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08-957-003-I M r 00 ci -,r a 0 4a O CL 9 Q I CJD O 00 OWNER'S ICRA REPORT I ICRA PROTOCOL I - ^ 1 Infection Control Risk Assessment Matrix of Precautions for Construction & Renovation Step One: Using the following table, idea ti; fythe �gof Constratedon Project Activity Mpe A -D) ' l ' yKt, � Inspection and Nan - invasive Activities. r.:. `: ` ?; ::,; :,,•. Includes Il is not tilnited to: , •.__., . P" ,but t ■ removal of ceiling tiles for visual inspection only, e.g. limited to 1 rile per 50 `:'::; �-` .; '•' square foot PATIENT RM. A XT WALL F.XT . W LL E a,.('-�;, r ; ;4.= • painting (lilt not sanding) :1-0:."!- . -:. f ; a , ■ wallcovering, electrical trim work, minor plumbing, and activities which do not " •ix- :1Q-Sa;r , generate dust or tequiro cutting of walls or access to ceilings other tflan for . -E.-t `;=e,;:: h, w visual inspection, • z•.. ; ., .-- -'•' "' ,. :. Small scale short. duration activities which create minimal dust 7 �4 .. ; ' ?:"` Includes, but is not limited to: ., .. i* T:7{P& s J ■ installation of telephone and computer cabling :j`� :,. atxess to chase spaces, ' :sr''`... ::::i : r,:. ■ cutting of walls or ceiling where dust migration can be ontrolled. a �.. ■ Respiratory ;h.l;;' Wfork that generates a inadera�to high IyYM oCdntlpr requires dent oii� lion or r,,,i ,,, t.a • r +_�,d . v.: removal of army fixed ballding_epmDaiients or assemblies . c is Medical Unit > :y - ,I..,;`•� ..'...,,. Includes. but is not limited tit: . -. ;py;�S: : i `- ■ 1goitIg o € walls for tainting or wall covarine : yRjty� "„ : naval of flcml oovcrings, ceilimttile�s_audd casework s' "l•`:r: ; r, . nmw wall constniption :;;rS . , r • . i~ :aa:s':, ■ yRitlnrduntt'ntfC nrelectrical work aboveceilines Y. ■ � i orcablin actividca _ •.,.; , r : . , ,:..,.. ::.`.... y,�.,s': � Major demolition and construction projects _• z ` . - ' "'• -•',' .;:.:. . Includes, but is not limited to: ' , . . .- TyrED'••: ■ activities which require consccutivo work shif(s •' *%'111 . :. ` * ° :�,:, f; . �•;t 5 requires heavy dano lition err removal of a complete cabling; systent ... '.r k. -..' • a new construc:titm ,.; Retrieve or isolate HVAC sysfenl in areas w here Step P Steps 1 -3 Adapted rdth permission V Kennedy, 6 Barnard, St Luke EPISCOpal Haspital, Houston TXi C Pine, CA Steps 4-i4 Adapted with permission a I ry sew Uniesit PkcOca I Center , Minnea P MN Forms modified and provided courtesy of Jltdcne Bartley, ECSF Inc. Beverly Falls MI 2002 Revlaed 2046 Step 4. Identify the areas surrounding the project area, assessing potential impact Unit Below I Unit Aboye Latetar Lateral Behind Front tS RG. MED U M�latsURG. PATIENT RM. A XT WALL F.XT . W LL E CORRIDOR Risk Group I Risk Crrnu Risk Go Risk G Kick Gros Risk Gros Step 5. Identify specifi; site of activity cg, patient rooms, medication room, etc. Step 6. Identify issues related to: ventilation, plumbing, electrical in terms of the probable es. C oats occurrence of p g Step 7. Identify containment measures, using prior assessment. VVhM types of barriers? (Eg, solids wall barriers); Will DEPAfiltration be required? m shv ' P (Note! Renovaiiot /ootietion area shall be isolated from the occupied areas during Lowdruction and shall be negative with respect to surtounding anus) I Step 8. Consider potential risk of Water damage. Is there a risk due to compromising structural integrity? (% wall, telling, roof) Stop 9. Work hours. Can or will the work be dome during non - patient cadre hours:' Step 10. Do plans allow for adequate number of isolationtnegaltive airflow rooms? Step 1 i - Do the plans allow for the required number & type of handwasliing sinks? Step 12. Does the infection control staff a m agree with the minimu ntunber of sinks for tine project? (Verify against AIA Guidelines for types and Arco) Stop 13. Noes the infection control staff agree with the plans relative to clean and soiled utility rooms? 4, Plan to discuss the.followia containment issues with the project tea Step 1 t; se. Eg, traffic flow, housekeeping, debris removal (how and when), Appewsaars Xdmryy and commu kare the responsibility Jor project moafrortfng that tacludav infection cpntrot concerns and risks The 10RA nuts be nrmifflaid drroaghout the project Revisions must be eonuuunkated to the 12E-cl !enl 'er, Steps 1.3 Adapted w" permisslori V rennedY, B Barnard, Sr Lvtke Ppiscotral Hosp1W, Houston TX, C Fine. CA 4 Stays 4 -14 Adapted with parnhAsion Fairview UniversityMedKal Canter, Minneapolis MN Forms n WZ&d and provided courtesy of ludene Pjnrttcy, SCSI Inc. Beverly Has Mr 2007• Revised 2006 Step Two: Using the following table, idersrs, jy the ft9opt P131 Groups that will be affected. if more than one risk group wiii be affected, select die higher risk group: • 'Xb ii � J R ' ri f z P : - : ` : ". ; -i . RefrRsk ■ Office ' ■ cwdiology • (= ■ Any area caring for areas ■ E Wt ardiography ■ Emergency Room immunacompmrnised YES ■ Endoscopy• ■ Labor & Delivery patients ' ■ A�ruelear Medicine ■ Lkb mtorles Bum Unit GROUP 1: LOW Risk ■ Physical Therapy (spccilaca) Cardiac Cash Lab ■ Rndiotngy /Mf2.0 Newborn ldutsely ■ Central Sterne Supply Yrovida active means to era slit airbttme dual ■ Respiratory ■ Outpatient Surgery ' Intensive Care Units - -- Therapy ■ Pediatrics is Medical Unit 2. is Pharmacy a Negative pressutre tightly covered cmlmiaers. es 1 wwY Otis rar e t n ■ Post Anesthesia Care isolation rooms (3. r • Unit a Oncology Seal unused doors with duct tape ■ Surgical Units IN Operating rooms 4. R sir' totxceuttc4tvorks YdR. 4. including C-section C'l,A&S 1 • 1, rse,a,te wtwk by sadhedllo ntiaimize raising dust rmm 3. Minor Demolitbn kK Remodeling iaU1I1Ii Step 2 Step Three: Match the Patient Risk Group (Lon, Medium, High, Ifl7gheO with the planned ... Coustracdon Project Type (A, B, C, D) on the following matrix, to find the ... Class of Precautions (1, 11, ill or or level of intcclion control activities required. Class I -IV Preeantione are delineated on the following page. IC Matta -C Class of Precautions: Construction Project ec t b Patient Risk Patient Itistc Group TYPE A TYPE 8 Tltr Iles C TU'P'B D sk Grose r aK ': l: ia= i' �j I ; t ' i :.Y EWW LOW RP 1 .- . i. a r i p ---z_ i�:> a u xi; . _ :: V • z III ' 1• r.. K Risk Groh a ..L••'• : �' ` _.x 11IIi;DII1M Jlt1s p .d;, ,, < ,.,: ,.•:. :•r ' . t' • ;• P..•f: MGM Risk Group t ' g P l<'• a r,r.r'ip;. „fir. 7r ' S - . x s �. �:: ]lilXV . uuiv 'a k tau r, Ii163 I2is G .��r� HIGHEST P � iK �: Note; Infection Control approved will be requilmd when the (Constriction Activity and Risk I..evel indicate thatb-'an-1-florictigas cotarol procedures 8 n-st rY . Step 3 Steps 1-3 Aduptet with peentis9im V Kennedy, B Barnard, st Luica 4mopal Hospital, Houston TX; C F'htte, CA 2 Slaoa 4 -14 Adapted with pertrtlaalon Felrvicw U■Iwxtity Medlaat Center, NNWO011S MN rfirrtt■ modlaad road proHd■d eourtesr W 7udone Bartley* ECSI Inc. Revar{y Hllis air 2002 Revised 2006 Infection Control Construction Permit Pc rmit No' .- - _ _ _ of Cot>.cttuction: ^_ .. - _ Project Start Date: _ w _Location _ Pro'ect Coordinator: • r - Estimated Duration: Contractor Performing W011 Iris mit Ex iraticm Date: Su visor. Tell: hone' YES NO CONSTRUCTMACrIVITY YES -9) 1Nrr TK)NLLWI'ROLRISKGROUP ' TYING A: lreatdion sw4rsvnsl"A tvay Immediately troplacea eeilingtikc displaced for GROUP 1: LOW Risk -. iYl'15 & Solidi scatq e1mR dtxatltat, LOW" It oROta't. a.1 t& I • Yrovida active means to era slit airbttme dual modcM to k heels Wipe want surfaxa with disinfectant, - -- from d1slcrofng into/aimot phera 2. 1YP rr:Aedt ay gu ntaacdawNs u ' I karokof 2. UROU1' 3: A1cd(msJHt h ne lk tightly covered cmlmiaers. es 1 wwY Otis rar e t n cutlinit P (3. Wet mop ottdlpr vacuum with HEPA filtered ' d trutae turd construe+ innxtiistiats 'fYpE R IN t Seal unused doors with duct tape CROUP 4:11 est /bolo � u 4. R sir' totxceuttc4tvorks YdR. 4. ia' tleatoreNVACsystem where Upon completion C'l,A&S 1 • 1, rse,a,te wtwk by sadhedllo ntiaimize raising dust rmm 3. Minor Demolitbn kK Remodeling 44091malod operations. ? 