Infection Control During Hospital Construction

Infection control is an important topic. If you’ve ever done work as a contractor inside a healthcare setting, such as a renovation, you no doubt had to take infection control precautions.

Now there’s a Canadian voluntary standard for infection control—the first of its kind anywhere.

CSA-Z317.13-07

For all of you American and other international readers, in Canada we have something called the Canadian Standards Association. Some of you may be familiar with the CSA because it’s a fairly well known organization. The CSA sets standards for all kinds of things in all different kinds of industries.

In 2003, in an almost quiet way, CSA established a new standard for infection control during construction or renovation in healthcare facilities, CSA-Z317.13-03. Since then, the standard has undergone a second revision, released one year before a regular standard would be. The 2007 edition of the CSA infection control standard, CSA-Z317.13-07, is even more descriptive than the original edition.

The Response to the Standard

Within our industry, we are seeing a culture evolve around the standard that is worth our attention. Many other countries are taking notice of this development and medical professionals from around the world have been lining up to buy the new standard from the CSA.

Why has there been much interest in the new standard? There are many reasons. For one thing, the CSA standard is the first of its kind. For a long time, there has been a demand for a universal standard for infection control for construction work in healthcare settings. Contractors have really needed such a standard, and so have hospitals. The average contractor taking on a hospital job is up against a whole mess of variables that it probably wasn’t aware of until it actually got into the building. This is especially true for renovation jobs. So having a standard in place should save both the contractor and the facility a lot of time, energy and aggravation and make the work much easier.

Patient Deaths & the Liability Perspective

The main reason for all the interest in the standard is because it’s very detailed and specific about what it requires from the contractor. As a result, it goes a long way to protect both sides from liability.

There’s a long history of unexplained and unexpected deaths to patients in healthcare facilities that have occurred during construction or maintenance projects. Investigations have been able to link some of these deaths to the construction work and the failure of the person doing the work to take the necessary infection control precautions.

There have also been countless situations where construction work was the suspected cause of patient death but the suspicion was impossible to prove. Why? Because if a patient is extremely ill, inhaling even a tiny amount of the wrong type of dust can cause a fatal infection. In Canada, roughly 250,000 patients a year experience hospital acquired infections, resulting in 8,000-12,000 deaths. It would take an incredible amount of resources and qualified individuals to investigate even half of the patient infections that occur.

How the Standard Helps Both Parties

It wouldn’t be fair to blame all of the infections on the contractor. Hospital workers also have a key role to play in infection control. One thing the CSA standard does is educate hospital staff very quickly even if they know next to nothing about construction. The standard includes a user friendly table that lists the construction activity type, the population group at risk from the activity, i.e., type of patients in the area and the preventive measures required. There are even detailed diagrams of how to construct infection control barriers, which must be constructed outside of renovation areas. With a little training, any infection control practitioner can assess most situations to see if they’re being done in compliance with the standard.

The standard is also of great value to contractors and safety professionals performing healthcare facility renovation or maintenance projects. First of all, the hospital might require you to work in accordance with the new CSA standard. Even if it doesn’t, you should read and consider following the standard anyway. Many of the practices within the standard are of great benefit to contractors not only in ensuring safety but in documenting that they showed due diligence.

Conclusion

Adopting the CSA standard is voluntary. But it would go a long way toward meeting the company’s obligation—in both the U.S. and Canada—to protect against known risks. More importantly, it will help healthcare facilities protect patients against infection.