Healthcare Construction & Infection Control (ICRA)
Construction in a hospital or clinic can stir up dust and spores that are dangerous to patients with weak immune systems. Workers also face hazards from the environment around them. A plan called an infection control risk assessment (ICRA) tells everyone how to protect patients and workers.
- Hospital Construction
- Renovation
- Facilities
What ICRA is
An ICRA is a team review (infection prevention, facilities, the contractor and clinical staff) that looks at the work type and the patients nearby, then sets precautions by risk level. The higher the risk, the stricter the barriers. It is required by accreditation standards and many authorities.
Dust, mold and fungi
- Dust from demolition, ceiling tile removal or drilling can carry mold spores such as Aspergillus, which can cause deadly infections in some patients. See Mold.
- Water leaks in walls and ceilings must be dried quickly. See Restoration Workers.
Typical controls
- Hard barriers or dust-tight plastic walls from floor to deck, sealed at edges
- Negative air machines with HEPA filters that keep the work area at lower pressure than adjacent areas, exhausting outside or through HEPA
- Tacky mats at entrances and walk-off mats
- Wet cleaning and HEPA vacuuming, no dry sweeping. Cart debris in covered containers
- Use designated routes for workers and debris, away from patients
- Cover or remove ceiling tiles only as the plan allows
- Protect air intakes and keep HVAC dust-free. See HVAC
- Control noise and vibration near sensitive areas
Worker practices
- Attend the project orientation and ICRA briefing. Know the permit and who to call.
- Do not enter patient areas in work clothes covered in dust. Change or cover up as the plan says.
- Do not open barrier doors more than needed. Close them behind you.
- Report broken barriers, ripped plastic and water leaks at once.
- Wear respirators where dust is high. See Respiratory Protection.
- Stay out of isolation rooms and patient rooms unless authorized.
Water, fire and life safety
- Hospital water systems can carry Legionella. Plumbing work and flushing need a water management plan.
- Maintain fire alarms, sprinklers and exits. Interim life safety measures (ILSM) cover temporary blocks or impairments. See Fire System Impairments and Firestopping.
- Control hot work carefully. See Hot Work Permits.
Standards & references
Last updated: