Infection Control Risk Assessment Guidelines and Standards Richard Vogel - Infection Control Specialist

FGI Guidelines 2 For new construction Minimum guidelines Source of information for ICPs in planning, design, and implementation of Infection Prevention and Control requirements in construction projects In 2014 edition. Infection Control (ICRA) is now included in the Safety Risk Assessment (SRA)

ICRA Requirements ICRA Requirement. For a health care facility project to support safe designs, HVAC/plumbing systems, and surfaces and finishing material selections, an infection control risk assessment shall be a part of integrated facility planning, design, construction, and commissioning activities and shall be incorporated into the safety risk assessment ICRA Considerations. At a minimum, the ICRA shall address the following: Design Elements Isolation Rooms HVAC needs Water/plumbing systems Surfaces and furnishings Construction Elements Infection Control Risk Mitigation Requirements

2010 FGI Guidelines Infection Control Risk Assessment (ICRA ) The infection control risk assessment is a multidisciplinary, documented assessment process intended to proactively identify and mitigate risks from infection that could occur during construction activities. This process identifies and takes into account the patient population at risk, the nature and scope of the project, and the functional program of the health care facility. The ICRA determines the potential risk of transmission of various air and waterborne biological contaminants in the facility

2010 FGI Guidelines ICRA Requirement For a health care facility project to support safe designs, finishes, surfaces, and HVAC/plumbing systems, an infection control assessment shall be a part of an integrated facility planning, design, construction, and commissioning activities ICRA Timing An ICRA shall be conducted during the early planning phase of a project, before construction begins, and continue through the project construction and commissioning.

2010 FGI Guidelines ICRA Recommendations Based on the results of the initial stage of the ICRA, the owner shall provide the following recommendations for incorporation in the functional program: (1) Design recommendations generated by the ICRA (2) Infection Control Risk Mitigation Recommendations (ICRMRs)

Determining Dust Control Measures STEP 1: Type of Construction STEP 2: Identify the Risk Group STEP 3: Project Class  How big is the construction project?  How ill/frail are the patients?  In-patient area/ High risk ambulatory?  Non-patient area?  Ambulatory Patient / Patient access area?  Major renovation?  Minor repair?

Design Elements  Design Elements :  Airborne and Protective Isolation Rooms  Hand Hygiene  HVAC  Surfaces and Finishes  Impact on Water Systems ICRA Considerations The ICRA shall address, but not limited to covering, the following:

Design Elements

ICRA Compliance  Infection Control Risk Mitigation Recommendations (ICRMR)  Monitoring Plan  Daily/weekly checklist to verify described methods are in place  Plans which describes specific methods by which transmission of contaminates will be avoided  Barriers, negative pressure, sticky mats, HEPA filters, etc  Communication  Report checklist findings to Infection Control/Safety Committee Compliance Elements ICRA Documentation This written record shall remain an active part of the project documents for the duration of the construction project and through commissioning.

Dust Control Measures Patient placement Barriers and other protective measures Protection from demolition Training Debris and traffic flow Bathrooms and food for construction workers Infection Control Risk Mitigation ICRMR Planning Infection control mitigation recommendations (ICRMRs) shall be prepared by the ICRA team and shall, at a minimum, address the following:

Prevention is the best cure