UCSF HEIC Construction Video (English)

UCSF Medical Center and Benioff Children’s Hospital are consistently recognized as among the leading medical centers in the world patients from all over California the United States and even in other parts of the world are referred to UCSF because physicians nurses and researchers here are part of a distinctive team who have earned a well-deserved reputation of excellence here at UCSF Medical Center and Benioff Children’s Hospital we ensure a safe environment for patients students staff faculty and visitors especially during construction activities in and around the facility perhaps some of you have had family or friends treated here the following videos will review some important dust control measures that are required during construction activities thank you for contributing to a safe environment for everyone at ucsf medical center and Benioff Children’s Hospital please pay attention to the following envision video entitled building on the plan infection prevention for construction personnel you may not see them but behind these walls above these ceilings within these vents inside these pipes and buried in this ground are organisms that can cause illness fungus or mold is often found in soil or damp areas given the right conditions it can grow on wet ceiling tiles damp plaster drywall carpet and settle dust these spores can enter from opening or closing doors be carried on clothes or shoes move through ventilation systems and grow anywhere there is moisture other germs can also be found in water or other areas such as pipes and sewage systems mold and bacteria can be spread when water pressure is turned on and off and corrosion and pipes is released whenever soil is excavated and when walls carpeting or ceilings are disturbed healthy people don’t normally get sick from mold or bacteria but for some patients in hospitals and health care facilities even the smallest amount of fungus or bacteria from the environment can lead to serious illness and even death this is why infection prevention and safety measures must go hand-in-hand and why your compliance is so important an infection control risk assessment or Achra is used to control the risk of infection in hospitals and healthcare facilities during construction or renovation it starts during the planning of the construction and lasts until the project is completed the Ikra is written into the construction contract and lists the steps that construction workers must use to contain dust and dirt the Ikra process will include daily inspections by construction and hospital supervisors during every phase of the project to make sure infection control and safety measures are being followed be familiar with these for each project ask if you’re not sure let’s begin by discussing the safety measures you may be required to perform during the construction or renovation project first and foremost open communication is the key to making any construction or renovation project successful know who your supervisor is and who to call to report problems address issues lodge a complaint or simply to keep the project moving forward services must never be shut off without first getting approval from the facility if there is an accidental shutoff or a broken water or sewage pipe address this immediately know the emergency plan for the facilities such as who to contact so systems such as water oxygen and electricity can be shut down because you pick up dirt and soil on your clothes especially during demolition you’ll be told where to go for breaks and lunch and which bathroom locations entrances exits corridors and elevators you’ll be allowed to use during the project we’re an ID badge at all times during the project never enter patient areas without first notifying the health care worker in charge of the unit if you accidentally see or hear information about a patient’s condition you should know there is a privacy law that states you must not share or discuss that information with anyone before beginning work your supervisor will let you know if the facility requires health screenings such as TB testing this will depend on the type of work you’ll be doing and what there is any risk of sharing space with

patients be sure you know what’s expected and follow the rules if you see an isolation precautions sign like this on the door of a room you need to enter you must first check with a nurse in charge of the unit if you are told not to enter the room notify your project supervisor if a biohazard sign is posted outside a room or area check with a supervisor before entering and if you see any sharps containers like this in your area alert your supervisor next it’s important that you know the proper personal protective equipment or PPE to wear for the task at hand PPE can be masks or respirators eye protection or face shields gloves and jumpsuits or full coveralls the type of PPE will depend on the specific task you are assigned and whether you will wear protective clothing in the worksite or when entering a clean area for example any time you are working with materials that produce heavy dust you should wear a mask heavy gloves should be used to handle dirty or contaminated objects if you are working with water sewer or vacuum systems wear a face or eye protection to protect your eyes from splashes and for projects that create medium to heavy dust disposable jumpsuits can be used to protect clothing when working in a construction site or contain dust on clothing when entering a clean area now that you are aware of the safety measures here are the infection prevention measures you may be using to contain dust and debris during the construction and renovation project depending on the task there are different ways you’ll be asked to contain dust and debris for small-scale dust generating projects such as minor sanding installing a telephone and computer cable or for access to shaft spaces plastic sheeting or a prefabricated containment unit may be required clean drop cloths HEPA vacuums or wet mop should be used as needed to control dust medium dust producing projects involving sanding or cutting walls demolition or removal of fixed building components removal of multiple ceiling tiles minored ductwork or electrical work above ceilings or work in patient care areas will require prefabricated containment units or firm wall barriers holes pipes and conduits into the construction site should also be sealed projects that produce high dust and take longer to complete such as new construction or demolition require maximal barriers the work area should be sealed either with a containment unit a gasketed door and frame or covered in plastic sheeting big projects also need space outside the work area for tool storage waste removal and clothing changes before the project begins in addition to barriers large projects often require negative pressure systems and HEPA filtration negative pressure is created so that the air flows into the construction site rather than out into surrounding areas in order to create negative pressure when a containment unit is not used you may need to seal unused doors a HEPA unit is a portable high efficiency particulate air filter also called an air scrubber hepa units are often used if the work site is next to a patient care area all HEPA units and barriers must be in place and checked for proper function before construction begins workers are responsible for maintaining negative air pressure and changing hepa filters for as long as the project lasts because it’s so important that barriers be maintained stay alert for indications that barriers are not working examples include visible dust and nearby areas or wetter stained ceiling tiles the presence of flies insects or rodents should be reported immediately during outside construction protect materials from moisture and contamination during inside construction wipe tools before leaving the worksite and store them in an approved area never store tools and materials in corridors stairwells or directly outside of exits use adhesive walk off mats to catch debris from the feet or from container wheels these mat should be changed daily or more often if needed or assign a worker to damp mop the exit and traffic pathways as required to control dust and dirt remove waste or debris in tightly covered large carts the containers should be wiped down covered and closed before they are removed from the worksite remove waste every day at pre-arranged times and remember to use assigned elevators and pathways when working in areas with nearby patients the work area should be cleaned daily by wiping down surfaces with an approved detergent or by using a wet mop or wet vacuum exits traffic pathways and nearby areas should be damp mopped as needed you the construction worker are the key to a

