In healthcare construction, Infection Control (IC) is paramount. Effective IC measures often differ between a smooth project and one plagued by delays, budget overruns, and health risks. Awareness of common pitfalls can help construction teams safeguard patient and staff health while maintaining a successful project.
Here are ten commonly overlooked IC pitfalls to avoid:
1. Underestimating Risks on Small Projects
Small projects may seem low-risk, but they often present unique IC challenges. Large-scale renovations make it easier to isolate affected areas, such as an entire wing, allowing for HVAC system adjustments and barriers to control debris and noise. In contrast, smaller renovations within active departments complicate these measures, making it harder to manage negative pressure, control debris paths, and mitigate noise. Overlooking these details can lead to cross-contamination and operational disruptions.
2. Insufficient Planning
Infection control and life safety planning must start at the project’s onset—not just before each construction phase. By considering Infection Control Risk Assessment (ICRA) and Interim Life Safety Measures (ILSM) requirements, teams can create a streamlined approach that minimizes risk, time, and cost. Thorough initial planning also allows for strategically scheduling HVAC and system shutdowns, reducing disruptions and preventing unplanned costs and delays. See the related post: Maximizing Infection Control: Proven Best Practices for Hospital Design
3. Neglecting Air Pressure Management
Maintaining negative air pressure within construction zones is critical. This requires well-maintained HEPA filters and consistent monitoring. It’s common to encounter shifts in pressure—often caused by HVAC settings in adjacent areas. For example, an economizer mode in a nearby zone can inadvertently shift pressure, making a negative pressure area positive. Regular checks and adjustments are essential to keep contaminants contained.
4. Overlooking Continuous Air Pressure Monitoring
Consistent air pressure monitoring is vital, especially in high-risk areas such as operating rooms (ORs), ICUs, and sterile zones. A “ball-in-the-wall” visual indicator can suffice for low-risk areas, but high-risk areas demand more reliable solutions. Electronic pressure gauges with logging, alarms, or text notifications ensure the area maintains the necessary negative pressure, helping to catch issues early and prevent contamination.
5. Incomplete PCRA Education for Workers
ICRA (Infection Control Risk Assessment) and PCRA (Pre-Construction Risk Assessment) training shouldn’t be limited to superintendents and project managers. All construction personnel must understand and adhere to infection control protocols, including maintaining barriers and pressure controls. Requiring workers to have ASHE certification or similar qualifications is a good start, but ongoing education is key. On-site identification, like stickers on ID badges or hard hats, can quickly identify trained workers, reducing the risk of unqualified personnel compromising IC protocols.
6. Inconsistent Communication with Hospital Staff
Seamless communication between the construction team and hospital staff is essential. Hospital operations and infection control can be jeopardized without clear communication about planned shutdowns or barrier adjustments. Establishing a communication protocol to notify hospital departments of potential disruptions, project milestones, and schedule changes helps ensure a safe and controlled environment for patient care. See the related post: Proven Best Practices for Successful Hospital Construction Planning and Design
7. Skipping Regular Barrier Inspections
Barriers are crucial for containing dust, pathogens, and other contaminants, but they can lose their effectiveness over time or due to accidental damage. Incorporating daily barrier inspections into the routine helps catch gaps, tears, or loose seals before they lead to contamination. Documenting these inspections and addressing vulnerabilities immediately ensures compliance with infection control protocols.
8. Ignoring Waste and Debris Management Plans
Dust and debris generated by construction can carry contaminants into patient care areas if not properly managed. Establishing dedicated egress paths and detailed waste management plans is essential. This includes using HEPA vacuums and air scrubbers during debris transportation and ensuring that all waste exits are sealed and managed according to infection control standards. In high-risk areas, using sealed containers for debris can further prevent the spread of contaminants.
9. Overlooking Compliance with Local and Federal Guidelines
Healthcare facilities must meet specific IC regulations, and construction projects must align with local and federal guidelines, such as those from CDC, OSHA, and ASHE. Familiarity with these guidelines, especially in higher-risk areas like NICUs or transplant units, is crucial to avoid regulatory issues and potential liabilities. Proper compliance also builds trust with the healthcare staff and ensures the project is managed to the highest patient safety standards.
10. Failing to Take Special Precautions in High-Risk Areas
Certain hospital zones, such as NICUs, ICUs, and operating rooms, require additional precautions due to heightened sensitivity to air quality and environmental controls. Projects near these areas should include pre-filtered HEPA systems, double barrier systems, and redundant air pressure monitoring. Scheduling construction activities outside peak hours and implementing extra IC oversight in these areas minimize the risk of contamination in vulnerable environments.
Conclusion
Avoiding these infection control pitfalls will improve patient, visitor, and staff satisfaction and keep your project on schedule and within budget. Addressing these infection control risks upfront lays the foundation for a successful project and a satisfied client.
If you start a project, I can help you reduce your risk and cost. Let’s discuss how we can minimize these risks and get it done on time and budget. Please message me through my website or LinkedIn to schedule a call.
