Physically Connecting Two Hospitals: Infection Prevention Challenges and Considerations

Session Description: BACKGROUND
A 24-story inpatient tertiary care hospital would be constructed and connected to an existing 21-story Comprehensive Cancer Center (CCC) Hospital. Construction includes removal of the outer building façade, connection on all floors of the CCC hospital and integration of the mechanical, electrical and plumbing systems throughout the buildings. The objective is to discuss infection prevention considerations, challenges and lessons learned during construction around an oncology population setting.
METHOD
Multifaceted considerations were needed for the Infection Preventionist (IP) during this project. IPs attended all phases of construction meetings, ensured the project employed detailed phased Infection Control Risk Assessments (ICRAs), had frequent walkthroughs, tracked air quality, monitored air pressure, employed dust mitigation strategies, had crew dedicated to cleaning and water tested patient rooms prior to re-occupancy. The IP monitored for fungal infections and signed off on phases before and after construction. To remove the outer wall, hospital engineers assessed for stack effect to ensure a safe negative construction space could be maintained and a building envelope was developed to insulate the interior hospital space from the elements. Internal monitoring of Aspergillus was initiated. Considerations were made for patients ambulating close to the construction area.
RESULTS
IPs received daily air quality readings; results from additional testing performed during heavy dust work was also shared. None showed significant increases which required mitigation. Negative pressures around barriers remained within range including when the outer wall was removed. Dust tracking was monitored on an ongoing basis and issues escalated to the PM and construction supervisor. Infection prevention re-education was provided to contractors. Aspergillus monitoring to date has not shown any cases related to healthcare onset.
CONCLUSION
IP involvement in all parts of construction is important. Increased vigilance, coordination, involvement and strategies is required when construction is occurring in or around a Comprehensive Cancer Center.