Here are 11 infection-control measures and their accompanying recommended steps for implementation for internal construction and repair projects, according to the Centers for Disease Control and Prevention.
1. Prepare for the project:
- Use a multi-disciplinary team approach to incorporate infection control into the project.
- Conduct the risk assessment and a preliminary walk-through with project managers and staff.
2. Educate staff and construction workers:
- Educate staff and construction workers about the importance of adhering to infection-control measures during the project.
- Provide educational materials in the language of the workers.
- Include language in the construction contract requiring construction workers and subcontractors to participate in infection-control training.
3. Issue hazard and warning notice:
- Post signs to identify construction areas and potential hazards.
- Mark detours requiring pedestrians to avoid the work area.
4. Relocate high-risk patients as needed, especially if the construction is in or adjacent to a PE area:
- Identify target patient populations for relocation based on the risk assessment.
- Arrange for the transfer in advance to avoid delays.
- At-risk patients should wear protective respiratory equipment (e.g., a high-efficiency mask) when outside their PE rooms.
5. Establish alternative traffic patterns for staff, patients, visitors, and construction workers:
- Determine appropriate alternate routes from the risk assessment.
- Designate areas (e.g., hallways, elevators, and entrances/exits) for construction worker use.
- Do not transport patients on the same elevator with construction materials and debris
6. Erect appropriate barrier containment:
- Use prefabricated plastic units or plastic sheeting for short-term projects that will generate minimal dust.
- Use durable rigid barriers for ongoing, long-term projects.
7. Establish proper ventilation:
- Shut off return air vents in the construction zone, if possible, and seal around grilles.
- Exhaust air and dust to the outside, if possible.
- If recirculated air from the construction zone is unavoidable, use a pre-filter and a HEPA filter before the air returns to the HVAC system.
- When vibration-related work is being done that may dislodge dust in the ventilation system or when modifications are made to ductwork serving occupied spaces, install filters on the supply air grilles temporarily.
- Set pressure differentials so that the contained work area is under negative pressure.
- Use air flow monitoring devices to verify the direction of the air pattern.
- Exhaust air and dust to the outside, if possible.
- Monitor temperature, air changes per hour (ACH), and humidity levels (humidity levels should be <65%).
- Use portable, industrial grade HEPA filters in the adjacent area and/or the construction zone for additional ACH.
- Keep windows closed, if possible.
8. Control solid debris:
- When replacing filters, place the old filter in a bag prior to transport and dispose as a routine solid waste.
- Clean the construction zone daily or more often as needed.
- Designate a removal route for small quantities of solid debris.
- Mist debris and cover disposal carts before transport (i.e., leaving the construction zone).
- Designate an elevator for construction crew use.
- Use window chutes and negative pressure equipment for removal of larger pieces of debris while maintaining pressure differentials in the construction zone.
- Schedule debris removal to periods when patient exposures to dust is minimal.
9. Control water damage:
- Make provisions for dry storage of building materials.
- Do not install wet, porous building materials (i.e., sheet rock).
- Replace water-damaged porous building materials if they cannot be completely dried out within 72 hours.
10. Control dust in air and on surfaces:
- Monitor the construction area daily for compliance with the infection-control plan.
- Protective outer clothing for construction workers should be removed before entering clean areas.
- Use mats with tacky surfaces within the construction zone at the entry; cover sufficient area so that both feet make contact with the mat while walking through the entry.
- Construct an anteroom as needed where coveralls can be donned and removed.
- Clean the construction zone and all areas used by construction workers with a wet mop.
- If the area is carpeted, vacuum daily with a HEPA-filtered–equipped vacuum.
- Provide temporary essential services (e.g., toilets) and worker conveniences (e.g., vending machines) in the construction zone as appropriate.
- Damp-wipe tools if removed from the construction zone or left in the area.
- Ensure that construction barriers remain well sealed; use particle sampling as needed.
- Ensure that the clinical laboratory is free from dust contamination.
11. Complete the project:
- Flush the main water system to clear dust-contaminated lines.
- Terminally clean the construction zone before the construction barriers are removed.
- Check for visible mold and mildew and eliminate (i.e., decontaminate and remove), if present.
- Verify appropriate ventilation parameters for the new area as needed.
- Do not accept ventilation deficiencies, especially in special care areas.
- Clean or replace HVAC filters using proper dust-containment procedures.
- Remove the barriers and clean the area of any dust generated during this work.
- Ensure that the designated air balances in the operating rooms (OR) and protective environments (PE) are achieved before occupancy.
- Commission the space as indicated, especially in the OR and PE, ensuring that the room's required engineering specifications are met.
Source: CDC
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Read more insight on infection prevention and control:
- Environmental Cleaning and Disinfection: What Infection Preventionists Need to Know
- Top 10 Patient Safety Issues for 2011
- 10 Things to Know about Proper Hand Hygiene
