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

Patient Care Units

Operating Rooms

NICU
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 Legionella
•a fungus •a bacteria
•found in dust, walls, •found in stagnant standing
ceilings, debris water
•spread by activities that •cooling towers, water
stir up dust & dirt, such as supply lines, air
knocking out walls, conditioning systems
removing ceiling tile, •spread by aerosolized
working in air handling water
system •causes pneumonia and
•causes pneumonia, lung infections
wound infections,
bloodstream 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 – Announced when an emergency situation exists. The emergency should be announced as
Emergency “internal” or “external.” The announcement is made three times and should include the number of
Operations Plan expected casualties and the estimated time of arrival (ETA).
(EOP) Activation

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 Announced when the National Oceanic and Atmospheric Administration (NOAA) issues a severe
Weather 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.