While upgrading healthcare facilities can be critical to improving patient care, the fact remains that outbreaks of infection are associated with construction and renovation projects without proper risk mitigation. This is where the infection control risk assessment (ICRA) comes in. As air quality, water systems, noise, dust, debris, and vibration can impact the health and safety of staff and patients in healthcare facilities, ICRA — and the use of ICRA barriers — is a vital component in patient safety programs and infection prevention.
ICRA was critical during the pandemic when it was used to help contain and minimize the spread of coronavirus. Even though the COVID public health emergency has officially ended, ICRA remains an ever necessary tool in infection control. There were still over 442,000 COVID hospitalizations between January and June of this year, according to the CDC, and it’s estimated that as many as 650,000 influenza hospitalizations occurred between October of last year and April 2023. Add to that last summer’s unseasonal spike in illnesses like strep A, croup, and RSV, and the roughly 7 million immunocompromised people living in the U.S., and it’s clear that proper application of ICRA is just as important as it’s ever been.
What Is ICRA?
ICRA, which stands for infection control risk assessment, is a step-by-step process in the healthcare industry for determining the level of risk that a particular construction or renovation project poses to residents, patients, or healthcare staff. It also provides control measures that must be taken to mitigate that risk.
ICRA Guidelines: ICRA 2.0
Contractors and facilities managers need to have a thorough understanding of ICRA guidelines to mitigate risk effectively. There are four basic steps to an ICRA:
- Identify the type of renovation or construction (A, B, C, or D).
- Identify the resident/staff/patient risk group that will be affected most and their risk level (Low, Medium, High, or Highest).
- Use the ICRA Matrix to determine the correct class of precautions (I, II, III, IV, or V).
- Implement the appropriate control measures to reduce or eliminate the risk to residents/staff/patients.
The type of renovation varies from Type A, which would include non-invasive and inspection activities, to major construction and demolition projects (Type D).
Staff and patient risk groups begin with Low (office areas) and continue through Medium (e.g., cardiology, radiology, and PT), High (e.g., ER, pediatrics, and surgical units), and up to the Highest Risk groups (e.g., burn unit, oncology, negative pressure isolation rooms, and immunocompromised patients).
The ICRA Matrix allows the contractor to quickly determine which class of Infection Control Precautions will be necessary based on the Construction Type and Risk Group established in steps one and two.
ICRA Matrix — Classifications for Control Procedures
CONSTRUCTION TYPE → _______________________RISK GROUP ↓ |
TYPE A | TYPE B | TYPE C | TYPE D |
LOW Risk | Class I | Class II | Class II | Class III* |
MEDIUM Risk | Class I | Class II | Class III* | Class IV |
HIGH Risk | Class I | Class III | Class IV | Class V |
HIGHEST Risk | Class III | Class IV | Class V | Class V |
Source: ASHE
*Type C and D work areas categorized under Class III that can’t be sealed off and completely isolated from occupied patient care spaces should be upgraded to include negative exhaust requirements per Class IV.
ICRA Containment
In addition to a host of other precautions, Classes III (under the conditions above), IV, and V require critical barriers and negative air pressure within the work site to minimize the spread of dust and other contaminants, with Classes IV and V requiring an anteroom as well. These are known as ICRA barriers or ICRA walls.
Classes III, IV, and V require removal or isolation of the HVAC system to prevent contamination of the duct system, and even Classes I and II require work to be performed in a way that minimizes or prevents the spread of dust and airborne particulates.
Modular ICRA Containment Walls
Thanks to their versatility, durability, and sustainability, modular wall systems are gaining popularity as ICRA barriers in healthcare settings. Consisting of prefabricated panels that can be pressure-fitted together, they offer adjustable designs that allow for easy installation in spaces of all kinds. There are a variety of modular wall products available on the market. These range in quality with regard to materials, adjustability, noise reduction, safety ratings, appearance, and installation.
Already in hospitals, bio research facilities and considered “Best Practice” in health Care training programs. Facility Managers, Infection Control Departments; appreciate the clean, professional look and the ability to maintain that appearance throughout the project. These panels can be erected without any mess or noise, you don’t even have to remove the ceiling tile. This system is the real deal. If the project is going to take a while, you need a clean work area or to create a clean area for your client, this is the system for you. One person can typically set up a 2’x 12’ enclosure in a half hour, breakdown in less than 15 minutes. The panels allow light to pass through creating a pleasant, safe work environment without the need of added temporary lighting. It provides a huge savings when compared to using metal studs and drywall. These are RE-USABLE.
Panels:
Our panels come with all fitting/clips for assembly of walls and joining panels and come in two color options- Opal which is opaque and Clear.
12″ Panel Assembly – Opal/Clear
2″ Panel Assembly – Opal/Clear
2′ Panel Assembly with HEPA Filtered Air Discharge Port
3′ Panel Assembly – Opal/Clear
3′ Panel Assembly with HEPA Filtered Air Discharge Port
4′ Panel Assembly – Opal/Clear
4′ Panel Assembly with HEPA Filtered Air Discharge Port
4′ Panel w/44″ Door, Pushbutton Combination Lockset- Opal/Clear
4′ Panel w/ 44″ Door – Lever Style Lockset – Opal/Clear
Accessories
Grid Clip Assembly (100/Bx)
Replacement Pushbutton Combination Lockset
Replacement Lever Style Lockset
Panel Transport Cart
Cost on request. Please note all prices INCLUDE freight delivery to your warehouse or job site. Packs available on request.
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