Infection Control

Counting particle dust during construction

Briefings on Infection Control, May 1, 2009

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The Joint Commission’s Environment of Care standards in the Comprehensive Accreditation Manual for Hospitals deal specifically with renovation within the hospital. The standards are designed to ensure the safety of the occupants, particularly patients vulnerable to infections from dust.

Standard EC.02.06.05 requires that hospitals manage their environment during demolition, renovation, or new construction to reduce risk to those in the organization. Element of performance 2 requires that when planning for demolition, construction, or renovation, the hospital conducts a preconstruction risk assessment for air quality requirements, IC, utility requirements, noise, vibration, and other hazards that affect care, treatment, and services.

Although the standard requires several initiatives, it does not address particle counting in the construction site and surrounding areas. But particle counting can serve as one of the best ways to prevent healthcare-acquired infections and protect facilities from lawsuits.

In early February, the Associated Press reported that St. Joseph’s Hospital, Inc., in Tampa, FL, was being sued by the parents of three pediatric cancer patients. The lawsuit alleges that the children—ages 2, 5, and 9—died after contracting fungal infections because they were exposed to a pathogenic fungus after the hospital failed to properly seal off an area during renovations. This kind of lawsuit brings home the point that a lack of particle count standards should not excuse any disregard for this part of the construction assessment, says  Wayne Hansen, PE, REA, CEM, a healthcare engineering consultant at Hansen Cornel Consulting Group in Huntington Beach, CA.

“The fact that there are no standards—that phraseology should be tossed out the window because the lawsuits are so expensive for everybody that the standards are a nonissue,” Hansen says.

Although the Florida dispute has yet to be settled, it shows the kind of situation that can be avoided simply by tracking dust particles regularly with a particle counter, says Marge McFarlane, PhD, CHSP, MS, MT, the safety coordinator at Sacred Heart Hospital in Eau Claire, WI. Debates with doctors or surgeons can often arise because of construction, but documented numbers settle arguments quickly. “The particle counts take away that debate,” says McFarlane. “You can say, ‘I have hard scientific evidence here. Something is causing it; let’s evaluate.’ It takes away all the emotion.”

 

 

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