SECTION 3 – PLANNING

DETERMINE ACTIVITY TYPE

d.
Activities that do not generate dust or disrupt patient care, such as:

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§ Visual inspections
NON-DUST GENERATING

§ Installation of trim

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§ Installation of Electrical work (cabling/networking), and

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§ Painting activities (sanding is not allowed)

G
A

§ Limited plumbing work that affects no more than one room for less than 15 minutes.

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§ Other activities that do not include dust creation:
§ Drilling

i
in
§ Sanding

a
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§ Cutting into walls or ceilings

Limited activities that create minimal dust and take less than 8 hours to complete:

IC
§ Work within, and using chase spaces/cavities (e.g. wall cavities, ceiling spaces)
MINIMAL ACTIVITY

§
§
Displacing a single ceiling tile; or
Via installed panels. 20
20
B

§ Cutting activities where dust migration can be contained (e.g. creating access points for
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electrical work)
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§ Repairing/sanding/drilling small areas (<1 square foot) of drywall

Plumbing work that disrupts a water supply for less than 60 minutes
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Construction and/or demolition activities (removing or installing components affixed to a wall/ceiling)

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MODERATE ACTIVITY

that create moderate-high levels of dust, and/or cause moderate disruptions to patient care:
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§ Sanding large/entire areas of drywall (>1 square foot)

C

§ Demolition/construction of walls (taking less than one shift to complete)

C

n.

§ Removing any floor coverings, multiple ceiling tiles, and/or casework

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§ Limited ductwork or major electrical work (above ceilings, significant cabling activities)
§ Plumbing disruptions lasting 30-60 minutes
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High-level dust generating activities (major demolitions and construction, work that disrupts patient
tri

care over multiple shifts) including:

MAJOR ACTIVITY &

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DEMOLITION

§ Extensive soil displacement;

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§ Construction that spans over 2 or more working shifts;

D

§ Plumbing work that disturbs patient care for more than 60 minutes;
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§ Removing entire electrical/cabling systems; and

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§ Construction/demolition of walls that span 2 or more working shifts.

N

3-56
SECTION 3 – PLANNING
IDENTIFY RISK GROUPS

d.
LOW RISK MEDIUM RISK MEDIUM-HIGH RISK HIGH RISK

Lt
§ Patient care areas § Emergency wards § Intensive care units
§ Non-patient areas
Office spaces – General (ICU, NICU etc.)

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§ §
§ Low-risk areas where

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patient surgical/medical § Trauma care
not otherwise listed

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admission/discharge wards § Operating rooms
§ Public areas (non-
units § Imaging, diagnostics (incl. pre and post op)

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adjacent to patient care
§ Waiting rooms § Delivery rooms, § Critical Care
areas)

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§ Occupational and nursery § Burn units
§ Workshops/Maintenance
physical therapy units § Nuclear medicine § Oncology
§ Administrative offices

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Morgue, autopsy Hydrotherapy Internal diagnostic

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§ § §
§ Housekeeping
§ Outpatient clinics § Echocardiography imaging

a
§ Soiled laundry
(where not listed § Laboratories § Isolation Rooms

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elsewhere) § Pediatrics § Pharmacy
§ Geriatrics § Cardiology

IC
§ Food and beverage § Laboratories
areas

20 § Clean laundry
20
§ Respiratory therapy
rooms
§ Hydrotherapy rooms
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PMA MATRIX
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C
n.
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bu
tri
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N

3-57
SECTION 3 – PLANNING

SELECT PREVENTATIVE MEASURES LEVELS

d.
Level I

Lt
PRIOR TO WORK START § Identify high risk patients near work areas

p
§ Identify other systems that may be impacted (ventilation, plumbing, etc.)