2, lalludialdylepiaefMy ceiling llW dfgtta:edrorvWta! Retrieve or isolate HVAC sysfenl in areas w here in teaton CLASS 11 1. P.mdeestAi emcmtoprsyadsiF-baaedustrmnr 6. contain eommailon waft belbmtrawotin6skly diaptnactg ndeaunospbere cuvaedootllsid8rL 2, water MW tons terraces to cutewI riot wklle cools;• 7. Wet rwp O&ar vacemn with NSPA altered vaemtm leaving work am ]. Scattaluaedtlootswifhductrape• Manna aB Remove or Isolate system 1a area where 4, al» dt atrand seal nit vents. S. ftsts dust mat at emrmcv oral exit or%vwk also. not remove barriers ftnln work aces until S. Nktcaurilim whh disildec" 9. tsolotc HVAC system In area n•Ixea Work b wing ttbtm ,d• mmr4 ui" aofk WA 1. obtain inEailon caidtol pe nail baron cu -action be>;iss, i Vttraum work veldt HEPA &tiered vattasns, CLASS III 2, isotmc HVAC PAM insntultarevortisbaiesadowto 7. WetnmpwhhdkiatkJane duct system Prevent co»mmloatka orthel duct sydaut• L Keenwm NOW tnalaials aucntily to tnininthc Saftsty 13q►muaent trod Infection Control 3. rm> Atldc oil crilkihirimor implement cmirtacahe sivadingurdbtvuddabrb ammiatedwith 2 modtal berate catimacda■ beams eateenrctkm. ; 9. Cataois cnn+dtur.1hm taste utters transport in 4. hsaktaallai% athaairpreea irswithinwaikdieutDltdag lioltycaverodeotvakiaa. ' Data HERAetttripW*11ltlaflcasunits to, Cnya transport remptadaorcans .- I•apemverlag. 1■illtd 3. Dor w rtaup4l tltntlera ftm work am uudl co q&-te 11. Uponeomptdion rolom IIVAC system w1wowadt rs Il7tNt eleanod L".. SM% Wro rronaed. or implement cOttll0l cube method (tazt with 1. nbtnto tarouhm cprw,rt permit keraeoo»aroction bcgirm 7. All ptusooral cnlethtt W(wk site are r"Wred to wear IV CLASS lt, 1 /Ilkla COVLTa ' !s bill dery o Z. lsolaicHVAGaytdrminmeeo •Iaxaasork tag tveturrieraraanwork untilc ieted •ctu oontsminal ' oldest g, Do ttM rcmr are ottt0 cti a ad the Eavdronmental 3. Cottgtlae all cHtic:A ban'rct■ altnplkvtatt txntrtd rxtbn t>rolcat is NaroaCkly by method be amco ntrudlon begins. smiev DVIA. 4, Maintain napifte airp=mKc wills■ Kock saeu1111:ktg 9. Vutvun wtxt aria wilt HEPA fiRaed vtteuam , 14FPAega}ppw air fairmiontmtuc 10. Wet tnnp with dis{nfecsust. Dan Initial S. Seal Wes, plFa.conthamsn,11pteuwaapprapria,aly. It. Remvit battler mateialscar "ytoptlukutte construction, r 6. construct anteroomtoWra tove oil Personnel topans sptvdklgofdiR ■roddrbriaax,twaledwith dvauglt tbnroom so duty can be vimumed using it HrPA CW14r tctto■ 3. vanerat cft w before Iml oil we&SMorcheywnwoar 12. Contain coosuuctknwastebCfotclramponintightly vkult or pgwco ,twalla That weromovad=16lirm1hey covckcdrarttatnern. Maintain negative air presets a Within work site Ea gnaw% -mkX& 11. COW nMapaR 05MI0010111 W was tape comin¢ Wei mop area wttE1 disinfectant. 34. Upon colttplalon «acre HVAC ayarv■ wMstst vrork I vvvs road Addilkaml Upon completion restore HVAC system where .`I - 11=r4rvJAdd6onsto this pcmii Oats (nittaht Oatc wiials ta+lrr) uuedhcd nveraoreedn pent* Request ny: Permit Authorized Dr. Date: net= 11 Adupued stint parmisslen V Kennqdy, B Uamard, St Luke EPtec6Pa1 Hospital, Houston rx, 5 Farms modlnad and provided courtesy W Judane aartley, WSi Inc Beverly Nola M1 2002 Revised 2006 ., mwcuort prokvcvt E. Infection Control Procedures, General A. PURPOSE: 1. Personal Protective Equipment (PPE) I. To prevent the acquisition of nosocomial infection in- patients /visitors /healthcare workers during a. These recommendations apply to potential infectious disea ;e cxlnsl:res. OSt1A : ccomme�dLtians ^ hospital construction and renovation. regarding PPE for exposures to other potential occupational h>?za d�s t I.e. ashestoa, chemi�alr, rtois9 B. SCOPE: ) should be farrowed. ^ ^ ^ - - - ^ ^ •. ^ i: 0� I. Applies to ail renovation /construction activities involving general and prime contractors, b. PPE Stations (fully stocked) must be provided at entrance of woriksite. All personnel entering subcontractors, material suppliers, vendors, working on site, and /or All Baptist Hospital of Miami staff., worksite are required to wear appropriate PPE and to remove same when exiting the workslte. Infectton Control Practitioners, Hospital Administration and other critical staff members. 2.13lood /Body Fluid Exposures _ , .. ^ ----- _ _ _ -1 . ^ Mimi C. RESPONSIBILITIES: a. When exposure to blood ! body fluids or materials conttlininet(id with sam9is antit:1pated at a ; All Baptist Hospital of Miami Operations and Maintenance Departments: minimum fluid resistant gloves must be worn. Fluid resistant g:Fwns, masks, gogules /shields must; ,,,� a. Adhere to American Institute of Architects (AIA) guidelines as referenced above in planning and be wom If splashing / splattering of blood /body fluids flt;rl aintaninaCaJ"c:qu:pmea: Pplur�lbliy i ^ performing all construction !renovation projects sewage pipes is likely to occur. b. Adhere to protocols outlined in this policy b. If tearing of gloves is likely due to the nature of the worikmon- disposable, heavy duty, fluid resistant c. Notify Epidemiology /Infection Control Department and review project with Epidemiology /Infection gloves must be used. These gloves may be disinfected. after use with EPA approved hospital Control Department when construction /renovation activity and risk level indicate that Class III and disinfectant. Class IV control procedures are necessary. 3.Class III and Class IV Construction/Renovation Activi•lies require the following PPE d. Notify Environmental Services Department prior to beginning project regarding requirements for a. During demolition and/or construction that generates a high level of dust: personnel and supplies to ensure project and adjacent areas are cleaned /disinfected /pest 1) Cover suit controlled. 2) Head covers e. Notify all affected departments /services when there is planned /unplanned disruption In water 3) Shoe covers supply and assist in providing alternate sources 4) Dust/mistlfume mask f. Provide general and prime Contractors, Subcontractors, Material Suppliers, Vendors, working on site, 5) Gloves/goggles are required if exposure to bloodlbody fluids is likely (see above) with a copy of this Policy b. Isolation Rooms g. Ensure that there is a fully stocked Personal Protective Equipment (PPE) station at the entrance to 1) Construction /renovation should not take place in an occupied Isolation Room unless the worts is the worlksite deemed to be of an emergency nature. Every attempt must be made to transfer the Isolation patient h. Ensure that barrier materials as required are constructed and maintained properly, HEPA filtered to another room before work begins. If this is impossible: vacuum and portable HEPA filter units for control of airborne contamination are provided unless a) PPE must be worn in accordance with Isolator Precautions Sign. otherwise contracted b) Evaluate job and take minimum tools / equipment into room. i. Obtain Infection Control Construction Permit (when indicated) from Epidemiology /Infection Control c) Equipment /tools to be removed from room must be deemed with approved disinfectant prior Department before construction / renovation begins. Infection Control Permit must be obtained to removal. whether work is performed by external contractor or by All Baptist Hospital of Miami Facilities POM d) Tools /equipment taken into latex isolation roam may not contain rubber. employees (see Appendix A for Infection Control Construction Permit) c. Containment Material and Disinfectant Specifications fcr Prevention of Environmental Contamination J. When an infection Control Construction Permit is required obtain signatures of responsible party from 1) Sheet plastic - polystyrene, 6 mil thickness. general Contractor and any prime contractor, or AD Baptist Hospital of Miami Facilities POM project a) Barrier doors -solid core wood in metal frame, painted. manager as appropriate. 2) Portable HEPA Filtration Units - provide primary, secondary and HEPA filters. 1. All Baptist Hospital of Miami Facilities POM employees will attend an education session on infection 3) HEPA filtered vacuum cleaner Control Protocols for Construction and Renovation, prior to beginning work when Class Ili or Class IV 4) Exhaust Hoses -heavy duty, flexible steel reinfonxid, ventilation blower hose. control procedures are required. 5) Adhesive walk -off mats - provide minimum size triers of 24 inches x 36 Indies. 