Construction is an inevitability at healthcare facilities. Improvements and updates need to be made and construction can be a complex — and potentially dangerous — process within hospitals. Any size construction project can risk exposing patients to dust and mold spores, noise, vibrations, odors or chemicals.

Guide to Infection Prevention and Control within the Physical Environment

Luckily, by planning ahead and taking necessary precautions, you can protect vulnerable patients and still allow healthcare construction projects to move forward. Isolating large-scale projects and utilizing a relative negative pressure for construction sites can reduce many of the risks. However, where hospitals tend to make mistakes is by failing to take into consideration the specific needs of the adjacent areas, which could potentially have unique complexities.

To help minimize the dangers of hospital contamination, the Joint Commission requires hospitals to perform an Infection Control Risk Assessment (ICRA) and a Preconstruction Risk Assessment (PCRA). While ICRA identifies the risks of patient exposure and the impact to adjacent areas, PCRA assesses fire safety, air quality, and noise impact, etc.

However, despite the best intentions of these risk assessments, deficiencies in the process still happen. Let’s examine the types of problems that occur and how facility managers can handle them.

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Common Problems to Ensuring Healthcare Construction Site Infection Safety

1. Communication Breakdowns
   Successful compliance requires cooperation from a diverse and multidisciplinary group. In addition to facility managers and infection control practitioners, construction sites also have engineers, construction crews, and environmental health and safety officials. Each person involved has a different job and different priorities, so keeping everyone on track with the importance of infection prevention can be a difficult task.
2. Failure to Consider Adjacencies
   As mentioned above, this is a common mistake hospitals make. The pressurization of areas adjacent to, above, and below a construction site should be considered carefully to ensure monitoring goes beyond the corridor and extends to all potentially affected areas.
3. Lack of Monitoring
   It’s easy to get caught up in projects and fall out of a routine monitoring schedule. However, just like general pressurization is important to track and review, construction site pressurization also requires routine checks to stay compliant.

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What Facility Managers Can Do to Reduce Healthcare Construction Infection Risks

Now that the key problems have been identified, let’s go over the behaviors and practices facility managers can implement to avoid or solve them.

• Checklists: Compile a standardized checklist ranked by risk and make sure every member of your team has the information they need to address each potential risk before a problem occurs.
• Contractor “report cards”: Help your contractor know exactly what to expect before stepping foot in your hospital. If at all possible, hire a construction crew with experience working in sensitive areas. Setting expectations up front and following up with periodic “report cards” will help keep everyone on the same page.
• Holding meetings, acquiring permits, documenting: Be vigilant about communicating with your team and keep documentation of all necessary paperwork and processes.
• Routine audits: Plan to do at least weekly audits of the construction site to ensure ICRA standards are met and additional problems haven’t occurred.
• Automated monitoring: With 24/7 automated monitoring, there are multiple control measures put into place to contain and minimize contaminants. By providing advanced warning of a problem, an automated monitoring system can help your team respond and fix an issue before it negatively impacts patients, while also avoiding construction shut downs.

Having a plan in place — and ensuring that all parties involved are on board with that plan — will help keep your facility safe and your patients unharmed.

To learn more about protecting your facility and your patients from infections in the physical environment, download our free guide: