Infection Control Risk Assessment Activities for Floods, Sewage Spills, and Malfunctions

Abstract

ISSUE: During the 2004 hurricane season, our facility was undergoing major renovation. Infection Control Risk Assessments had been completed for all projects. However, through a malfunction of a contractor's sump pump, rain water and construction debris were pumped into radiology and central supply areas causing major flood damage. Prompt remediation of this crisis was impaired through stress on systems, poor communication and documentation of appropriate steps. PROJECT: A performance improvement team was formed to address communication and remediation steps which included infection control, facilities operation and development, environmental services, and safety. A checklist was developed to address all components of an infection control assessment. This checklist included a place to indicate which activity was appropriate for the situation and the responsible party to carry it out as well as a place for signoff when the task was completed. The form listed the key components identified from the Guideline for Environmental Infection Control, 2003 which are: patient and supply management, furniture removal, traffic control, access restriction, removal of sewage and other solid wastes, and removal of water. Elements listed in structure remediation included cleaning and disinfection of hard surfaces, management of carpeting, assessment and replacement of tiles and flooring, evaluation of wallboard and other porous structural material. Furniture assessment and recommendations for management of furniture and cubicle panels (i.e. hard surface, cloth and wood) as well as electrical equipment assessment were included. The checklist was posted on the infection control website making it available to all employees. All areas were inserviced on the tool to facilitate teamwork, communications, and quick and appropriate remediation of affected areas. RESULTS: The tool was developed and approved by the Infection Prevention and Control Committee. The tool provided an efficient and effective way to assess the impacted area after flooding, sewage spills or malfunctions. The team found that all parties understood their roles and responsibilities better and the process was documented. Improved communication facilitated by the tool streamlined the response effort and improved turn around time. LESSONS LEARNED: Infection control risk assessment for remediation after a flood, sewage spills or other malfunctions can be streamlined via the use of checklist form that includes key elements, assigns responsibility and documents when tasks are completed. This tool facilitates communications during a time of crisis and assures that all key factors are addressed. Placing the tool on a hospital website makes it available for use to all areas. Checklist was used as an example in the APIC/JCAHO workbook in 2005 but not discussed in depth that this presentation will cover.