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by HEPACART on Aug 19, 2020
Always take precautions to contain airborne dust and pathogens in healthcare facilities.
A fundamental difference between healthcare construction and others is that in healthcare, you're working in the presence of vulnerable patients. Expansion and renovation in any occupied structure pose challenges, but in hospitals, the danger of airborne dust and pathogens spreading healthcare-associated infections (HAI) must be heeded at all times. This calls for a strong commitment to dust containment for any size project, whether pulling new data cables through a drop ceiling or adding a new hospital wing.
Contractors experienced in healthcare construction know the extraordinary level of detail involved in successfully planning and executing a project, and have developed their own checklists. We've reviewed a few of them, and have summarized some basic steps.
- Investigate
- Plan
- Communicate
- Monitor
- Document
1. Construction Contractors Should Investigate
Before beginning work, your construction team should conduct a preliminary investigation. This will include visits to the location to confirm the location of electrical utilities, plumbing, and other physical characteristics of the space.
Also, it is important to be on the lookout for issues unique to the project at hand, such as lead paint, asbestos, or other hazardous materials. While on location, the contractor should meet with the hospital infection control team, which typically can include representatives from nursing, hospital administration, environmental services, information technology, and public safety, to establish a good working relationship.
Ensuring compliance with infection control protocols is just one goal of these meetings; another is to improve the patient experience by minimizing the inconveniences normally associated with construction, such as noise, vibration, altered traffic routes, and temporary closures.
2. Construction Contractors Should Plan
After you've gathered sufficient facility information and established a rapport with key hospital personnel, it's time for some planning. The construction team and hospital teams should meet for an infection control risk assessment that will cover everything from scope and duration of the project to air monitoring, filtration plan and procedures, personal protection equipment, temporary partition types, daily documentation, and final cleaning. The ICRA Matrix of Precautions for Construction & Renovation aids in determining the extent of precautions needed, depending on the project's size and proximity to vulnerable patients.
Another essential planning document is the interim life safety plan (ILSP), which the contractor should draft and submit to the facility for approval. An ILSP covers such matters as emergency egress, current and future wall ratings, and temporary partition locations.
Planned interruptions to utilities, which are common in construction, should be communicated to the facility's engineering staff. A plan must be established for identifying the particular utility then communicated to the people who will be affected, allowing for temporary measures to be taken.
Finally, you should provide an accident prevention plan and have it approved by the client, covering details of hazardous activities, emergency phone numbers, procedures for safe cleanup, and many other details.
3. Construction Contractors Should Communicate
Planning for thorough communication is crucial for a complex project to run smoothly. With so many moving parts, things can quickly get out of hand if the right information doesn't get into the right hands on time.
This includes familiarizing subcontractors with infection control and noise protocols, letting hospital staff know about temporary changes, and clarifying the project's impacts on patients, staff, and visitors, both before and during construction.
The facility's personnel must be made fully aware of planned service interruptions to utilities. Facility and engineering staff, as well as the specific departments that will be affected by shutdowns, must be told what to expect well in advance.
Training of the entire construction team is a critically important way to communicate an understanding of not only how to follow safety protocols but also why they exist in the first place. Read our post on ICRA Hospital Training for Contractors on Dust Containment for more on the subject.
4. Construction Contractors Should Monitor
Keeping tabs on every aspect of a construction job provides the only hope of maintaining control and providing a safe, healthy environment. One thing typically monitored during construction projects in occupied healthcare facilities is air pressure when negative pressure is being used to prevent dust from escaping into patient areas. Failure to maintain the proper pressure differential could result in dust affecting patients, so monitoring is necessary.
Another thing to monitor is noise. A widely-cited 2005 study of noise at Johns Hopkins established the negative effects of excess noise on patients whose stress levels rise as a result. More recently, researchers at King's College London again called attention to the damaging effects of high noise levels, affecting patients' ability to rest, heal, and recover.
As the contractor, you should monitor noise and take steps to reduce it where possible. Here are some ways to do that.
- Acquire tools and equipment designed to emit less noise.
- Strategically place noisy machines away from sensitive areas.
- Line temporary barriers with sound-absorbing mats.
- Explore other ways to use sound-damping materials.
A third thing to monitor is safety. You need to keep watch on work crews and subcontractors and take corrective steps to observe any breach of safety protocols, even dismissing violators if necessary.
5. Construction Contractors Should Document
You've finished the project, carefully cleaned, and properly sanitized the area, which is now ready for use. But no project is complete without closeout documentation, typically required by various inspecting agencies at the time of site inspection. Those documents are likely to include the following.
- Certificate of Occupancy
- Various material and test certificates relating to fire protection
- Compliance letter issued to the facility's project manager
- Electrical ground resistance test reports
- Medical gas certification and test reports
- Domestic water analysis certificate
Summary
We hope this overview of healthcare construction has been useful to you. At HEPACART®, we provide dust containment carts, negative air machines, barrier walls, anterooms, and other equipment designed to make every healthcare contractor's job easier, safer, and more efficient.
To learn everything you need to know about dust containment units, including what they are, the dust containment problems they provide solutions for, plus purchase and use considerations, click the button below to read our guide.
Additional resources:
- 5 Healthcare Construction Best Practices for Occupied Healthcare Facilities
- ICRA Construction Trades Best Practices Awareness Training (video)
- ICRA Training Module 1 (video)
- ICRA Matrix (PDF)
Other posts on this topic from our blog:
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