Hospital Infection Prevention & Control Issues for Construction

Projects

What you need to know to:

Protect our patients

Protect yourself

Marsha Barnden, RNC, MSN, CIC

Corporate Director Infection Prevention & Clinical Standards

Adventist Health

PROTECTING THE PATIENT

Hospital Construction Projects are different from

other work sites • Sick patients are in the hospital and these patients

can be more susceptible to infectious diseases

Some areas in the hospital contain very ill patients who are highly susceptible to infections

Examples of these high risk areas are the Nursery, NICU, cancer unit, surgical areas, burn unit, and ICUs

Operating Rooms

NICU

Patient Care Units

I’m working in a hospital with sick patients, but I don’t work with the patients, so what is the connection between my work and patient

safety?

Bacteria and fungus can grow in dust, drywall, beneath carpeting, old wood structures, in the ceiling space above ceiling tiles, and any area that has been

wet and dried or any wet areas where water has collected.

Activities that “stir up” dust and debris or stagnant water can send fungus and bacteria into the air (aerosolization) and, if precautions are not taken, into a patient who may come in contact with these

organisms.

Infection with these organisms can be fatal to the patient.

Exposure to these organisms rarely pose a risk for a healthy person.

Two environmental organisms of concern to hospitals:

Aspergillus•a fungus•found in dust, walls, ceilings, debris•spread by activities that stir up dust & dirt, such as knocking out walls, removing ceiling tile, working in air handling system•causes pneumonia, wound infections, bloodstream infections

Legionella•a bacteria•found in stagnant standing water•cooling towers, water supply lines, air conditioning systems•spread by aerosolized water•causes pneumonia and lung infections

What can we do to keep our patients from getting exposed to these “bugs’?

1. Educate healthcare & construction workers

2. Carefully evaluate job sites and determine what must be done to protect the patients: Identify risks

Take necessary actions to protect patients, employees and visitors

Ways to protect patients during construction/renovation

• Patients may have to be relocated during construction.

Barriers: Either solid wall or heavy plastic may be needed to keep construction area and

patient areas separated.

Walk off mats both inside and outside of entry into site are needed to trap dust off shoes.

Debris to be removed from site must be covered.

• In some cases, air pumps with hoses to the outside may be needed to create a negative pressure work area (in relation to the patient area). Opening windows in this area creates the opposite effect. Windows should remain closed .

Maintenance should be aware of any work involving water supply system.

Wet construction materials may have to be replaced.

Immediate cleanup of flooded areas

Water reservoirs may need to be drained or flushed before area can be occupied by

patients.

Hospitals are required to monitor construction sites to assure patient

safety• Air sampling for the presence of mold and fungus may be

done in and around the construction area.

• Hospital monitoring for compliance to Infection Control & Safety polices is ongoing during the project.

TB Testing and Immunizations

• Provide Employee Health with a copy of current TB test results.

• TB testing is available in Employee Health.

• Provide Employee Health with a copy of your immunization records.

PROTECTING YOURSELF

What could be a risk for me while working

on a hospital construction site? • Accidental exposure to contaminated

materials during demolition-

How can I identify“contaminated materials” ?

What do I do if I find needles, needleboxes, red bag waste, body fluid spills at my job site?

Contact your Supervisor.Hospital staff will be responsible for removing the biohazardous objects.

What do I do if I accidentally get a needlestick injury or exposure to body

fluids?

Contact you Supervisor immediately to arrange medical evaluation.

Flush exposed area with water.

Emergency Codes at XYZ: To familiarize yourself with how to respond when an emergency code is announced overhead.

Code Triage – Emergency Operations Plan (EOP) Activation

Announced when an emergency situation exists. The emergency should be announced as “internal” or “external.” The announcement is made three times and should include the number of expected casualties and the estimated time of arrival (ETA).

Code Triage – Standby Called when an emergency requires preparation/analysis of the situation at hand, if time permits. If a true disaster exists and requires EOP activation, then the above Code Triage – EOP Activation is announced and followed.

Code Red Called in the event of a fire, followed by the location of the fire. Is announced three times with the location specified in each announcement. If in an area adjacent to the location, evacuate your area.

Code Blue Announced when a patient has a respiratory/cardiac arrest. The location of the event is announced three times with the code.

MET Team Announced when a patient has a significant change in condition based on established criteria. A specialized team of ICU and Respiratory personnel respond.

Severe/Inclement Weather

Announced when the National Oceanic and Atmospheric Administration (NOAA) issues a severe weather watch/warning for Rockdale County. A “warning” is issued only when a tornado or other severe weather has actually been sighted, either visually or by radar. A “watch” is issued when weather conditions are favorable such that a tornado or severe weather may develop. Also includes Inclement Weather plan for staffing.

Code Grey Any situation requiring security including a facility Lockdown, Civil Disturbance or Bomb Threat situation. Include location and announce three times.

Code Silver An Active Shooter is identified on campus. Staff are to secure area, remain in place and take cover. Include location and announce three times.

Code Pink Kidnapping situation and is usually related to infant abductions. Include location and announce three times.

Code Orange Hazardous materials release, including radiation/nuclear spills and chemical containment. Include location of the spill and announce three times.

Code CDC In the event of a Bioterrorism Event, Code Orange will be announced first followed by the Code CDC announcement, repeated three times.

Welcome to your work site at XYZ Medical Center

Your work here is helping us make a better place for our patients.

If you have questions on any information you have just viewed, contact your Supervisor or

the Infection Prevention and Control Department at ext XYZ.