According to the Centers for Disease Control and Prevention (CDC), more than half of infection outbreaks caused by the common mold, Aspergillus spp., are associated with construction and maintenance activities in hospitals.
The CDC also estimates that five percent of all hospital admissions result in infections that patients acquire while receiving treatment for other conditions.
Without proper training on how infections can occur in healthcare settings, contractors often make common mistakes and fail to realize the impact of their actions on patients in the facility. In hopes to avoid these mistakes, most hospitals have a kick-off meeting with contractor superintendents to explain the Infection Control Risk Assessment. The ICRA, prepared by Infection Control personnel, analyzes the risk to patients regarding the proximity of the construction site. Unfortunately, many workers are not briefed on the assessment and do not recognize the need to become familiar with the ICRA, because they are performing relatively simple tasks around the hospital and there is typically no discussion about what actually causes an infection.
Infection Control University (ICU) provides Infection Control Awareness Training Certification in-line with CMS guidelines to all staff and contractor employees who work in healthcare facilities to minimize the risk of Hospital-Acquired Infections (HAIs) around maintenance, remodeling and construction-related activities.
The improper handling of general construction materials in healthcare settings needs to be addressed to lower these rates of infection and minimize the risk of infection for patients, healthcare facility contractors and all healthcare employees. By educating healthcare employees and facility managers about HAIs, facilities can minimize the risk of infection and more importantly – save patient lives.
Understanding HAIs According to the American Journal of Infection Control, “The actual percentage of hospital-acquired infections (HAIs) directly related to construction is unknown, the morbidity, mortality and costs of mitigation are considerable.” Infection Control and Prevention roles are vital positions within a healthcare facility aimed to discipline the concern of preventing HAIs – which are caused by viral, bacterial and fungal pathogens that can be airborne, waterborne or transferred through surfaces in a healthcare setting. The most common types of HAIs are transferred through maintenance and construction-related activities. Sites that generate high levels of dust from major demolition and construction activities can be unknowingly transported to many areas of the hospital. The areas of the hospital that are at the highest level of HAI-risk include intensive care units, operating rooms, dialysis units, critical care nurseries, burn care units, trauma rooms and outpatient clinics.
Patients aren’t the only people in healthcare facilities to be affected by the lack of understanding of HAIs. contractors themselves are at risk when unfamiliar with techniques and procedures required to properly handle materials that can be supporting dangerous fungi and bacteria.
Healthcare construction-related risks Hazardous materials, as defined by the Healthcare Environmental Resource Center, are “materials that pose a particular concern for transportation and worker health and safety.” The Federal and State Departments of Transportation determine whether or not a material is hazardous from a transportation-safety standpoint. The most common hazardous materials in healthcare facilities include mercury, pharmaceuticals, radiologicals, sterilants and disinfectants, cleaning chemicals, laboratory chemicals and pesticides.
However, even simple construction debris can become hazardous in a healthcare setting. Removing ceiling tiles, cutting into drywall, drilling and other dust-generating activities can have a negative impact on immuno-compromised patients. The term hazardous takes on a whole new meaning inside healthcare facility walls. For example, construction in a nearby Radiology Suite can cause six HAIs and two patient deaths. Workers must understand how their work can cause grave illness and even death in healthcare patients when proper precautions are not taken.
Facility-wide training model By implementing ICU’s innovative cloud-based learning center, all healthcare and contractor employees can receive Infection Control Awareness Training Certification and have 24/7 access to reference information and proven techniques that will help reduce the risk of HAIs. The online training program meets all Centers for Medicare & Medicaid Services and CDC requirements, enforces safer work practices and helps to promote a safer, healthier facility.
HAIs can be acquired anywhere healthcare is delivered, including inpatient acute care hospitals, outpatient settings and long-term care facilities. In 2014, the CDC estimated that one in every 25 healthcare patients acquires an infection while receiving treatment for other conditions.
ICU’s Infection Control Awareness Training is a tool built to arm the contractors that work in hospitals with a greater understanding of how infections occur and their impact on patients and the hospital as a whole. No hospital staff can keep up with training every worker that comes into the facility. Like the military when training for a mission, corporations align all assets and communicate throughout the ranks on how they intend to fight and win. Similarly, ICU provides a hospital with a high-level review of how educating all healthcare and contractor employees can drive positive change.
Evolution of ICU Because contractors are frequently transferred between facilities to work on multiple jobs, replacement staff is put in their place. The high volume of individuals at work in any facility sheds light on the need for all contractor staff to be educated on infections and how they can occur in healthcare facilities.
At an In-Service Training for an acute care hospital’s maintenance and engineering team, ICU provided information on how maintenance work can cause infections in patients. ICU asked if the maintenance team had ever been told how infections actually occur. Their response was revealing: “We have never had anyone explain how we impact infections. We are just told what we can and can’t do in certain areas of the hospital because of patient conditions,” said one of the facility staff members.
Hospital staff members are often so over-worked that they just want to explain the rules rather than taking the extra time to provide more in-depth knowledge about how infections occur. The quiz provided during the In-Service training gave ICU the idea that its programs can help fill the gap by providing helpful targeted information about reducing infections to all workers performing tasks in healthcare settings. For example, by taking time to explain dust migration and how harmful bacteria and fungi attach to that dust, the facility’s construction workers related the material to their work habits. These workers finally understood that the ICRA wasn’t just a list of rules to follow; ICU educated them and emphasized that each worker played a part in keeping patients healthy by how they perform their work.
This quiz also provided ICU with an opportunity to encourage maintenance workers to become advocates for contractor education and patient health. The construction team appreciated the knowledge and gave them a whole new outlook on how their work performance impacts everyone travelling throughout a healthcare facility. contractors are now shifting their focus from finishing the task at hand to maintaining a safe environment for patients and themselves.
Educating and training healthcare employees and contractors who are unfamiliar with how infections occur are much less likely to take preventative measures in their work. It is important to train all personnel on the front lines of healthcare facilities in order to reduce the overwhelming number of HAIs that claim 271 deaths per day – implementation of ICU’s online program will save patient lives.
Thom Wellington is the co-founder of Infection Control University and CEO of Wellington Environmental. As a member of APIC and ACHE, and with more than 25 years of experience in managing infection risk, Wellington’s background has illuminated for him the vitality of improving the quality and performance of healthcare facilities and patient care through employee and contractor education.