Audit

Inspections are to be made periodically until project completion.

PROJECT DEMOGRAPHICS

Project Name:

Project Location:

All approved Infection Control Risk Assessment (ICRA) permits are posted at each entrance to the construction/renovation area.

GENERAL CONDITIONS

Air pressure barriers are active (negative pressure maintained, exhaust fans functioning, air quality adequate, no excess fumes or vapors).

All exits and unobstructed and useable, including the construction area.

The means of egress in the construction area are unobstructed and useable.

Temporary construction/renovation partitions are dust tight, and sealed.

Construction area is secure (barriers are adequate to prevent entry from unauthorized persons, vermin, etc.)

Infection Prevention and Facilities has been notified of ANY equipment or systems disabled prior to them being disabled

Proper construction garb/ ppe is in use. Including appropriate hospital approved badges.

Construction personnel hygiene, appearance, and conduct is appropriate.

Is the construction/renovation area clean and orderly.

Patient care equipment and items have been removed from the construction area or covered.

All waste and scrap has been removed and disposed of properly, in a clean and sealed container.

All water utility disruptions will be thoroughly flushed and temperature tested prior to returning to service for routine use.

DUST CONTROL MEASURES

Demolition and/or dust producing activities will be conducted OFF/AFTER normal patient hours?

Doors and windows shut, and sealed as appropriate?

Construction personnel and materials are transported through specific construction traffic paths, non patient paths?

Project Barrier Types?

Project barriers are in place according to ICRA specifications.

A zipper wall access will be utilized?

A zipper pulled as appropriate?

Supply vents sealed where appropriate?

Return vents sealed where appropriate?

Negative pressure required?

Negative air machine is in place, operational, and exhausted appropriately?

Negative air machine will have HEPA filter in place.

Negative airflow will be maintained continuous throughout project.

Negative airflow will be maintained during all dust producing activities?

An anteroom will be constructed, maintained, and used appropriately for the duration of project.

Minimum pressure requirement?

Pressure reading?

Was minimum pressure differential met?

Walk Off/Tack Mats are clean and adequate?

Walk Off/Tack Mats have been changed with acceptable frequency?

Mat #?

Moist mats are required and appropriately maintained?

Construction/renovation areas, adjacent areas, and personnel are free from dust and debris?

Ceiling tiles are replaced when the space above the ceiling is not being accessed? (1 per 25 ft. without containment cube)

Mist bottle is used for access of individual tiles?

Construction personnel will remove dust and debris from their work clothes prior to leaving work site?

Construction personnel will clean, vacuum, and mop area as indicated and at the end of each day.

Environmental Services in contacted at extension #3333 for terminal site cleaning.

FINAL INSPECTION INFORMATION
Person completing the inspection, please sign below
Please enter date and time of the inspection.

Email this completed form to: rachel.white@mmhealth.org

Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.