmental Care, FMS.

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

11. Cover transport receptacles or carts. Tape covering unless solid lid.

12. Remove or isolate HVAC system in areas where work is being performed.

CLASS IV

1. Obtain infection control permit before construction begins.

2. Isolate HVAC system in area where work is being done to prevent contamination of duct system.

3. Complete all critical barriers or implement control cube method before construction begins.

4. Maintain negative air pressure within work site utilizing HEPA equipped air filtration units. N/A

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

6. Construct anteroom. Require all personnel to pass through this room to 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.

7. All personnel entering work site are required to wear shoe covers.

8. Do not remove barriers from work area until completed project is thoroughly cleaned by the Environmental Care, FMS.

9. Vacuum work area with HEPA filtered vacuums.

10. Wet mop with disinfectant.

11. Remove barrier materials carefully to minimize spreading of dirt and debris associated with construction.

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

13. Cover transport receptacles or carts. Tape covering unless solid lid.

14. Remove or isolate HVAC system in areas where work is being done.

Additional Requirements:

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