Applying building management tactics to infection control

Facilities managers are great at mitigating life safety issues like generator performance and ligature risks like door handles. However, many often struggle at controlling infection risks in the hospital environment when performing maintenance, repairs or construction. Perhaps controlling infection risk needs to be thought of in a new way. The National Cancer Institute defines infection as the “invasion and growth of germs in the body.” What if the word “body” was changed to “building system?”

Consider this: in plumbing systems, water is moved to ensure that it does not become stagnant and treatments are applied to keep it clean. In electrical systems, it must be ensured that motor cases are tight, vents are not clogged and there is no dirt on the windings to reduce temperatures. For HVAC systems, filters are replaced and coils are cleaned to guarantee proper airflow. For fire suppression systems, verification ensures that the sprinkler heads are free of dust to eliminate delayed responses. Before turning over new systems, an acceptance test is performed to ensure everything works properly. All the while, maintenance technicians wear the appropriate personal protective equipment (PPE) to maintain their safety.

Infection control tactics can be compared to building system maintenance, but in the case of infection control, it is the person — rather than a machine or system — that is being protected. The concept is simple. Sources of contamination (e.g., dust and mold spores that travel with it) must be controlled to prevent their spread in hospitals to patients. Limiting the spread of infectious agents during facilities maintenance or construction work can be achieved by following a risk assessment methodology that includes introducing outside air, moving air from clean to dirty rooms, tightly containing space where dust is generated, confirming filters are effective, inspecting pressure gauges, testing the surrounding area for particulates and properly using PPE where appropriate.

When maintenance or construction is performed, facilities managers should think about the impact on the most important “system,” which is the patient. Facilities can and must do better.

For more information on controlling infections and maintaining an infection-free environment, managers should visit ashe.org/icra2 and download the ASHE Environment Rounding Tool available via the link at left.