2.Inspect project during the course of construction, at completion and prior to occupancy of area ( 6) Disinfectant - utilize disinfectant supplied by Environmental Services Department. with Epidemiology /Infection Control Department representative) to ensure that infection control 4,8arriers guidelines and protocols outlined In this policy have been met (See Quality Control and Enforcement a. Class I Sections of this policy) 1) No barriers required b. Class II 2.Epidenilology !Infection Control Department 1) Seal unused doors with duct tape a. Review all construction / renovation plans where activity and risk level indicates that Class 111 and 2 Block off and seal air vents Class IV control procedures are required. Determine class with All Baptist Hospital of Miami Facilities ties POM input Provide written recommendations, :............................................:.......................................................•......... ...........,...•............... as appropriate, consistent with AIA Guidelines. ::•7• :• :•:A{I: lit:• Dlsl' SS• 1{•: t71G: S•:•::•:: �:•:::•::•::•:::•::;:•::: :�::•:'•:::::•::::•::•:::•:•::� ::•:::•::•::•::::•:::'::•::'•::•:::•::•:::•::: :�::::•:_:•::•:�:•::•::::•:::•: b. Provide infection Control Construction Permit as required (see Appendix A) :;•::•a :•lZiitf • tit••• lastia •tiaiTiB'r.•i3icti>;ridGi' �:from�•�oortor:i�ailiii ':•: with 'seairis•sea}eii.wittl:duoEtia' er:to:::'::: :' : :': c. Provide education on infection control protocol for construction and renovation to general Contractor ..::...:.....1....:-:-:, . . .•:: • • " ..prevenf•iliist:a' rid• iieiiri§: ftroi'ri•:e'scapiiig:iic•i9iym+; alt •tiari•Ters:eriect ®il•itviifl: 'fits:6iivi# lest :b�:ssaleii::::•::::•::::::•: and rime contractors and their and / or All Baptist Hospital of Miami Facilities M ' t n •:' � :....................' ...... ..............................' ..................... • .;.......... �...................... am a once P personnel, . � :: T . o... t a 1 m. ..fi l nr•. � ::::: :. he ' •a a d: its :: � .. s. �.ia..fttei's.•itl�t:ais...q... . ' .e...a #.alltv;tors#ia.. a'.st�rY+!!.. swill ...#?�....d•.a�:��i?........... / Engineering ro act manager and personnel as appropriate. �' P •' ••..........b'•:iAirtf..: " ic• barriers.• are. t�o-be • "stied:at:.ernstration•of•ceil ":';:alive... s •.ctiasesand�:•::•::•::::•:.:•: r. d. Make periodic visits to work sites ensure that ...................... .. ............ ................... to Infection Control Protocol Is being followed and report ;•;;.; ;.: ctbllirig�spt�es •iii•:stbji:t'na✓sitieiit• iii• aii.aiid: i{ etiiis•: v�rfterI •iittiizli�q:as:a:'rsfsiiti•: air•" leil(uii•: /.•�uct�::•::::�::::• :•::•: deficiencies to the All Baptist Hospital of Miami Facilities Project Manager See Appendix B Infection *-::::::,-::%:::* """"""""""""" """"""""""""""""" " " "" " """"" "' ( APP �; .......... ............................... :::: c •: fin'• 'ram • ' n '• tI ' •ceitln• cr•'a ss• rots roe . n' . . ).......... t3P®!?irtg &.�...... �4@ j.. #4►. �•?tiS..!�....... 9>•...... iii ...1?S! ...!&.S}�.QI?fi....S(! .. i?�4i?lQd•:•:::•::;•:::•: Control Protocol Monitor " " " " ' ) •::::a1iedS:foi':• walk:• ii6ove •:cei}in: "';: "avrile:.......... ire: eiiciii§ iir: e:• aitiiiiid :[acJd'er'"sealir'r";off•;ope .,....;fifEeii•::•::•: ::•:::::: . ........................ .......9s. W........ T? o> a.'• sfY. re..................................... ... ... ..9..........n!n9,............. e. Inspect act at completion and riot ar project p to occupancy of area (with All Baptist Hospital of Miami .. t •tl• : •: •�i • • • • .and. h isr. tin fi( ntit::•::•::•::•::::::•:::•::•::•:::•::::•:::::•::•::::•::•::•::•:::•:: �:•::•:::: �:::•::•: �:•::•: �:•:::•: ::•:�::::'::::::•::•:::::::•:•: Facilities ProectManager) to ensure that infection control guidelines n rotocolsoutlintsdin •'`'`"' �"""""" "9"""""""""""""""""" ""�"""""""" " """""""""""" """" """" " "." "' 1 9 and (AIA) P ' : :: •d :An ce1 'acre s• an Is'• lsrred•1br• rove atlo 'at3 d' I •areas•s;hatl••ba• faced: � . � :: s this have been met See ail Con a Enforcement s i policy Qu Control and Section of this of ( tY policy ) :•: iinrrier}'iatei" :titih ® ":tiiiatfentteil� ::•: � :•::•::•::•::•::•::• :::•:::•:::•::•::•::•::•::•::•: �::•:::: �::•:::•::•:::•:::•::•::•::•::•::::•:: •::•::•:::•::•::•:::•:::.:::•:: •y: • n 3.EnvlronmentalServicesDe rot ::;. . ..:.::::::.::.: �..:::•:............................................................... ... �::.:•.....::::••:::.� :::•.� :•. Department ::::::•: �•? :•:::Ali af:Gtass :ilJ tiaml�s;•P.�::•::::.::•:::•. � •• ••::::. � ::::• :::::::::::::. � ::::::•%%,.1:.1.%1.%1.1.: :. .: :::::. � ::::. �::. �. a. Provide t and o me contractors and All Baptist Hospital of Miami Facilities PO personnel: general Pri P M :•:a :� .'rife'* " "'•:is:: 'fo" . a:. "tti" tie" "ilia . "•ari•:dii'iit3 .. "riiiriuir'1:::::•: approved disinfectant. I ,) A t•1orr1 regirii+eid............. ba•riiad of:{iatYe..y)e... en•,.•• ha'. ie........ a ...pP!M9�;�P�?► ................ :•:0t•2:telat•�9 :• b. Contract for insect /rodent control at wo sit d a I .... ............................................................................... ............................... . rk a an adjacent teas during and after completion of ... ...... .................................................................................... ............................... ::' �r: �' iafffc.; I�esinctions:::.:•:::::. �. �::::::. �::::: .:�.�::::•:.�::::::::::•::.�:.� :•::.:: �::::.:: �. �. � .�::.�:::::.:�.�.�::::::::::.�. project •:•: a::• 7�. atiei�ii•! tiasitar.• 7: siaff�ira�a�iiti§' t�tie: �reiiliiiif• srbkiiid :coii:'striiet%iii�aiea::� .. propiiate:• direidir ?ri:::•::•:::•::::•::::•::•: o. Clean and disinfect areas adjacent to worksfte Burin the """""""""""""""""""""""""""""""'•"""' ' 9 project. �. .•s :p;'•'S its•' � p ................ ............................... .� . . mifst.... in. tIr� 'laria>':'ta...Caril.�'nl��.�; .•.:'.:':.':.:'.:.'.:'. � .':.':.'.'::.':. � .'::.'::.':.::':.':.': ':.:::':.'.:::'. � .':.:':::.:':.::':.:'. 1 Perform final cleaning /disinfection of area at completion of the project •:: B: Vsiitilalavi 'r:::•::::•::•::•::•::•::•::� •::•:•::•::::•::•::•::::::•:::•::::::•::: �:::: �::•::•::::•::•:::•::•:•::•::?:•::•::•::•::•::•::::•::• :::::::•::::::•:::•:::•::•:::•: 4.Perforrnance Requirements /for General and Prime Contractor :� � ��: �jg� (ata•11°ie:•HVAC:systittri:tb: pre�ierit•: tkfittartiinettori• af: iTlicl: sysfairi: wtieili•: oiaitsirtic�k�iri :l•:renouatibii:•::•::•::•::::• a. Review Baptist Hospital of Miami Facilities Infection Control Protocol for Construction and Renovation, """"""""""""""""""""""""""""""" """"""""""""""""" """""""""""""' :: regpires;' �I��s ;•[I;t•g{r4:(�/;�nt{a1:{�r��@d( lies• pr,•; At; Erergitlrls; abatementr�........................................ irftischafgeii ,�ta•}}�cipid �:•; :;:•; prior to beginning work. :•: areas •sh'ali•i;a•}aEt?A:filtereif:: � :•:::::•:::•:::•::•::::•::� ::•::: �:• :::•::::•::•::::•:::•::•:•:::• • •:••• •'••::•:::•:::•:: b. Review and sign (when indicated) Infection Control Construction Permit, prior to beginning work ......................'..........'............'......... ....'.......................... .'.. ....... .........'............. ...... ........ :•:;b::•:Me nfaitf :•i1 ' at}ve:tsih: i'.9s5idl°e:ilW z '•f{EF.tA•e' iii "' }. aih: filttatlarl :iiriifs:Vit�iirivJOilslite. fot•::::•::•::•:::�::•::•:: c. All on site management /employees will attend an education session on Infection Control Protocols � ¢ � q per' """"""' ::•coiistru ... »'l.tnrxovatlo.. . uiriri •'•f>,t' as's'tli' and: l�: control... roceiiiiras�oi ' :As......ilius•atiaterri 'lit::::. % . � ::. � :: for Construction and Renovation prior to work. • •ctJa ................1}:�1..... ti..............................: P.......... ...........Pif!9............... p................. , beginning �;: HEP. A: siiili)? P.® d:. afrlil3iatiiiniriachiites: sEiail: jiroznde: a{ r, flov�lrita: coitsfriietiiin: aGea•:► iitliiss :iFraii:•1:Oi1•::•::'::•::• d. Adhere to Baptist Hospital f Miami o Facilities Infection Control Protocol for Construction and ::•: F: P. 1N•: ei: b: �l#{ 9��tltta��: �iVftl{•: dctbt;# •:fi!