Lead Infection Preventionist UnityPoint Health Trinity
Disclosure(s):
Sarah Castro, MPH, CIC: No financial relationships to disclose
Background: There is currently a gap between the requirement for a comprehensive water management plan, and the implementation of an infection control risk assessment (ICRA) that includes mitigation for waterborne pathogen growth and spread associated with construction activities. Many healthcare systems participate in accreditation programs that survey to the Centers for Medicare and Medicaid Services (CMS) requirements. CMS requires healthcare facilities to develop and adhere to American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE) compliant water management programs. ASHRAE standards include the need to manage water during times of construction, but do not provide specific construction activity risk factors or mitigation measures. This quality improvement project developed an ICRA tool that incorporated traditional construction risks and mitigation strategies with those needed for water disruption.
Methods: The Infection Prevention and Facilities departments collaborated to develop a comprehensive set of tools incorporating water management for construction with the American Society for Health Care Engineering (ASHE) ICRA 2.0 guidelines. A literature review was conducted to identify healthcare risks associated with water disruption and existing ICRA tools for water management. Based on the evidence, a comprehensive toolkit was developed that included a decision matrix, construction permit and comprehensive mitigation strategies.
Results: Implementation of the new ICRA and water management for construction tools began in August 2023. All construction contractors were trained on the new tools and required construction permit. Twenty construction projects have been completed since implementation, with all applicable water mitigation strategies completed and verification measures met.
Conclusions: The incorporation of water management into existing ICRA processes addresses the significant risks associated with waterborne pathogens during construction activities, and ensures accreditation requirements for a comprehensive water management plan are achieved.
Learning Objectives:
Identify the patient safety risks associated with water disruption during construction activities.
Utilize the evidence to create comprehensive infection control risk assessment (ICRA) tools that include water management risks and mitigation strategies.
Operationalize an ICRA process that includes water management for construction at your healthcare facility.
