Format IIA Model Infection Control Program for Commissioning an Ambulatory Surgery Center

Abstract

ISSUE: Construction-related infection control guidelines for healthcare facilities are primarily directed toward preventing healthcare-associated fungal infection (e.g., Aspergillus species) in occupied buildings. There are, however, no generally accepted standards for infection control commissioning of a newly constructed ambulatory surgery center. A model infection control program for commissioning such a building is presented. PROJECT: To develop an infection control-commissioning program for a newly constructed ambulatory surgery center; to confirm HVAC system cleanliness, operation, and filtration efficiency; building cleanliness; and to establish acceptance criteria for airborne particulate and opportunistic fungal species. RESULTS: A multidisciplinary team was created including representatives from Infection Control, Infectious Diseases, Construction Management, Administration, Laboratory Medicine, Environmental Services, Industrial Hygiene consultants and contractors. A program of sequential, step-wise inspections and testing was developed. The program elements included surface sampling of the HVAC system and duct interiors; HVAC and room pressure relationship testing, and filter efficiency testing; moisture testing; and fungal and particulate air sampling. LESSONS LEARNED: The use of multiple inspection and testing methods (visual inspection, pressure testing, particle counters, and air samples) provided the most useful information for infection control commissioning. Close partnering with the construction contractor was the single most significant contributor to the success of the infection control commissioning process.