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§ Determine if patients need to be moved or additional protections needed

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§ Schedule work during off-hours when there is limited healthcare activity
§ Ensure new materials are kept clean and dry during transport and storage

G
DURING WORK § Minimize dust generation (e.g. use dust capture systems)

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§ Use additional protections to prevent dust migration (e.g. pop-up tents)

i
§ Clean up as work progresses (using HEPA vacuums, wet mops, etc.)

a in
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Level II

IC
Use all controls listed in LEVEL I

PRIOR TO WORK START §

20
Identify high risk patients near work areas
20
§ Identify other systems that may be impacted (ventilation, plumbing, etc.)
§ Determine if patients need to be moved or additional protections needed
§ Schedule work during off-hours when there is limited healthcare activity
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§ Ensure new materials are kept clean and dry during transport and storage
ht

DURING WORK § Use walk-off mats at entrances and exits to work zone
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§ Monitor for effectiveness of housekeeping

§ Change/clean as needed
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§ Seal doors and openings (e.g. air ducts) with tape and poly sheeting
C

AFTER WORK § Flush water lines in the area for 10 minutes

§ Perform terminal clean prior to occupancy (HCF housekeeping staff)
n.
tio
bu
tri
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rD
fo
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N

3-58
SECTION 3 – PLANNING

Level III-IV

d.
Use all controls listed in LEVEL I & II

Lt
§ Set up MDT and schedule meetings
PRIOR TO

p
WORK § Ensure stakeholders have IPAC training

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START § Identify any disrupted essential services

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§ Ensure staff/workers in affected areas are educated and aware of infection risks

G
§ Complete ICRA/PMA with sign off
§ Outline process for any scope changes to be reviewed and approved with ICP/MDT

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§ Use effective dust barriers (poly, tape, air-tight)
DURING

i
Erect Ante-Room (when required)

in
WORK §
§ Use dust suppression/collection systems with HEPA vacuums

a
§ Must also be used on interior cavities (walls, ceiling spaces, etc.)

Tr
§ Confirm area is fully sealed (air ducts, doors, above ceiling)
§ Keep all doors and windows closed

IC
§ Maintain and monitor air pressure differential between occupied and construction areas
§ Inspect dust barriers regularly
§ Repair breaches immediately
20
20
§ Use sufficient air handling unit(s)
§ Use an isolated work path (dedicated elevators, entrances, etc.)
§ Monitor workers for decontamination procedures when leaving work zone
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§ HVAC Systems:
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§ Protect ductwork from moisture and dust

Excavation Activities:
rig

§
§ Clean intake AHU filters more frequently
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§ Water soil to minimize dust

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§ Consider air sampling (decided with ICP and MDT prior to work)
§ Plumbing
C

§ Dead leg water pipes in plumbing system removed at connection to main line
Flush any water lines that were shut down
n.

§
AFTER
WORK § If water lines were accessed or major plumbing was required, disinfect lines prior to flush
tio

§ Clean any contaminated HVAC systems prior to turning on

Filter changes may be required
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§
§ Clean (Construction Clean) work areas thoroughly before removing dust protection barriers
tri

§ Terminal Clean may be required before barriers are removed, as per MDT/facility policy
Confirm HVAC systems are working
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§
§ Remove dust barriers/walls so that dust does not contaminate clean zones
rD

§ Complete final visual inspections of affected area(s) before allowing patients/healthcare

HANDOVER
workers into the area
fo

§ Final Construction Clean - State of cleanliness expected prior to Terminal Clean

conducted by HCF Staff. Disinfection is not required
ot

§ Terminal Clean - Thorough cleaning by HCF staff - Includes disinfection

N

§ After work is complete, review if measures were sufficient/effective, recommend improvement

3-59
SECTION 3 – CLASS EXERCISE #3

SCENARIO 3
A new electrical line needs to be installed in a ceiling space above an active respiratory therapy area. The ceiling

d.
space was once used as a mixed air plenum. The work will take 2 days to complete. What Preventive Measure Level

Lt
is required?

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EXERCISE 3

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Using the ICRA/PMA below to perform an analysis using the provided matrices:

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i ng
a in
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IC
20
20
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Construction Activity:
C

TYPE:
n.
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POPULATION RISK GROUP:

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PM LEVEL
tri
is
rD
fo
ot
N

3-60