Construction, Renovation, Repair, Excavation and Demolition Activities in The Hospital Requires

Document Name.
: Infection Control and Risk Analysis

Document No.: NABH/GSMCH/ HIC
No. of Pages: 5
Issued Date: 15/11/2022
Date of Implementation: 16/11/2022
Prepared By: Designation: Quality Manager
Name: Mr. Nitin Kumar
Signature:
Checked By: Designation: Medical Superintendent
Name: Dr. J. P. Singh
Signature:
INFECTION CONTROL MEASURES DURING CONSTRUCTION/RENOVATION

Construction, renovation, repair, excavation and demolition activities in the hospital requires
planning and coordination to minimise the risk of infection in patients.
1.1.1.1 Pre-Construction Risk Assessment (PCRA) Matrix for Determining Infection Risk
Class
1. Select Project Type
Project Activity Types (A,B,C,D): Designations which define the amount of dust generated,
the duration of activity, and/or the amount of involvement with heating, ventilation and air
conditioning (HVAC) and water systems during a project.
Type A Inspection and non-invasive activities

Examples include:
 Removal of ceiling tiles or open access for visual inspection (limited to one tile
per 50 square feet); replacement of tiles with damage or minor staining
 Painting (but not sanding);
 Wall covering, electric trim work, minor plumbing, and activities which do not
generate dust or require cutting of walls or access to the ceiling other than for
visual inspection.
Type B Small scale, short duration activities that may create minimal dust or disturb mold
Examples include
 Installation of telephone and computer cabling;
 Entering chase spaces
 Cutting of walls or ceiling where dust migration can be controlled
 Minor sanding of walls for painting or wall covering
Type C Any work that generates a moderate to high level of dust or requires demolition or
removal of any fixed building components or assemblies
Examples include:
 Major sanding of walls for painting or wall covering
 Removal of floor coverings, ceiling and case work, wallpaper
 New wall construction
 Duct work above ceilings
 Major cabling activities
 Any activity that cannot be completed within a single workday
Type D Major demolition and construction projects

Examples include:
 Removal of a complete ceiling system
 Requires heavy demolition or removal of a completed system
 New construction
2. Select Risk Group
Low risk Medium risk High risk Highest risk
 Office  Cardiology  CCU  Any area caring for

immunocompromised
areas  Cafeteria  Emergency Room patients
 Non-  Echocardiogr  Food preparation area  Burn Unit
patient/ aphy  Labor & Delivery  Cardiac Cath Lab
low  Endoscopy  Laboratories  Central Sterile Supply
risk areas  Nuclear  Medical Units  Dialysis
not Medicine  Newborn Nursery  Intensive Care Units
specified  Public  Outpatient  Negative pressure
elsewhere corridors Surgery/Procedure isolation rooms
Rehabilitation rooms  Oncology
 Radiology  Pediatrics  Operating rooms
 Respiratory  Pharmacy including C-section
Therapy  Post Anesthesia Care rooms
Unit
 Surgical Units
3. Determine Infection Risk Class

Construction Classification (Class I, II, III, IV): Designation which specifies measures necessary
to safely perform any facility construction, renovation or maintenance. This classification is
determined by matching the Construction Project Activity Type with the designated Risk
Group in the matrix below.
Construction Project Type

Patient Risk Group
Type A Type B Type C Type D
LOW Risk Group I II II III
MEDIUM Risk Group I II III IV
HIGH Risk Group I II III IV
HIGHEST Risk Group II III IV IV
4. Implement the desired infection prevention/control precautions

Description of Required Infection Control Precautions by Class
Class During construction Upon completion
I  Execute work by methods to  Clean work area upon completion

minimize raising dust from of task.
construction operations.
 Immediately replace a ceiling tile
displaced for visual inspection
II  Provide active means to prevent  Wipe work surfaces with

airborne dust from dispersing into cleaner/disinfectant.
atmosphere.  Contain construction waste before
 Water mist work surfaces to transport in tightly covered
control dust while cutting. containers.
 Seal unused doors with duct tape.  Wet mop and/or vacuum before
 Block off and seal air vents. leaving work area.
 Place dust mat at entrance and exit  Upon completion, restore HVAC
of work area system where work was performed.
 Remove or isolate HVAC system in
areas where work is being
performed
III  Remove or Isolate HVAC system in  Do not remove barriers from work
area where work is being done to area until completed project is
prevent contamination of duct inspected by the HICC and
system. thoroughly cleaned.
 Complete all critical barriers i.e.  Remove barrier materials carefully
sheetrock, plywood, plastic, to seal to minimize spreading of dirt and
area from non-work area or debris associated with construction.
implement control cube method  Vacuum work area.
(cart with plastic covering and  Wet mop area with
sealed connection to work site with cleaner/disinfectant.
HEPA vacuum for vacuuming prior  Upon completion, restore HVAC
to exit) before construction begins. system where work was performed.
 Maintain negative air pressure
within work site utilizing HEPA
equipped air filtration units where
possible.
 Contain construction waste before
transport in tightly covered
containers.
 Cover transport receptacles or
carts. Tape covering unless solid lid
IV  Isolate HVAC system in area where  Do not remove barriers from work
work is being done to prevent area until completed project is
contamination of duct system. inspected by the HICC and
 Complete all critical barriers i.e. thoroughly cleaned.
sheetrock, plywood, plastic, to seal  Remove barrier material carefully
area from non-work area or to minimize spreading of dirt and
implement control cube method debris associated with construction.
(cart with plastic covering and  Contain construction waste before
sealed connection to work site with transport in tightly covered
HEPA vacuum for vacuuming prior containers.
to exit) before construction begins.  Cover transport receptacles or
 Maintain negative air pressure carts. Tape covering unless solid lid.
within work site utilizing HEPA  Vacuum work area.
equipped air filtration units, where  Wet mop area with
possible. cleaner/disinfectant.
 Seal holes, pipes, conduits, and  Upon completion, restore HVAC
punctures. system where work was performed.
 It is preferable that all personnel
entering work site are required to
wear shoe covers. Shoe covers
must be changed each time the
worker exits the work area.

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Document Name.

: Infection Control and Risk Analysis

Name: Mr. Nitin Kumar

Name: Dr. J. P. Singh

INFECTION CONTROL MEASURES DURING CONSTRUCTION/RENOVATION

Type A Inspection and non-invasive activities

Type D Major demolition and construction projects

2. Select Risk Group

Low risk Medium risk High risk Highest risk

 Office  Cardiology  CCU  Any area caring for

3. Determine Infection Risk Class

Construction Project Type

MEDIUM Risk Group I II III IV

HIGH Risk Group I II III IV

HIGHEST Risk Group II III IV IV

4. Implement the desired infection prevention/control precautions

Class During construction Upon completion

I  Execute work by methods to  Clean work area upon completion

II  Provide active means to prevent  Wipe work surfaces with

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