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ICRA: Keeping Construction Sites Safe for High-risk Patients

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Modern healthcare facilities are an incredibly valuable resource for our communities, and their ability to provide a safe and healthy environment is critical to patients who walk through the doors. Medical facility managers are laser-focused on preventing infection's day-to-day spread through preventative measures and thoughtful procedures. However, coughing and infected surfaces are not the only ways infection and irritation can majorly impact a healthcare facility. Too often, the spread of infection can be caused by the dust and debris from a routine maintenance, renovation, or construction project.

Construction projects are seemingly never-ending in a medical center, whether to upgrade a space or to add additional rooms or buildings. Whatever it is, these projects are more than a disruption to daily operations. They have the potential to be harmful not only to patients but to staff as well. While hospital surfaces are disinfected, and staff prioritizes wearing Personal Protective Equipment (PPE) appropriately, these measures do little to protect against the potentially dangerous debris and dust that are kicked up from harsh construction activities. Infection Control Risk Assessment (ICRA) standards exist to place guidelines around construction activities and best practices to keep patients and staff safe and healthy. 

This blog will explore how ICRA guidelines help facility managers take appropriate preventative steps and use the assessment to complete construction and renovation projects safely. With the ICRA in your toolbelt, your facility will be able to navigate construction projects successfully. 

ICRA's Role in Healthcare

Within the healthcare industry, ICRA protocols are not just “nice to have”. They are a “must-have.” Aside from industry regulations and standards, the importance of infection control is clear. Just take a look at the numbers. Every year, approximately 99,000 people die as a result of secondary infections during hospital stays. A staggering number of these infections are linked back to the hospital's HVAC systems. With statistics like these, it is obvious that the impact of high-quality air filtration and strategic preventative measures in healthcare facilities is no small thing. By taking charge of your facility’s infection control and applying ICRA principles, you can significantly impact the lives of the patients your facility serves. 

The Gold Standard in Health-focused Construction

With a fundamental focus on patient care and health, it’s no surprise that medical priorities must come first between hospital schedules and construction timelines. When you are selecting construction crews or contractors to come into your facility to complete a project, make sure that the team you choose is well-versed in ICRA practices and can work with you to adapt processes as necessary for the good of the patients. For example, a seasoned ICRA-certified contractor will understand that they must postpone or reschedule vibration-causing work — such as operating a jackhammer — during scheduled eye surgery. Depending on the type of construction activity, contractors must be constantly aware of varying ICRA requirements and preventative measures, as well as take stock of their impact on the hospital through each task. This includes creating a strategic, ICRA-compliant plan for the unlikely event of a widespread power outage or how these emergencies may affect traffic flow and construction debris movement in the facility. 

Ultimately, strict management and clear communication are the keys to making sure that everyone is informed and can work together to minimize the impact of construction activities on patients and medical activities. 

Practical ICRA Protocols Every Contractor Should Know

The workers on a hospital or medical center construction site can visually see and report any potential dangers or ICRA violations as the project progresses. These hardworking teams have their hands full with tedious tasks, so they must have practical measures to keep track of the impact on the facility’s overall health and safety. 

A few ways to practically do this include: 

  • Using thorough daily checklists to ensure strict adherence to ICRA-compliant safety protocols
  • Performing weekly reviews that can inform any necessary plan adjustments or modifications
  • Monitoring negative air pressure with equipment that provides both continual visual measuring and alarms

With these and other preventative measures in place, construction crews are better able to identify potential problems before they can potentially cause the spread of infection unintentionally. It’s yet another reason why ICRA-certified or at least ICRA-informed construction crews greatly benefit your facility. They can not only do great work but also partner with you to prioritize health and safety in a setting where it matters most. 

Why Construction Workers Must Be ICRA-informed

An informed construction team is a safe construction team. Workers must have a deep understanding of ICRA principles and infection control best practices to provide the highest level of safety and ICRA compliance. They also need to know how to differentiate between healthcare construction and traditional commercial construction, be aware of the unique hazards that come with healthcare construction, and assess the risk profile of a work site before starting on any project in a healthcare setting. The ideal construction team would be able to not only create a general ICRA plan based on the risk level of the facility and project at hand, but they should also have a good understanding of the best practices associated with ICRA and the specific classification. For example, they should understand how to use negative air pressure, place barriers, and implement disinfection practices appropriately. 

Your hospital’s facility management team can have the best of intentions with infection control practices through construction projects, but the true test of how well you’ll be able to comply with ICRA guidelines is how knowledgeable and dedicated your construction crew is. 

How to Prevent Construction Site Contamination

It’s critically important to maintain an organized construction site, particularly when it comes to infection control practices and equipment

To keep your construction site contamination-free, there are several steps you can take: 

Create Checklists

Have a standardized checklist categorized by risk levels. Equip your team with the know-how to preemptively tackle each issue.

Make Use of Contractor “Rubrics”

Clearly outline your expectations for each contractor before they enter the healthcare facility. Ideally, your crew should have prior experience in high-risk areas and ICRA protocol.

Keep Documentation

Keep open channels of communication and meticulously document all processes and permits.

Perform Audits

Conduct at least weekly audits to ensure ICRA standards are met and address any near-misses to continually improve your infection-control measures. 

Implement Automated Monitoring

Employ 24/7 automated monitoring systems to maintain a tight rein on contaminants.

Staying Ahead of the Curve: Mastering ICRA Standards

Navigating the complexities of infection control is an ongoing process for any construction project within a healthcare facility. Being ahead of ICRA standards improves your infection control measures and ensures that construction projects align with best practices. This vigilance ultimately benefits everyone, making the healthcare environment safer for both patients and staff.

Ready to elevate your facility’s infection control measures during construction or renovation? Download our ICRA matrix now and start your facility’s journey toward a safer, more controlled construction environment.


Infection Control Risk Assessment - ICRA Matrix