Kidd, F., Buttner, C., & Kressel, A.B. (2007). Construction: A model program for infection control compliance. American Journal of Infection Control, 35, 347–350.
This study describes a five-year expansion project to build a nine-story employee garage, a new post-anesthesia care unit, a new cardiothoracic intensive care unit, and expansion of existing operating room space to include eight new operating rooms. The construction plan included demolition of five circa 1910 mostly unused buildings.
One infection control practitioner (ICP) attended a University of Minnesota Health Care Facility Construction Management Indoor Air Quality Workshop.
An infection control education program for contractors was developed that all construction workers were required to complete the training prior to working on the construction project and annually thereafter.
The infection control training takes 30 minutes. The lesson plan is organized by sections that include precautions to take before, during, and after construction work. There also is an audiovisual program about Aspergillus and its transmission and the susceptibility of immunosuppressed patients.
An infection control team including the general contractor, project manager, ICP, and operating room nurse planner make rounds weekly or daily on all projects to monitor for compliance and answer questions. In addition, other precautions were implemented since patients could not be relocated away from the area of greatest activity.
Members of the design and construction department are engineers and architects and have attended classes on construction and infection control.
During the first four years of demolition and renovation, the University Hospital had no nosocomial Aspergillus infections.
In the fifth year, of construction, two patients who had possible hospital-acquired infections were identified. An industrial hygienist was brought in to evaluate intervention and make recommendations, but nothing of concern was found.
Particle sampling remained the same from pre-construction to post-construction.
Both possible nosocomial Aspergillus infections occurred after a building that was connected to the hospital and shared air space began a large renovation project without using infection control prevention.
Hospitals must be aware not only of what is happening inside their own facilities, but also what is happening outside. ICPs must establish collegiality with contractors, architects, maintenance, and engineering personnel to produce an effective, comprehensive infection-prevention atmosphere during construction and renovation.