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Construction, ICRA, risk assessment

Summary

There are many considerations in the design and construction or renovation of the health care facility. The environment must cultivate a safe, caring, healing environment for patients and their loved ones, while also being efficient, functional and safe for staff.

Improperly designed and maintained environments pose numerous risks for patients, including hazards from fires, chemical exposures, or contaminated air, water or environmental surfaces.   For example improper, ventilation design or maintenance has been associated with opportunistic infections such as Aspergillosis in highly immunocompromised populations such as bone marrow transplant patients.  Airborne infections, such as tuberculosis have caused outbreaks among patients, workers and even visitors.  The potential threats related to terrorism including anthrax, smallpox and the reported outbreaks of SARS among healthcare workers and patients has dramatically highlighted the importance of facility design for enhancing the control of infectious agents.

In response, professional, accreditation and oversight agencies have provided guidance for new construction and major renovations in health care facilities that builds infection prevention and safety into the planning process.

Planning for new construction or major renovation requires early consultation and collaboration among infection control professionals (ICPs), epidemiologists, architects, engineers, risk and safety professionals, and environment of care managers to ensure that infection prevention is built into the design.  An essential first step in a comprehensive Construction and Renovation Plan is an "infection control risk assessment" (ICRA).   This assessment provides the foundation for long range planning, as well as for each phase of the project from concept to completion – regardless of size or scope of the project.

To assist in planning and conducting an ICRA, a number of resources are available from key agencies.  Additional resources are provided for protecting the environment from airborne, chemical, biologic and radiologic hazards.

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