Infection Control Risk Assessment (ICRA) during Construction
and Renovation
1
This matrix is to be used to set guidelines on the appropriate infection prevention and control procedures
required for the type of activity depending on where the activity will occur. The Infection Prevention and
Control representative may add or omit requirements specific to a project. Recommended barriers are to be
installed before construction begins.
Step 1: Identify the Type of Construction Activity Planned:
Type A
Inspection and Non-invasive activities.
Includes but is not limited to removal of ceiling tiles for visual inspection (limited to 1 tile per
50 square feet), painting, wall covering, electrical trim work, minor plumbing and activities
that do not generate dust or require cutting of walls.
Type B
Small scale, short duration activities that create minimal dust.
Includes but is not limited to installation of telephone and computer cables, access to chase
spaces, cutting of walls or ceiling where dust migration can be easily controlled at the source.
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.
Includes but is not limited to sanding walls, for painting or wall coverings, removing floor
coverings, ceiling tiles and millwork, new wall construction, minor ductwork or electrical work
above ceilings, major cabling activities and any activity that cannot be completed within a
single work shift within the set containment.
Type D
Major demolition and construction projects
Includes but is not limited to activities that require consecutive work shifts, heavy demolition
or removal of a complete ceiling system and new construction.
1
Matrix modified from Bartley J. Infection Control Issues in Construction and Renovation Toolkit.
Association for Professionals in Infection Control and Epidemiology, Inc. 2007; 89-91.
Step 2: Determine Risk Group Impacted by the Proposed Construction
Activity:
Lowest Risk
Medium Risk
High Risk
Highest Risk
1. Office areas
2. Engineering
3. Environmental
Services
1. All patient care
units not listed in
Groups 3 or 4.
2. Rehabilitation
3. Cardiac rehab
4. Radiology/MRI
5. Outpatient
Services
6. Cafeteria-
non-
food prep area
1. Emergency
2. Post-anesthesia
Recovery Units
3. Labor & Delivery
4. Newborn Nurseries
5. Nuclear medicine
6. Echocardiography
7. Central Supply
8. Pediatrics, inpatient
9. Laboratory
10. Endoscopy
11. Cafeteria food prep area
12. Anesthesia work rooms
1. Operating
rooms,
including C-section
2. Cardiac
Catheterization
3. Intensive Care Units
4. Oncology
5. Infusion/Radiation
Therapy
6. Pharmacy admixture
7. Dialysis, inpatient
8. Sterile Processing
9. Any area caring for
immunocompromised
patients
Step 3: Assign a Class Based on Prior Assessments:
Risk Level
Construction Activity
Type ‘A’
Type ‘B’
Type ‘C’
Type ‘D’
Lowest Risk
Class 1
Class 2
Class 2
Class 3/4
Medium Risk
Class 1
Class 2
Class 3
Class 4
High Risk
Class 1
Class 2
Class 3/4
Class 4
Highest Risk
Class 2
Class 3/4
Class 3/4
Class 4
Step 4: Identify any areas surrounding the project area, assessing the
potential Impact:
Dept. Above
Dept. Below
Lateral
Lateral
Behind
Front
Risk Group
Risk Group
Risk Group
Risk Group
Risk Group
Risk Group
Step 5: Review traffic flow and debris control (how and when), Are hand
washing sinks going to be blocked or shut off. Is an ILSM needed?
□
Yes
□
No
Step 6: Execute Requirements for Construction Procedures Based on
Classification Assignment. Copy the form on the next two pages and
complete. Completed forms should be forwarded to Infection Prevention
and Control and Planning and Construction or Facilities Management
Project Managers for department files.
Infection Control Construction Permit
Project Name:
Project Number:
MOP Number:
eMac Number:
Project Manager:
Project Start Date:
Location of Construction:
Estimated Duration:
Contractor Performing Work:
Permit Expiration Date:
Construction Supervisor:
Telephone:
YES
NO
CONSTRUCTION ACTIVITY
YES
NO
INFECTION CONTROL RISK
GROUP
TYPE A: Inspection, non-invasive activity
GROUP : Least Risk
TYPE B: Small scale, short duration, moderate to
high levels
GROUP : Medium Risk
TYPE C: Activity generates moderate to high levels
of dust, requires greater than 1 work shift for
completion
GROUP : High Risk
TYPE D: Major duration and construction activities
requiring consecutive work shifts
GROUP : Highest Risk
CLASS 1
Date:
______________
Initial:
______________
A. Minimize raising dust from
construction operations.