{iy!•s>k8ti:::•::::'.•::•: •::•::•:: •::•:::::•::•::•::::::•::::•:..........:.....-:..........:.....,:.",:.*.,.,.,.,.*::.,.,.I :: � ::•:::•::::::•:: �:•:•::• �•::•: �::•::� •: Renovation. '... •........... ....... '� : c::'_ Ariterriorri •iccrosiiiicfea :wgeii� ....strkietrorr•i'nern vatielir :r•e ...ires•Eidss•liit•irontrol:..rii ..tirea•mu' • ••ilia•: � :::::. e. Submittals by General Contractor ........ ... .... ... cPrr ......... o ...... .�? .......................... P.. �.......... �............ :� maiiitairieii�at •:rtis�ativei:piessiirei iri; lief atioii: toacljacerit :,i'rsa's:neif':t'1rid'er: con' sfrtietieili: F :r:erie�:vaiiofii:::•::::::•::•: 1. Specify details of barriers, air handling equipment (portable HEPA filter units) products and •; :7' ..,• Ru9#:> �ltaliiarit• �• CH3ari► fi�•::•::•:;•::•::•:•::•::•::•:::•::•:::•: �::•: •:;:�::;•:•:•::•:::::�•::•::•:: �:;:�:::•:•::•:::•::::•::•: �:•:::•: �•:::•::•:�:•::::.:•: �: materials to be used to control potential contamination generated by construction /renovation :. - ::•e, :; Adhesive ;:watk* 6fE�mats"si.ai[•i;kt3pt ctei3�i:aiid:ciiaiiged:des{i.r, etas :iiecessaiii•;ia'{i!ayerit:.:: :.:::•::•::•::::•::':: activities. .. ... .. ::::::.a6Wmllf6tl6rr:6i:ii6'sf ............ ::::: • •:::::::•:. 2. C. Infection Control Consultation and Infection Control Construction Permit Requirements ::�;:::�$Y:��•.��: Gaff{ Qr: S# l�tl• A0•:►; 4fi'{ Q1! 8i}•: f} p► 11�di2( CoIyr:: GI�N9g: Gilt61d: 9.a�tb:9:b:>tt{{9r{S:•: :•::•::• 3. Construction /renovation activities require consultation with the Epidemiology! Infection Control • :...................... ... ..............., ....... .......................... .......................*:.,.,.1.1.*., . � ta. tie;• elan® wifheitti ®i{a•NEFs�C:#ikeried•: vacuum •or•with:stwef::Top.:.:.:.:.::*.**."*.**",.,*,:, •:::•::::•:; ;•::• ::: ; ; :•; :•:::•; :::; :•;:•:• • • Department based upon the activity type (Types A - D) described below and the level of risk to ::�:c;:1'tUtieri:ari� :vae{itiining:•is: clonal •it•:riii{sfi:b;s•:w�Fi�:a: HEi? i': 61fei• ed:• uai:: iiuni:•::•:::•:•::•::•:::•::•::•::•::• ::•::•::•::'::•::•::•::•:::•::: patients/ visitors /staff described in the Infection Control Risk Group (below). . """"• """"""' ""' : �: t1: �: V�UI�� ?'VW#;:t&f?�i�:jitY�:Cl9ait �itd: i�i�! 1f�: Ci•:(• U81{ r9:• �1? prOX� :4:di;�tifQif+fC�):� ►�:8i1�;# :�:•::•::•: 4. Before a project begins consult the Construction Activity /Infection Control Matrix (below) to •; :�•�� "•the: •'rio ' ' • and:• aitei •:tlaiii:eis•}iaJe•kieei�i• roirioiied::•::•::•::•::•::•:::•::•::•::•::•::•::•:::• :::'::•::::•::•::•::•::•::::•:: determine whether an Infection Control Consultation and Infection Control Construction Permit is :•::.:.......' .......... g " "' p" �..........' .......................................................... ............................... :•: e�: mein; 3ttiiotiar):• de} Si{ s: sfiaH• iia•: plt�d�:Ul:tii�hi}yse'a{ed•:tor► tame' is•:klieftire:re'rriovei:iydiii• hie :•idcciiie:•sitt�•}f•::•:::•:: required. First, etetmine the type of construction 1 renovation activity (see chart below); then • :..... ............ ... . ... ....... ... .. � .... ............ .................'. .... . ...... .......... ... .... .... ....... ... ....'............. %1.1.%, travetln 'threw tern• areas: •:::::. � . � • ," :. "* :. � ::.:•:::.: . determine the Infection Control Risk Group (see chart below), then consult the Construction Activity :•:B:Ililatei•:Sti "' P / Infection Control Matrix (below). "" ::�:a ?:6:apGst�Hi>srHCBI :bf : Mia} iii• Matiiut;# iti9ilaa� :sttiff:t►At{fieg:ail':t 1ft6�ied•:ddD:$itmaitts•'L• net• lilt .4s':ai4tl:•it�isC•in:•:::::•::: 'bvisiori•of�sifem�rte: sources• of: water�::•:::::::•:•::•::•::•::� :••:::•::•:::•:::•;::•::•:;• i::•::•:::•::•: �:;:•::•:::•::• :i::::•::•::•::•:::•:;•:::•:;:• TYPE Inspection and Non - Invasive Acttvitles. Includes but 1s not limited to removal of ceiling tiles A for visual Inspection (limited to 1 file per 50 square feet), painting (hilt not sanding) wall covering, electrical trim work. minor to a r g, probing and activities that do not generate dust or require cutting of watts or access to ceilings other than for visual inspection. TYPE Small-scale, short duration activities that create minimal dust. Includes but is not limited to 8 installation of telephone and computer cables, access to chase spaces, cutting of walls or ceiling where dust migration cars be controlled. ::::ay.FE•.:: ... AnY.•1xvrK•# lea #:gQ!t�►:ota!o:a•►ttzalai•cO: niter?: iexQl: 4? :�p4t•?�:ra�ix�s:•t�'tia1iiian: �r.:tetr�x�l:• oI'•a....f.X...b... . i • a .1 ed. lwfdita'': bfl .:.......nfa�,�:....'...bles:� . .'t...' . ..... r.assem ..{ rod' liiieii• kiniC •is•iia.ltrrn'teci•:tia•sariiii ................. . i/ g• fiPp?o rig•::•:::•: ::wlt's•fo'r:phiritiiii:br vaaif:cayerm�; :ieriroving:flo cayEUiii�s i eilin�.'tHes aiidctseiniark ;: iiew " :w H'• r• n• I a C f1 t r' { . tk'• v ' ' In' to tv m1 •t1r•' ••outs `•rti' •+; . a..s.. i?a#lo .,�:1?... .. 4( I? Gtw ..aric....a!ac'i.�ait........ �b>�. �`.ai�.. 1 ...a ..b� ..:�a# ! >�� . 95 j�l: � . {� ............................ ...................................... ............................... TYPE Major demolition and construction projects. includes but is not limited to activities that D require consecutive work shifts, heavy demolition or removel of a complete ceiling system and new construction. Any work that requires disruption of water supply for more than 1 hour. :•: N; �:• St1{ fieri• ft9asitile;: sefieclrile •iriferiu'ttbn:fbi•:ldw:vvidter:u ... Iii• tiiilis::•::•::•:::::•::•::•::•::•::::•::: �:::•::• ::•:::•::•::::::•::•::•::::•::• :� ��:�tasii:;�vaier:sla ' `:tit(e:�': • triii:tr�PM, ' ai:of.{ . �..,.. ..:�r� :...:r • • �: ors' � .1 ' �ts::�:: :: ?;: :' • ............ DI?tY . fr . n'ut#G:Gta;�t#• t>$ t#h:�tY, d.. PtIP aii:�:aria•r� . :-- ...... trawl Bolistiticfeli'(•reriovafe' ••a1'eas;.into.sersria;s::: • : � . � .::: � ::.: � *.*.,.,.%,.,.,.,.*:.*:.*.,.*.*:.*.,:.,:.* . :. ::. ::. � ::.:1.1:.,.*.*.,.'.'.,.*.*.*.*.,.*.,. '•:d:: Adhie' re:fo:l�tA�yillcleliiies.•'re:. :: i�ig •tierifii�iioi'r:bfi�4aiei:feiri' ieiatiii�esr: rise: af.• fasicei:ae'ratitiis•itiid:•:::•: � :•::•:: n '/• ' 1v ...... aaictafaw'Pro. v� . t��s... ..el#;•::::•::•::;•: � :•:::::� •::;.:-.,.,.%,.,.,.*: •:::•:'•::•:;•::•: � •::;•::•::•::•:•:::•:'•:'•:� ::•:;•:::::•:;; :•::� •: �:•::•:::::•::•::;•: F. infection Control Procedures by Class of Construction! Renovation Activity 1. Class 1 a. Execute work methods to minimize raising dust from construction /renovation operations b. Immediately replace an y ceiling the displaced for Inspection a Refer to above procedures for cleanup and disposal 2,Class 11 a. Water mist work surfaces to control dust while cutting b. Seal unused doors with duct tape c. Place walk off mat at entrance and exit of area d. Block off and seal air vents e. Contain construction debris before transport In tightly a) vered containers f. Wet mop and ! or vacuum the area with HEPA filtered vacuum before leaving work area VIN a surfaces with approved disinfectant 9 P PP INFE N CONTROL K GROUPS ,:• 3: CI0$$: 1{ 4:•::•:::•::•:::•:::::::.....::......:: ...........:::::::::::::::::::::::::::::::::::::::::: ::::::::::::::::::::::::::::::: t;TW CONTRO S G OU 5 :'a� •i?ii'evs" •' in •'3ri••Class :i'at;d:ti': slid jii' :aijditlorr :ttie fottotiiii ........................ ............................... ...�...9 ..................... t .....,......... • .... r.4............. !?9 :::::::::::::::::::::: ::::::::::::::::::::::::::::::: •'ti•':Dbfaih- lhf6iMi :•i^;ciillrol:Ciirisfilii:tiarl PatM fiairii• E • idemrci&i r'1•N64fl6d.ru f fi:l Ty4iiirlirieiif :::::::: :: GROUP/ GROUP 2 GROUPS :;;•;;•;; ;G,,,,,•P•4:•;..;•;:•: LOWEST RISK MEDIUM RISK IAEDIUM -HIGH RISK ::•::}ll�akl?::Fi{QK:: 1. O Ito A see 1, r re AU other 1. Ce to At patient care Emergency n t. a Unoccupied Wards areas {e.g. caltlitmrahab. 2. Hadlo opyrMRt 2. At Ota ambulatory true ctlrlica 3 Peat Aneatheati care tJnh 1, Otroctl4[1S unlit; and un&ke ■lrotad in Group 3 4. Labs & delivery (non OR) outpatient clinics for or4 6. NaImalNawbomNtsserles cancer patients 2. Outprdlertt clinics {exk opt G [>ESY Surgery 4. Transplant units and for oncology end surgery} 7. Nuclear FAttdlc}ne adpnNeM cUnlca 3. Admior agxscharge 8. physiotherapy lank areas S, Wnr� and outpatient slits 9. Echocartiivlogy olinir� fur patients with tQ. Pump"faam AIDSarotlt4e• tt, Ltdtorotxice immunodotlaoray 12. ¢enoralA4edtsurgunits 6. Dialysis Units sitter titan Iftase /latest in 7. Tertiary Cara nurseries Group 4 A. Labor 8 DeIWRry 13. pediatrics Oporatlrtg Rooms 14. Geriatrics 4. Al Cardiac Cathrrr¢atlor 16. Long term clue & Arglography areas in. CarkifovaswlnrrCatdiob gy patients it. Anesthesia and pump areas 1 2. AN Ertdoscapp ero¢s 13. Pharmacy 1 our ttdrn x o y elves t4. 5leriie pro cessktg room 1 n' •:. b.9ft►1:9.a1}tsStt(Il�'t#ts'tl$ :•: •:c::•lSiii;:ori•:dover'siik;•: head: arid• Billie': aoJeis;•: diistir :riiist:r!•fiiilae•'irias(i:..` • r:to: e�r'tetiri "•aiaiksiier_ :•droves':::•::•:: ::•a+id: " "" es; a1 'e:i�e'iii'rei{•ifi:iii....iira• tie• Btbpolfiiid " ...... flitiil':{ §:iitie' ..... ....... ...... .......... •: � : d: :•Retitoxe:'Or•i;;olat4:F•1�!A� : OYwFr (•fr{;ar�a:•>•vrla�:a+rark• ►'# ��in�•:4c'�:► ego: i3ray. Qritaantt�� 'n�t�r�:•:al4ha:•::;•::•::•: :• :duct's Steal•'::::•::: ::�: ; :• ::•:::•: :• ::•::: :•: � ::•:: � :•::::•:::•: � : � :•: ::•:::•::• :' •:::. � :::::::::.::: � :. � :. � :. � :::::::::•::::•:::. � . � .':::::::::.:: . Y.. : : :: •:}a::•::•::Goriplee:aH'cle• bthieis:{ aefiie c5rsttii�kY ( sea• Bat�a•seGtii)::•::•:•:•: � :• •' • •::•::•:•: ::; :: :. , .. . . . .. :: . ..:.. ' .. .. •ris. . .. :.. .. � .. .:. . ::'::.:. :t. ::•::••a):::••.Rtgepp'iPd.a �Frj;s t4rq i9iintti9. cB�t:i.rQ?)Pttip.arid.rei�ava.l.f . po Gg:::: :•:::•:: �1n :red•kia�:iniecfioiis:vi!a§�a i;�:regiilar:tias}i:� as: aj? Propiiafe: j•: piiol :lo:}eaurii;.vuoi{csri'e;:.:If..:.......................................- .................. :•:• ::•:Bari= aTspoi;adte:P.P.E•is: ti;;edi;: bli#ari:l+ifti);dlsltifeofa fit• viii,i 'r:tb:•ranieSvfiiff:fr`di��'Y. dills' sire: -: ::•::•::•::::•::••::::•::::::•: '� :3 • � :•� �vlairtiaiii•ti:• • • aUuta� afr•� •less . ie:within�wiirlc •ire'; � � klss� PrEPA:.. .. d' aIr' fttratbii�aiilts ::::•::•::•::•:::•::•: ::.:; ,.,�f.:.: Vaetiiirn :woli�sitauuitii:HEt?q:firte' tali• v•a §:ileeifeii•:ariit•af•slid:bf' pia® ct::: ::•:::•;:::;;:•::•::::::::•:;;: ;•:5) :•::: YVai•:' rfia} isVlibilt9lte:•: V�iU?: dFSR�v�I•: tllsliifebteiit :•etter:ve0tiuriiD}$::•::•:::•: ;•: � :•: � :::�:::•:::•: � ::•::•::•::: � :::�:; :•:•:;• :•: fi• :. . :. :fi)o�itot•'reiiiove :tialiiie • ••'f'rotrr :work :> areas :iiiltit: ccsiri'r • • iii . ... 'ei;t :ts :cieaiit;fd�ti � �Envrrruimenfal :•::• •:'::•: :s'ervice's: ::: e::• I7eiribde :tiai'riel'.:riiateria{s:aiiii� •::•::•::•:::idib'ri'ifeb : "'� "• "refid ' :' ii§a•t•ias:b'ee � : �'• ®:•::•: "•'d'•::•:•'•: :• ..................... tconstru ns.ca ly:,(attisi: a • • , • • • • , • • • n cl arle;�:l•;di §iii %eta . :•:: :•:;byEtivi{�alxtleft�t•:�:er�, sees• A: epartm�' �:• tt�•mMi�,lzo':aoro~�a3r4laGptl:• set: 4t+ i> �:: aritt�iila�e :�r�:•1j9f1t�Y:ss�le4 ��:�:�: : •.caiitaineis:•fa:•iemovat:fiot rt: woniisrfe::•: '•::':::•:::•::•::•::::•::•:':• •:. � :.: � ::. � ::: :.:::: � . � :.: � :. � :•::. � :.: � :: •::::::::::•. � ::::. . . :. � .: -'-:4.)' •::•::•:Gover salt §: F: lei; eptaeites• iis13ii• tCr :traiispoi2:rrriiisttilicfion deans::::::::::•:.:::: � ::::.: � :::•.: � :.•:::::::.:::•. ....... •' a):;15o evei ....'rrg .....ijsses ........ ..:... . m a ..... I.... n* ... .... inrrn - ::I.)•::: :.:•See r:hateei:pi; 66; -.bd6i itiW'A'n''d'':tihi6Wr.* elf• dpiofiiatety- When- tt'►ieiy.ON,etiato'.V.6 lei's :::•:.........::::::: P .................................................... .................•............. CONSTRUCTION ACTIVITY! INFECTION CONTROL MATRIX :' :'2) ::'::; Cox' Strt? ct' `mteroom.•pgjalcan #:to;wortkslt ,;;i4r{ term •1s•tcg;T>t :gseti7oremovq :RPE:whentpaving: ; :::•::•::tile:war}islte : ;P?faoe:a.l iw., trash.carrtarner ln•ihe anteroom to d se of PPE use a .red lasficba " (. i? . 3: .....I.......... •. ::::::. . .................. :::;ta Itde :tilebritairief. {f : �iiittiaviilYes' iiiaCari :3ls:adtit8ii►liiattt<c1: with:tl7dl:biai[Y:tTtitds ( {e:pHirlliiing :::::::: ::: Infection Control consultation is required when the construction activity and risk level Indicate ::............................................................................................................. ............................... % that Class Ill and Class IV control procedures are necessary :''", war roc) ::::.::::::::::•::•::::::::; :.....:.-.%.................:..........:.......-......... ••.:::::::::::::::::::::::::: ;::::::::::::; ::::::::::::::::::... ........ . •3 :::•:.Lleail•PPE:is:fo:tie:ich outside of:t}i ®:arifeiiioiri iiriii i §:ta tie: nn halals entsltri ilia . .p .0 �: CONSTRUCTION ACTIVITY ISK LEVEL TYPE TYPE TYPE TYPE rcAn arBrr u)+n Mn Gros 1 I If II 111 Gros 2 f 11 111 IV Grew 3 g Ill III IV Gros 4 It Ill •::tV'.•:::� �:�:: IV D. Infection Control Construction Permits 1. infection Control Construction Permit Is required when the construction activity and risk level indicate that Class III and Class IV control procedures are required. a. When an Infection Control Construction Permit Is required it must be obtained from the Epidemiology /Infection Control Department before beginning any demolition or construction work. Decision regarding classification of construction activity (Class 1, 2, 3, or 4) rests with the Epidemiology/Infection Control Department. b. The infection Control Construction Permit must be displayed at the entrance to the work area during the entire construction period. c. At the completion of work the Infection Control Construction Permit must be returned to the Epidemiology /Infection Contro l Department. CITY OF SOUTJ -i MiAMi BUILDING DEPT, STRUCTURAL 3ECTi0N APPROVED BY: 1 , 1. >111111111111111111 1. Lu WE- � vY , J !i 1. s we� ® � t>�t i4' �- a �h sssvtr.•taasa m Coo l� �s s` o .- � o c') V- 0 ti o co �• I d' M c>3 ti E ro rn N to O i I- d � p 1' o) r-- r t) , ti r` 4M 0 C.4 tD 't 0 m 01 alp O "? -C tt1M �� Co HMO � 'aN= O'�tJre- Z st an 0 0 m 1p :3 ay�"cc) F> = ai W 7 •r t9 LLtL-7Odt'nt- -Q Co I C 411C 1 C-d- 4111111111111111110 1111111111111111111111 4D 40 cc 9 M9 0 8 wagoin CC 43 E `* I Ce CO co y W I'letin as 11111111111111111, ca 10-S .Q C 'O 3-: Comm. No: 08067 Date: Drawn: * Revised: � 2007 HARV q ARD DULLY, ICRA i. i ` G�l U � 2pn� - 2007 Description of Requited infection Control Preeaallons by CI a. During Construction Project Upon Cnanstietion of Project ' 1. Execute work by methods eta minimize raising I. Clean wort area upon completion oCraalc. k. dust ftatn rAesirucdtm oprxatlons ' 2. Immediately troplacea eeilingtikc displaced for :.: visual inspection I • Yrovida active means to era slit airbttme dual 1. Wipe want surfaxa with disinfectant, from d1slcrofng into/aimot phera 2. Cctttisin construction wash before transport in 2. Water mist work surftces to control dust avlti(e tightly covered cmlmiaers. cutlinit P (3. Wet mop ottdlpr vacuum with HEPA filtered 3. Seal unused doors with duct tape vacuum before Leaving work area. u 4. IIlockofiand tscal stir vents. 4. ia' tleatoreNVACsystem where Upon completion 5. Pleee dust mat atlentlatice and exit ufwork :tree work vvasperftatmcd 6. Retrieve or isolate HVAC sysfenl in areas w here " work ishtdrle frJrlttckl. Remove or Isolate system 1a area where not remove barriers ftnln work aces until work is bung done to prevent contamination of completed prajcet iR inpected by the owner's duct system Saftsty 13q►muaent trod Infection Control 2 Complete all critical Frarriers'i:a s{ttxlrock, [7cparlrrtent and Thoroughly cleaned by the plywood, plastic, lo seal area6omt10lt work arc ouner'BEnvironmarialSCtvltxslkparttttent or implement cOttll0l cube method (tazt with 2. Remove barrier materials carefully to rswrimi2e plastic covering and sea led canner ticm to work spreading ofdirt and debris associated with i site with [IEPA vacuum for vacuuming prior fo construction, r CXIt)lmlitre construction belgins 3. Vacuum work area with 11FPA filtered vacuums 3. Maintain negative air presets a Within work site 4. Wei mop area wttE1 disinfectant. utilizing HEPA equipped air filtration units 5. Upon completion restore HVAC system where 4. Contain Canstrtictien wears brf'occ ttanaltarl in oak was }tCrf4trmed tightly cove containers S. Cover transport 1CCaptaeleS Of carts. Tape covering unless solid lid. 11- Isolate TiVAC system in area where work is t. Ratrove hen ter material carefully to minimize Gtd�, bang dole to prevent contamination of duct Betted ng of dirt and debris associated With F syglam, construction, rf':. 