Delivering Quality Construction Infection Control in an Active Hospital
In construction, each type of project presents its own set of logistical and technical challenges. One unique component to healthcare construction is the delivery of a quality project in an existing, fully operational facility comprised of sick patients who still need to be treated and cared for throughout the process.
In 2014, the results of a Healthcare-associated infections (HAI) prevalence survey were published, which showed that in 2011 an estimated 722,000 patients in U.S. acute care hospitals developed HAI. Out of the 722,000 affected patients, approximately 75,000 of those patients died during hospitalization. While it is impossible to measure the exact number of patients that devolved HAIs from facility related construction activities, the survey analysis concluded that each year an estimated 5,000 patients develop an HAI that ultimately leads to death, as the result of ongoing construction.
Our understanding and knowledge of best practices in regards to construction infection control has come a long way since the 19th century discoveries of Louis Pasteur. However, today it is the action and implementation of that knowledge that must be emphasized in real world conditions through an infection control risk assessment (ICRA). Development of an infection control plan is an essential element to any healthcare project in order to determine the best means and methods of infection control that will be applied to that specific type of construction.
The first step in developing a successful and accurate ICRA is to determine both the type of construction (table 1) and the patient risk group (table 2) that could be affected.
Table 1: Types of Construction
Table 2: Patient Risk Groups
Upon confirmation of construction type and patient risk group evaluations, the second step is to review and identify potential hazards that present a threat. Typically, hazards identified are either airborne or waterborne and consist of dust, microbial, gases, fumes and odors. Throughout evaluation it is important to keep in mind that existing conditions can be disturbed as a result of vibration from construction activities that may lead to additional hazards.
Any project team can provide better infection control results through the development of an infection control action plan. In addition to, the daily implementation of workforce education and training, daily ICRA plan review and assessments, as well as continuous evaluation and adjustment of the infection control plan to the changing conditions of hospital operations and construction projects. While developing the appropriate initial ICRA is the cornerstone for addressing potential hazards, it is the daily execution of that plan that will mitigate risks.