B. Doors within the travel path of
construction activity shall be kept closed.
C. Immediately replace any ceiling tile
displaced during visual inspection.
D. Immediately clean any dust that may have
been created from all surfaces.
E. Areas suspected of water damage, past
or present should be sprayed with copper
8-quinolinolate or equivalent and Infection
Prevention notified.
F. Building Materials will remain dry and will
be discarded if cannot be completely
dried in 48 hours.
CLASS 2
Date:
______________
Initial:
______________
A. Provide active means of preventing
airborne dust from dispersing into
atmosphere.
B. Seal un-used doors with duct tape or
Long Mask tape.
C. Block off and seal air vents.
D. Remove or isolate HVAC system in areas
where work is being performed.
E. Outside exhaust locations must be 30 feet
from air intake locations unless otherwise
noted.
F. Lightly mist debris and contain
construction waste before transport in
tightly covered containers. Debris should
be removed daily. Do not board elevators
containing patients when removing.
G. Water-mist work surfaces to control dust
while cutting.
H. Wet mop and/or vacuum with HEPA
–
filtered vacuum before leaving area.
I.
Wipe all surfaces with hospital-approved
disinfectant.
J. Place adhesive mat at entrance and exit
of work area. Adhesive mats should be
type to remove dust and debris from
footwear exiting the construction zone.
K. All items in previous class (es) must also
be performed.
CLASS 3
Date:
______________
Initial:
______________
A. Obtain Infection Control approval
before construction begins.
B.
All items in previous class (es) must
also be performed.
C. Construct physical barrier with anteroom
if possible before construction begins.
D. Seal holes, pipes, conduits and punctures
appropriately.
E. Maintain negative air pressure @
minimum .03 inches water gauge within
work site using HEPA-filtered air filtration
units.
F. Attach 24/7 auto dialer monitoring to
system and provide emergency power.
G. Personnel clothing leaving work site
should be free of loose soil and debris.
(2) 2'x4' adhesive mats should also be
used.
H. Tools and carts are to be damp wiped
before leaving the construction area.
I.
Vacuum work area with HEPA-filtered
vacuums daily. Filters are to be sealed in
bags for site removal.
J. Lightly
mist
debris
and
contain
construction waste in tightly covered
containers. Debris should be removed
daily, or more frequently, if necessary. Do
not board elevators containing patients
when removing wastes.
K. Cover transport receptacles or carts.
L. Wet mop or wipe down area immediately
adjacent to the construction area and just
inside, with owner-approved disinfectant
daily.
M. Do not remove construction barriers until
project
is
thoroughly
cleaned
by
Environmental Services.
N. Clean air ducts and filters in construction
area prior to removing construction
barrier.
O. Barriers will be cleaned before removal
and upon completion of the project with
the approval of the Facilities Management
Project Manager.
P. Remove barriers carefully to minimize
spreading dirt and debris.
CLASS 4
Date:
______________
Initial:
______________
A. Obtain Infection Control approval
before construction begins.
B.
All items in previous class (es) must
also be performed.
C. Construct anteroom and require
personnel to pass through this room so
they can be vacuumed using a HEPA-
filtered vacuum before leaving work site
or wear cloth or paper coveralls that are
removed each time they leave the work
site.
D. Isolate HVAC system in area where work
is being performed to prevent
contamination of duct system
E. Seal holes, pipes, conduits, and
punctures appropriately.
F. Maintain negative air pressure @
minimum .03 inches water gauge within
work site using HEPA-filtered air filtration
units.
G. Place adhesive walk off mats at entrance
to work area within anteroom.
H. All personnel entering/exiting the work
site are required to wear shoes covers.
Shoe covers must be changed each time
the worker exits the work area.
I.
If work is in or adjacent to a critical area
where airflow, temperature, and humidity
levels must remain stable they will be
monitored to maintain minimum required
levels and necessary actions taken
documented.
Additional Requirements:
Date:
Initials:
Exceptions/Additions to this permit are noted
by attached Memoranda
Permit Request By:
Permit Authorized By:
Date:
Date: