Construction/Renovation SUMMARY
Updated 11/03 |
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Introduction: Minimize Risks When You Renovate
Construction can disrupt microorganisms in the environment
so that they pose a risk to patients. Fungal spores (i.e. Aspergillus)
are frequent contaminates of ceiling tiles and wall board. During
construction they are disrupted, and dispersed into the air. These
spores can pose a threat to immunocompromised patients.
At risk patients may include:
| those receiving immunosuppressive
therapy: |
 |
bone marrow and solid organ
transplantation |
| |
| those who are neutropemic
due to: |
|
leukemia
lymphoma |
|
aplastic anemia
myeloplastic disease |
| |
| those with a neutrophil count
<500 |
| |
| those with congenital or acquired
immunedeficiency syndrome |
| |
| those immunocompromised due
to |
|
severe disese |
|
extreme prematurity |
| |
| those who receive steroids |
| |
| those who have open wounds |
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At Risk Construction Activities
- Demolition of existing ceilings or walls
- Exposure of ceiling spaces by removal of all or part of ceiling
- Breeching of walls, ceilings, or floors, i.e. drilling, removing
ceilings
- Removal of uncovered or partially covered debris from construction
areas
- Construction of new facilities on the JHMI campus
- Major disturbance of soil where dust or dirt becomes airborne
- Dusting leaks
- Major excavations or implosions (demolition of structures by
collapse explosion) in the surrounding community.
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At Risk Areas and Locations
| Definition of Infection Control Risk Areas/Locations |
GROUP 0
LOWEST |
GROUP 1
LOW |
GROUP 2
MEDIUM |
GROUP 3
MEDIUM HIGH |
GROUP 4
HIGHEST |
|
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- Office areas
- · Areas not communicating with patient care activities
|
- Patient care & other areas not covered under group 3 or 4
- Laundry
- Cafeteria
- Dietary
- Materials Management
- PT/OT/Speech
- Admission/Discharge
- MRI
- Nuclear Medicine
- Echocardiography
- Laboratories not specified as Group 3
- Public Corridors (through which patients, supplies, and linen pass)
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- Emergency Rooms
- Radiology
- Post-anesthesia Care units (except Weinberg)
- Labor and Delivery (Nelson 2)
- Newborn Nurseries
- Newborn Intensive Care unit
- Pediatrics (except those listed in group 4)
- All Intensive Care Units (except those listed in group 4)
- Microbiology lab
- Virology lab
- Long term/sub-acute units
- Pharmacy
- Dialysis
- Endoscopy
- Bronchoscopy areas (including Blalock & Meyerhoff Unit)
- Nelson 4
- Park 3
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- Weinberg building:
IPOP
HIPOP
4&5 A,B,C,D
3A WICU Radiation therapy (basement)
2, Chemo infusion
1, clinical area
- Moore Clinic
- Osler 8
- Nelson 6&7
- CMSC 8 E&W
- Pharmacy Admixture
- Operating Rooms
GOR
Weinburg OR
PACU
Wilmer OR
JHOPC OR
Greenspring
- C Section Rooms
- Sterile Processing
- CVDL (CMSC 5)
- Cardiac Catheterization
- Outpatient invasive procedures rooms
- Oncology Units
- Anesthesia and Pump areas
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Patient Areas that are not operational at night and on weekends,
should scheduled construction to be done during non-patient times to minimize risk.
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References
Center for Disease Control and Prevention (1994). Recommendations for
Prevention of Nosocomial Pneumonia. AJIC, 22: 247-92.
Opal, S.M., Asp, A.A., Cannady, P.B., Morse, P.L., Burton, L.J., &
Hammer, P.G. (1986). Efficacy of infection control measures during a
nosocomial outbreak of disseminated aspergillosis-associated with hospital
construction. J Infect Dis, 153: 634-637.
Purcell, R.J. (1989). Controlling Aspergillus contamination in heating
ventilation and air conditioning systems. Plant Technology and Safety
Management Services: Infection Control Issues in PTSM (pp.23-26). Chicago:
Joint Commission of Accreditation of Healthcare Organizations.
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