successful construction or renovation project when you understand the infection control and safety issues and follow all prevention measures carefully you are protecting not only your safety but that of our patients as well all on-site construction workers are required to attend a class sponsored by infection control as a condition of the contract construction workers are required to attend this class on an annual basis as a condition of working at the Medical Center contractors and the project manager will keep a record of attendance and will make certain everyone working at UCSF is current with this tray Nia at the completion of this video you will be required to take a short quiz to ensure that you understand its content this is an important step and help you keep the work environment safe for everyone if you have any questions or would like to review any of the materials presented facilities personnel will be glad to assist you upon successful completion of the quiz you will have met the infection control requirements for the next 12 months which will enable you to work at ucsf medical center and Benioff Children’s Hospital prior to entering a patient care environment or patient room you must clean your hands with either soap and water or alcohol gel you must also clean your hands upon exiting if you see an isolation precaution sign on the door of a room you are about to enter you must first check with a nurse before entering if you are told not to enter please notify your project supervisor demonstrated here are the isolation precaution signs used at ucsf medical center and Benioff Children’s Hospital mold can cause severe disease or even death to people whose immune systems are not working well like those people with cancer AIDS the elderly or the very young dust created during demolition and construction contains mold the mold is breathed in and is no risk to healthy people with a working immune system but for those who are more vulnerable it can cause very severe disease there are additional dust control measures to keep in mind while working at UCSF signs with the project manager’s name and 24-hour contact information must be posted outside the construction zone construction barricades must be sealed and full height from the floor to the underside of the ceiling above infection control design and construction and facilities management staff will regularly inspect the project site for dust control measures if thus control measures are not in place work will be stopped until the measures are correct it finds may also be assessed if dust control measures are not in place when ceiling or wall access is required outside the construction barricades a polyethylene enclosure such as a portable tent must be utilized in areas where patients are housed or transported a ceiling or wall access permit is required and must be obtained from UCSF facilities management when transporting your containment equipment be sure all exterior surfaces including wheels have been thoroughly cleaned please be courteous of all patients visitors and staff around you having a co-worker assist in setting up a containment enclosure will make this an easy process make sure all gaps are properly sealed and be careful not to damage any ceiling tiles or surfaces during this process walk off mats are required at exit points of all dust containment setups and enclosures it’s good practice to work in pairs or with coworkers when handling equipment and materials this helps expedite this process and could help in maintaining the integrity of the enclosures after all tasks have been completed and all penetrations have been sealed and secured all tools leftover materials and interior surfaces of the containment enclosure must be vacuumed with a certified HEPA vacuum it is good practice to follow the vacuuming procedure with wiping down the surfaces with disposable wet cloths these are usually obtainable from hospital staff or by prearrangement through facilities management after the interior of the barrier and tools have been thoroughly cleaned they can be removed with the help of a co-worker in certain sensitive

or critical areas as outlined by facilities management or infection control a HEPA filter negative air containment enclosure must be used contact facilities or infection control for more information on the requirements for this setup I want to go over the different setups for our HEPA negative air machines today the requirement of which will need to be evaluated for all our construction projects the activities of construction both demolition and new installation often generate dust and debris in the air which can be harmful to many of our patients in the hospital in order to mitigate this risk we require that the dust and the debris not escape the construction area into the rest of the hospital we use the heavier machines and three different setups to clean the air if possible we always want to set up the machine to create a negative airflow coming into the construction area and being exhausted through the machine to the outside of the building I want to show you a typical setup here that has the Machine exhaust hose run to a custom panel in the window and to exhaust the air to the outside of the building this will create an airflow into the room and out the window this will keep all dust and debris inside the room as it is filtered and exhausted by the negative air machine the negative air machine must be running continuously while any construction activities are happening in the space the machine must always have been tested and certified within the year with current certification attached to the machine and the filters always maintain clean when the construction project is first evaluated by the PM and infection control department it will determine which setup can be used in each location it is always preferable to exhaust the air directly to the outside of the building sometimes this is not possible I want to move on to another construction area and show you the other two setups that we can use when exhausting directly to the outside of the building is not possible here we have a large construction site in the middle of the basement to the hospital there are no outside walls to penetrate or windows to the outside in the space we only have two possible setups available in this space the first one here is exhausting the negative air machine into an existing exhaust duct from the hospital exhaust system we were fortunate to have a large existing duct to tap into this setup the attachment needs to be secured and airtight this will produce a negative airflow through the room and out the exhausts in some cases we do not have an existing exhaust to tap into in this case the infection control Department can give permission to just scrub the air inside the space to capture the dust and debris created by construction activities here we are using this machine to scrub and clean the air quicker in a larger space if you are only able to run the machine inside the construction space without exhausting the air you will not have a negative airflow into the space and will need to be more careful in entering and exiting in the space so as not to let dust and debris migrate into the hospital which way the negative air machines are allowed to be set up is determined by the infection control Department enlisted in the approved infection control requirements for each individual project to protect our patients major outdoor construction projects also require dust control measures during outdoor demolition and excavation soil and debris must be kept continuously moist as they may contain germs that may be aerosolized windows on units facing major outdoor construction projects must be shut and disabled signs alerting staff and visitors of outdoor construction should be placed on doors leading to outside stairwells that face the outdoor construction project these doors will also be alarmed during the project debris that is hauled away by trucks must be kept moist and covered prior to hauling roadways will be free of dirt and wash daily soil containing Legionella may enter plumbing systems through cracked pipes report any disturbed cracked or broken pipes to the project manager who will then report this information to facilities managed during outdoor major construction or demolition activities the contractor will complete a daily checklist to ensure that appropriate dust control measures are performed each day the contractor must cease thus producing activities if water is not available or if a situation arises leading to

uncontrollable dust generation air sampling for mold spores may be performed at strategically important locations and times during the demolition and construction phases of a project to assess the effectiveness of dust control at the project site collected samples will be sent to the microbiology lab for culturing and analysis the microbiology lab will report sampling results to infection control construction in hospital environments post dangers not only to the contractors but to hospital staff and patients interim life safety measures our health and safety measures that are put in place to protect the safety of patients visitors and staff who work in the hospital in basic terms we’re talking about things like exit signs pathways to an egress point fire protection systems smoke barriers and many other items that contribute to the well-being and safety of occupants in the hospital construction or maintenance activities that have an impact on the life safety systems in the hospital will require an interim plan to address deficiencies created by the work activity the Joint Commission developed interim life safety measures to protect the safety and health of patients by compensating for hazards caused by the leg safety code deficiencies or construction activity when doing work within the facility please always consider the condition of patients in the hospital environment there may be people who because of their medical conditions cannot walk or may even be under anesthesia and therefore cannot evacuate on their own if needed if a construction worker causes a fire in an area without sprinkler systems smoke detectors or any other fire life safety system consequences could be serious prior to any new construction the scope of the project will reviewed with campus fire marshal and Safety Office representatives to assess the risk to fire life safety questions that will be asked during this process would include items such as will existing exit pass be impaired or blocked well the construction area require additional exit routes with the existing corridor with be reduced below allowable reductions and will there be an increase in flammable hazards or combustible fire load due to construction will fire alarm system and suppression systems we impaired in or outside of the construction area as part of the project activities if there’s an increased life safety risk posed by the construction project an ILS M plan will be developed and documented on the medical center pre-construction risk assessment and ILS M plan form this form will be posted at the project site also posted at the project site will be there emergency conditions and basic staff response flipchart please review with project staff for important contact numbers and medical center safety and emergency response information throughout the project medical center representatives will be inspecting life safety procedures to verify compliance with our standards our medical center staff are dedicated to providing the safest healthcare and hospital construction project environment we treat this work as if our own family and children our patients and staff and take all possible steps to minimize the hazards we hope you do the same during work if you are exposed to blood or other hazardous body fluid do three things immediately first wash the exposed area second page the needle stick hot line at this number third notify your supervisor perhaps you have had a friend or a loved one who has been admitted to hospital our patients include babies children and adults they are our top priority we need to keep them safe make them your top priority to thank you for making this project a safe one you