2. Complctaall critical banYCrs (a sheelrnolc, Z. Contain construction wasletleforetYansport in ' ,.a:,� o to seal area from non work area PIW+ ud,plastic, tightly cw'teedcolttaIllers. k�i,, t cube method cart with or implement control � 3 Cover rt tacks or carts. 1'a . transport �++P fN' plastic covering and aculed kXlaneeltoa to work cAYerint; unless Solid list l a site with [iGPA vacuum for vltaturiting prior to 1r.-- exit) hefory aoastrueXion begins. d. varalutna. Vacuum work area vntb li1rYA filtered l . ; p 3. 1e4ainsain negative air pressure width work site S. Wes mop tumt with distnleGStn. ulilizlns HEPA equipped air filtration amts. 6. upon canpielion testorellV,A C system WIIGTC 4. Seal tier i txtrtduitx send tC2Ut CS ca, c■, pw p P vvtxk war performed p _ I later . approp► y s. le and all axestt+ttd CcXU;ttvel anteroom require D r they be a I road pass through this atom sa can vacuumed J, ri„ a H EPA vacuum its using 6P clrannrlteforeleav g S • L: s,• site Or they Ca[t WL'nl' cloth or work a paper 4 }•° . rem vteiT each tune they eaves coveralls that arC o 1 w silos the work s" I: 6. 1 anted ' work site artl tsred to , All persa ncl ng req it 6 wear ahoc wvati. Shoe covers rimer be changed 'sEr; each trine the tY01itLY CXira tFle nNkttk at'ea. Y r %, 1i41►ot remove banie:ns flan work aiYa IuRLY l g' completed project 1c inspected by the owners i Safbtyl7epartntma and Infection Cwtttot °: rllrtettL Department and thaxouglily cleaned by by the envncr's Envirctttmetxal Services r Hann MN t n F rvicw U,dtrerait M ca{ Ceuta ea Steps M14 Adapted talth tt■rm seta td r ed r Dom■ Forme inod{ned and provided courtesy crAMene Oartley, EC9t Inc. aov&k Hlaa Mt 1002 Revised 2006 ., mwcuort prokvcvt E. Infection Control Procedures, General A. PURPOSE: 1. Personal Protective Equipment (PPE) I. To prevent the acquisition of nosocomial infection in- patients /visitors /healthcare workers during a. These recommendations apply to potential infectious disea ;e cxlnsl:res. OSt1A : ccomme�dLtians ^ hospital construction and renovation. regarding PPE for exposures to other potential occupational h>?za d�s t I.e. ashestoa, chemi�alr, rtois9 B. SCOPE: ) should be farrowed. ^ ^ ^ - - - ^ ^ •. ^ i: 0� I. Applies to ail renovation /construction activities involving general and prime contractors, b. PPE Stations (fully stocked) must be provided at entrance of woriksite. All personnel entering subcontractors, material suppliers, vendors, working on site, and /or All Baptist Hospital of Miami staff., worksite are required to wear appropriate PPE and to remove same when exiting the workslte. Infectton Control Practitioners, Hospital Administration and other critical staff members. 2.13lood /Body Fluid Exposures _ , .. ^ ----- _ _ _ -1 . ^ Mimi C. RESPONSIBILITIES: a. When exposure to blood ! body fluids or materials conttlininet(id with sam9is antit:1pated at a ; All Baptist Hospital of Miami Operations and Maintenance Departments: minimum fluid resistant gloves must be worn. Fluid resistant g:Fwns, masks, gogules /shields must; ,,,� a. Adhere to American Institute of Architects (AIA) guidelines as referenced above in planning and be wom If splashing / splattering of blood /body fluids flt;rl aintaninaCaJ"c:qu:pmea: Pplur�lbliy i ^ performing all construction !renovation projects sewage pipes is likely to occur. b. Adhere to protocols outlined in this policy b. If tearing of gloves is likely due to the nature of the worikmon- disposable, heavy duty, fluid resistant c. Notify Epidemiology /Infection Control Department and review project with Epidemiology /Infection gloves must be used. These gloves may be disinfected. after use with EPA approved hospital Control Department when construction /renovation activity and risk level indicate that Class III and disinfectant. Class IV control procedures are necessary. 3.Class III and Class IV Construction/Renovation Activi•lies require the following PPE d. Notify Environmental Services Department prior to beginning project regarding requirements for a. During demolition and/or construction that generates a high level of dust: personnel and supplies to ensure project and adjacent areas are cleaned /disinfected /pest 1) Cover suit controlled. 2) Head covers e. Notify all affected departments /services when there is planned /unplanned disruption In water 3) Shoe covers supply and assist in providing alternate sources 4) Dust/mistlfume mask f. Provide general and prime Contractors, Subcontractors, Material Suppliers, Vendors, working on site, 5) Gloves/goggles are required if exposure to bloodlbody fluids is likely (see above) with a copy of this Policy b. Isolation Rooms g. Ensure that there is a fully stocked Personal Protective Equipment (PPE) station at the entrance to 1) Construction /renovation should not take place in an occupied Isolation Room unless the worts is the worlksite deemed to be of an emergency nature. Every attempt must be made to transfer the Isolation patient h. Ensure that barrier materials as required are constructed and maintained properly, HEPA filtered to another room before work begins. If this is impossible: vacuum and portable HEPA filter units for control of airborne contamination are provided unless a) PPE must be worn in accordance with Isolator Precautions Sign. otherwise contracted b) Evaluate job and take minimum tools / equipment into room. i. Obtain Infection Control Construction Permit (when indicated) from Epidemiology /Infection Control c) Equipment /tools to be removed from room must be deemed with approved disinfectant prior Department before construction / renovation begins. Infection Control Permit must be obtained to removal. whether work is performed by external contractor or by All Baptist Hospital of Miami Facilities POM d) Tools /equipment taken into latex isolation roam may not contain rubber. employees (see Appendix A for Infection Control Construction Permit) c. Containment Material and Disinfectant Specifications fcr Prevention of Environmental Contamination J. When an infection Control Construction Permit is required obtain signatures of responsible party from 1) Sheet plastic - polystyrene, 6 mil thickness. general Contractor and any prime contractor, or AD Baptist Hospital of Miami Facilities POM project a) Barrier doors -solid core wood in metal frame, painted. manager as appropriate. 2) Portable HEPA Filtration Units - provide primary, secondary and HEPA filters. 1. All Baptist Hospital of Miami Facilities POM employees will attend an education session on infection 3) HEPA filtered vacuum cleaner Control Protocols for Construction and Renovation, prior to beginning work when Class Ili or Class IV 4) Exhaust Hoses -heavy duty, flexible steel reinfonxid, ventilation blower hose. control procedures are required. 5) Adhesive walk -off mats - provide minimum size triers of 24 inches x 36 Indies. 2.Inspect project during the course of construction, at completion and prior to occupancy of area ( 6) Disinfectant - utilize disinfectant supplied by Environmental Services Department. with Epidemiology /Infection Control Department representative) to ensure that infection control 4,8arriers guidelines and protocols outlined In this policy have been met (See Quality Control and Enforcement a. Class I Sections of this policy) 1) No barriers required b. Class II 2.Epidenilology !Infection Control Department 1) Seal unused doors with duct tape a. Review all construction / renovation plans where activity and risk level indicates that Class 111 and 2 Block off and seal air vents Class IV control procedures are required. Determine class with All Baptist Hospital of Miami Facilities ties POM input Provide written recommendations, :............................................:.......................................................•......... ...........,...•............... as appropriate, consistent with AIA Guidelines. ::•7• :• :•:A{I: lit:• Dlsl' SS• 1{•: t71G: S•:•::•:: �:•:::•::•::•:::•::;:•::: :�::•:'•:::::•::::•::•:::•:•::� ::•:::•::•::•::::•:::'::•::'•::•:::•::•:::•::: :�::::•:_:•::•:�:•::•::::•:::•: b. Provide infection Control Construction Permit as required (see Appendix A) :;•::•a :•lZiitf • tit••• lastia •tiaiTiB'r.•i3icti>;ridGi' �:from�•�oortor:i�ailiii ':•: with 'seairis•sea}eii.wittl:duoEtia' er:to:::'::: :' : :': c. Provide education on infection control protocol for construction and renovation to general Contractor ..::...:.....1....:-:-:, . . .•:: • • " ..prevenf•iliist:a' rid• iieiiri§: ftroi'ri•:e'scapiiig:iic•i9iym+; alt •tiari•Ters:eriect ®il•itviifl: 'fits:6iivi# lest :b�:ssaleii::::•::::•::::::•: and rime contractors and their and / or All Baptist Hospital of Miami Facilities M ' t n •:' � :....................' ...... ..............................' ..................... • .;.......... �...................... am a once P personnel, . � :: T . o... t a 1 m. ..fi l nr•. � ::::: :. he ' •a a d: its :: � .. s. �.ia..fttei's.•itl�t:ais...q... . ' .e...a #.alltv;tors#ia.. a'.st�rY+!!.. swill ...#?�....d•.a�:��i?........... / Engineering ro act manager and personnel as appropriate. �' P •' ••..........b'•:iAirtf..: " ic• barriers.• are. t�o-be • "stied:at:.ernstration•of•ceil ":';:alive... s •.ctiasesand�:•::•::•::::•:.:•: r. d. Make periodic visits to work sites ensure that ...................... .. ............ ................... to Infection Control Protocol Is being followed and report ;•;;.; ;.: ctbllirig�spt�es •iii•:stbji:t'na✓sitieiit• iii• aii.aiid: i{ etiiis•: v�rfterI •iittiizli�q:as:a:'rsfsiiti•: air•" leil(uii•: /.•�uct�::•::::�::::• :•::•: deficiencies to the All Baptist Hospital of Miami Facilities Project Manager See Appendix B Infection *-::::::,-::%:::* """"""""""""" """"""""""""""""" " " "" " """"" "' ( APP �; .......... ............................... :::: c •: fin'• 'ram • ' n '• tI ' •ceitln• cr•'a ss• rots roe . n' . . ).......... t3P®!?irtg &.�...... �4@ j.. #4►. �•?tiS..!�....... 9>•...... iii ...1?S! ...!&.S}�.QI?fi....S(! .. i?�4i?lQd•:•:::•::;•:::•: Control Protocol Monitor " " " " ' ) •::::a1iedS:foi':• walk:• ii6ove •:cei}in: "';: "avrile:.......... ire: eiiciii§ iir: e:• aitiiiiid :[acJd'er'"sealir'r";off•;ope .,....;fifEeii•::•::•: ::•:::::: . ........................ .......9s. W........ T? o> a.'• sfY. re..................................... ... ... ..9..........n!n9,............. e. Inspect act at completion and riot ar project p to occupancy of area (with All Baptist Hospital of Miami .. t •tl• : •: •�i • • • • .and. h isr. tin fi( ntit::•::•::•::•::::::•:::•::•::•:::•::::•:::::•::•::::•::•::•::•:::•:: �:•::•:::: �:::•::•: �:•::•: �:•:::•: ::•:�::::'::::::•::•:::::::•:•: Facilities ProectManager) to ensure that infection control guidelines n rotocolsoutlintsdin •'`'`"' �"""""" "9"""""""""""""""""" ""�"""""""" " """""""""""" """" """" " "." "' 1 9 and (AIA) P ' : :: •d :An ce1 'acre s• an Is'• lsrred•1br• rove atlo 'at3 d' I •areas•s;hatl••ba• faced: � . � :: s this have been met See ail Con a Enforcement s i policy Qu Control and Section of this of ( tY policy ) :•: iinrrier}'iatei" :titih ® ":tiiiatfentteil� ::•: � :•::•::•::•::•::•::• :::•:::•:::•::•::•::•::•::•::•: �::•:::: �::•:::•::•:::•:::•::•::•::•::•::::•:: •::•::•:::•::•::•:::•:::.:::•:: •y: • n 3.EnvlronmentalServicesDe rot ::;. . ..:.::::::.::.: �..:::•:............................................................... ... �::.:•.....::::••:::.� :::•.� :•. Department ::::::•: �•? :•:::Ali af:Gtass :ilJ tiaml�s;•P.�::•::::.::•:::•. � •• ••::::. � ::::• :::::::::::::. � ::::::•%%,.1:.1.%1.%1.1.: :. .: :::::. � ::::. �::. �. a. Provide t and o me contractors and All Baptist Hospital of Miami Facilities PO personnel: general Pri P M :•:a :� .'rife'* " "'•:is:: 'fo" . a:. "tti" tie" "ilia . "•ari•:dii'iit3 .. "riiiriuir'1:::::•: approved disinfectant. I ,) A t•1orr1 regirii+eid............. ba•riiad of:{iatYe..y)e... en•,.•• ha'. ie........ a ...pP!M9�;�P�?► ................ :•:0t•2:telat•�9 :• b. Contract for insect /rodent control at wo sit d a I .... ............................................................................... ............................... . rk a an adjacent teas during and after completion of ... ...... .................................................................................... ............................... ::' �r: �' iafffc.; I�esinctions:::.:•:::::. �. �::::::. �::::: .:�.�::::•:.�::::::::::•::.�:.� :•::.:: �::::.:: �. �. � .�::.�:::::.:�.�.�::::::::::.�. project •:•: a::• 7�. atiei�ii•! tiasitar.• 7: siaff�ira�a�iiti§' t�tie: �reiiliiiif• srbkiiid :coii:'striiet%iii�aiea::� .. propiiate:• direidir ?ri:::•::•:::•::::•::::•::•: o. Clean and disinfect areas adjacent to worksfte Burin the """""""""""""""""""""""""""""""'•"""' ' 9 project. �. .•s :p;'•'S its•' � p ................ ............................... .� . . mifst.... in. tIr� 'laria>':'ta...Caril.�'nl��.�; .•.:'.:':.':.:'.:.'.:'. � .':.':.'.'::.':. � .'::.'::.':.::':.':.': ':.:::':.'.:::'. � .':.:':::.:':.::':.:'. 1 Perform final cleaning /disinfection of area at completion of the project •:: B: Vsiitilalavi 'r:::•::::•::•::•::•::•::•::� •::•:•::•::::•::•::•::::::•:::•::::::•::: �:::: �::•::•::::•::•:::•::•:•::•::?:•::•::•::•::•::•::::•::• :::::::•::::::•:::•:::•::•:::•: 4.Perforrnance Requirements /for General and Prime Contractor :� � ��: �jg� (ata•11°ie:•HVAC:systittri:tb: pre�ierit•: tkfittartiinettori• af: iTlicl: sysfairi: wtieili•: oiaitsirtic�k�iri :l•:renouatibii:•::•::•::•::::• a. Review Baptist Hospital of Miami Facilities Infection Control Protocol for Construction and Renovation, """"""""""""""""""""""""""""""" """"""""""""""""" """""""""""""' :: regpires;' �I��s ;•[I;t•g{r4:(�/;�nt{a1:{�r��@d( lies• pr,•; At; Erergitlrls; abatementr�........................................ irftischafgeii ,�ta•}}�cipid �:•; :;:•; prior to beginning work. :•: areas •sh'ali•i;a•}aEt?A:filtereif:: � :•:::::•:::•:::•::•::::•::� ::•::: �:• :::•::::•::•::::•:::•::•:•:::• • •:••• •'••::•:::•:::•:: b. Review and sign (when indicated) Infection Control Construction Permit, prior to beginning work ......................'..........'............'......... ....'.......................... .'.. ....... .........'............. ...... ........ :•:;b::•:Me nfaitf :•i1 ' at}ve:tsih: i'.9s5idl°e:ilW z '•f{EF.tA•e' iii "' }. aih: filttatlarl :iiriifs:Vit�iirivJOilslite. fot•::::•::•::•:::�::•::•:: c. All on site management /employees will attend an education session on Infection Control Protocols � ¢ � q per' """"""' ::•coiistru ... »'l.tnrxovatlo.. . uiriri •'•f>,t' as's'tli' and: l�: control... roceiiiiras�oi ' :As......ilius•atiaterri 'lit::::. % . � ::. � :: for Construction and Renovation prior to work. • •ctJa ................1}:�1..... ti..............................: P.......... ...........Pif!9............... p................. , beginning �;: HEP. A: siiili)? P.® d:. afrlil3iatiiiniriachiites: sEiail: jiroznde: a{ r, flov�lrita: coitsfriietiiin: aGea•:► iitliiss :iFraii:•1:Oi1•::•::'::•::• d. Adhere to Baptist Hospital f Miami o Facilities Infection Control Protocol for Construction and ::•: F: P. 1N•: ei: b: �l#{ 9��tltta��: �iVftl{•: dctbt;# •:fi!{iy!•s>k8ti:::•::::'.•::•: •::•::•:: •::•:::::•::•::•::::::•::::•:..........:.....-:..........:.....,:.",:.*.,.,.,.,.*::.,.,.I :: � ::•:::•::::::•:: �:•:•::• �•::•: �::•::� •: Renovation. '... •........... ....... '� : c::'_ Ariterriorri •iccrosiiiicfea :wgeii� ....strkietrorr•i'nern vatielir :r•e ...ires•Eidss•liit•irontrol:..rii ..tirea•mu' • ••ilia•: � :::::. e. Submittals by General Contractor ........ ... .... ... cPrr ......... o ...... .�? .......................... P.. �.......... �............ :� maiiitairieii�at •:rtis�ativei:piessiirei iri; lief atioii: toacljacerit :,i'rsa's:neif':t'1rid'er: con' sfrtietieili: F :r:erie�:vaiiofii:::•::::::•::•: 1. Specify details of barriers, air handling equipment (portable HEPA filter units) products and •; :7' ..,• Ru9#:> �ltaliiarit• �• CH3ari► fi�•::•::•:;•::•::•:•::•::•::•:::•::•:::•: �::•: •:;:�::;•:•:•::•:::::�•::•::•:: �:;:�:::•:•::•:::•::::•::•: �:•:::•: �•:::•::•:�:•::::.:•: �: materials to be used to control potential contamination generated by construction /renovation :. - ::•e, :; Adhesive ;:watk* 6fE�mats"si.ai[•i;kt3pt ctei3�i:aiid:ciiaiiged:des{i.r, etas :iiecessaiii•;ia'{i!ayerit:.:: :.:::•::•::•::::•::':: activities. .. ... .. ::::::.a6Wmllf6tl6rr:6i:ii6'sf ............ ::::: • •:::::::•:. 2. C. Infection Control Consultation and Infection Control Construction Permit Requirements ::�;:::�$Y:��•.��: Gaff{ Qr: S# l�tl• A0•:►; 4fi'{ Q1! 8i}•: f} p► 11�di2( CoIyr:: GI�N9g: Gilt61d: 9.a�tb:9:b:>tt{{9r{S:•: :•::•::• 3. Construction /renovation activities require consultation with the Epidemiology! Infection Control • :...................... ... ..............., ....... .......................... .......................*:.,.,.1.1.*., . � ta. tie;• elan® wifheitti ®i{a•NEFs�C:#ikeried•: vacuum •or•with:stwef::Top.:.:.:.:.::*.**."*.**",.,*,:, •:::•::::•:; ;•::• ::: ; ; :•; :•:::•; :::; :•;:•:• • • Department based upon the activity type (Types A - D) described below and the level of risk to ::�:c;:1'tUtieri:ari� :vae{itiining:•is: clonal •it•:riii{sfi:b;s•:w�Fi�:a: HEi? i': 61fei• ed:• uai:: iiuni:•::•:::•:•::•::•:::•::•::•::•::• ::•::•::•::'::•::•::•::•:::•::: patients/ visitors /staff described in the Infection Control Risk Group (below). . """"• """"""' ""' : �: t1: �: V�UI�� ?'VW#;:t&f?�i�:jitY�:Cl9ait �itd: i�i�! 1f�: Ci•:(• U81{ r9:• �1? prOX� :4:di;�tifQif+fC�):� ►�:8i1�;# :�:•::•::•: 4. Before a project begins consult the Construction Activity /Infection Control Matrix (below) to •; :�•�� "•the: •'rio ' ' • and:• aitei •:tlaiii:eis•}iaJe•kieei�i• roirioiied::•::•::•::•::•::•:::•::•::•::•::•::•::•:::• :::'::•::::•::•::•::•::•::::•:: determine whether an Infection Control Consultation and Infection Control Construction Permit is :•::.:.......' .......... g " "' p" �..........' .......................................................... ............................... :•: e�: mein; 3ttiiotiar):• de} Si{ s: sfiaH• iia•: plt�d�:Ul:tii�hi}yse'a{ed•:tor► tame' is•:klieftire:re'rriovei:iydiii• hie :•idcciiie:•sitt�•}f•::•:::•:: required. First, etetmine the type of construction 1 renovation activity (see chart below); then • :..... ............ ... . ... ....... ... .. � .... ............ .................'. .... . ...... .......... ... .... .... ....... ... ....'............. %1.1.%, travetln 'threw tern• areas: •:::::. � . � • ," :. "* :. � ::.:•:::.: . determine the Infection Control Risk Group (see chart below), then consult the Construction Activity :•:B:Ililatei•:Sti "' P / Infection Control Matrix (below). "" ::�:a ?:6:apGst�Hi>srHCBI :bf : Mia} iii• Matiiut;# iti9ilaa� :sttiff:t►At{fieg:ail':t 1ft6�ied•:ddD:$itmaitts•'L• net• lilt .4s':ai4tl:•it�isC•in:•:::::•::: 'bvisiori•of�sifem�rte: sources• of: water�::•:::::::•:•::•::•::•::� :••:::•::•:::•:::•;::•::•:;• i::•::•:::•::•: �:;:•::•:::•::• :i::::•::•::•::•:::•:;•:::•:;:• TYPE Inspection and Non - Invasive Acttvitles. Includes but 1s not limited to removal of ceiling tiles A for visual Inspection (limited to 1 file per 50 square feet), painting (hilt not sanding) wall covering, electrical trim work. minor to a r g, probing and activities that do not generate dust or require cutting of watts or access to ceilings other than for visual inspection. TYPE Small-scale, short duration activities that create minimal dust. Includes but is not limited to 8 installation of telephone and computer cables, access to chase spaces, cutting of walls or ceiling where dust migration cars be controlled. ::::ay.FE•.:: ... AnY.•1xvrK•# lea #:gQ!t�►:ota!o:a•►ttzalai•cO: niter?: iexQl: 4? :�p4t•?�:ra�ix�s:•t�'tia1iiian: �r.:tetr�x�l:• oI'•a....f.X...b... . i • a .1 ed. lwfdita'': bfl .:.......nfa�,�:....'...bles:� . .'t...' . ..... r.assem ..{ rod' liiieii• kiniC •is•iia.ltrrn'teci•:tia•sariiii ................. . i/ g• fiPp?o rig•::•:::•: ::wlt's•fo'r:phiritiiii:br vaaif:cayerm�; :ieriroving:flo cayEUiii�s i eilin�.'tHes aiidctseiniark ;: iiew " :w H'• r• n• I a C f1 t r' { . tk'• v ' ' In' to tv m1 •t1r•' ••outs `•rti' •+; . a..s.. i?a#lo .,�:1?... .. 4( I? Gtw ..aric....a!ac'i.�ait........ �b>�. �`.ai�.. 1 ...a ..b� ..:�a# ! >�� . 95 j�l: � . {� ............................ ...................................... ............................... TYPE Major demolition and construction projects. includes but is not limited to activities that D require consecutive work shifts, heavy demolition or removel of a complete ceiling system and new construction. Any work that requires disruption of water supply for more than 1 hour. :•: N; �:• St1{ fieri• ft9asitile;: sefieclrile •iriferiu'ttbn:fbi•:ldw:vvidter:u ... Iii• tiiilis::•::•::•:::::•::•::•::•::•::::•::: �:::•::• ::•:::•::•::::::•::•::•::::•::• :� ��:�tasii:;�vaier:sla ' `:tit(e:�': • triii:tr�PM, ' ai:of.{ . �..,.. ..:�r� :...:r • • �: ors' � .1 ' �ts::�:: :: ?;: :' • ............ DI?tY . fr . n'ut#G:Gta;�t#• t>$ t#h:�tY, d.. PtIP aii:�:aria•r� . :-- ...... trawl Bolistiticfeli'(•reriovafe' ••a1'eas;.into.sersria;s::: • : � . � .::: � ::.: � *.*.,.,.%,.,.,.,.*:.*:.*.,.*.*:.*.,:.,:.* . :. ::. ::. � ::.:1.1:.,.*.*.,.'.'.,.*.*.*.*.,.*.,. '•:d:: Adhie' re:fo:l�tA�yillcleliiies.•'re:. :: i�ig •tierifii�iioi'r:bfi�4aiei:feiri' ieiatiii�esr: rise: af.• fasicei:ae'ratitiis•itiid:•:::•: � :•::•:: n '/• ' 1v ...... aaictafaw'Pro. v� . t��s... ..el#;•::::•::•::;•: � :•:::::� •::;.:-.,.,.%,.,.,.*: •:::•:'•::•:;•::•: � •::;•::•::•::•:•:::•:'•:'•:� ::•:;•:::::•:;; :•::� •: �:•::•:::::•::•::;•: F. infection Control Procedures by Class of Construction! Renovation Activity 1. Class 1 a. Execute work methods to minimize raising dust from construction /renovation operations b. Immediately replace an y ceiling the displaced for Inspection a Refer to above procedures for cleanup and disposal 2,Class 11 a. Water mist work surfaces to control dust while cutting b. Seal unused doors with duct tape c. Place walk off mat at entrance and exit of area d. Block off and seal air vents e. Contain construction debris before transport In tightly a) vered containers f. Wet mop and ! or vacuum the area with HEPA filtered vacuum before leaving work area VIN a surfaces with approved disinfectant 9 P PP INFE N CONTROL K GROUPS ,:• 3: CI0$$: 1{ 4:•::•:::•::•:::•:::::::.....::......:: ...........:::::::::::::::::::::::::::::::::::::::::: ::::::::::::::::::::::::::::::: t;TW CONTRO S G OU 5 :'a� •i?ii'evs" •' in •'3ri••Class :i'at;d:ti': slid jii' :aijditlorr :ttie fottotiiii ........................ ............................... ...�...9 ..................... t .....,......... • .... r.4............. !?9 :::::::::::::::::::::: ::::::::::::::::::::::::::::::: •'ti•':Dbfaih- lhf6iMi :•i^;ciillrol:Ciirisfilii:tiarl PatM fiairii• E • idemrci&i r'1•N64fl6d.ru f fi:l Ty4iiirlirieiif :::::::: :: GROUP/ GROUP 2 GROUPS :;;•;;•;; ;G,,,,,•P•4:•;..;•;:•: LOWEST RISK MEDIUM RISK IAEDIUM -HIGH RISK ::•::}ll�akl?::Fi{QK:: 1. O Ito A see 1, r re AU other 1. Ce to At patient care Emergency n t. a Unoccupied Wards areas {e.g. caltlitmrahab. 2. Hadlo opyrMRt 2. At Ota ambulatory true ctlrlica 3 Peat Aneatheati care tJnh 1, Otroctl4[1S unlit; and un&ke ■lrotad in Group 3 4. Labs & delivery (non OR) outpatient clinics for or4 6. NaImalNawbomNtsserles cancer patients 2. Outprdlertt clinics {exk opt G [>ESY Surgery 4. Transplant units and for oncology end surgery} 7. Nuclear FAttdlc}ne adpnNeM cUnlca 3. Admior agxscharge 8. physiotherapy lank areas S, Wnr� and outpatient slits 9. Echocartiivlogy olinir� fur patients with tQ. Pump"faam AIDSarotlt4e• tt, Ltdtorotxice immunodotlaoray 12. ¢enoralA4edtsurgunits 6. Dialysis Units sitter titan Iftase /latest in 7. Tertiary Cara nurseries Group 4 A. Labor 8 DeIWRry 13. pediatrics Oporatlrtg Rooms 14. Geriatrics 4. Al Cardiac Cathrrr¢atlor 16. Long term clue & Arglography areas in. CarkifovaswlnrrCatdiob gy patients it. Anesthesia and pump areas 1 2. AN Ertdoscapp ero¢s 13. Pharmacy 1 our ttdrn x o y elves t4. 5leriie pro cessktg room 1 n' •:. b.9ft►1:9.a1}tsStt(Il�'t#ts'tl$ :•: •:c::•lSiii;:ori•:dover'siik;•: head: arid• Billie': aoJeis;•: diistir :riiist:r!•fiiilae•'irias(i:..` • r:to: e�r'tetiri "•aiaiksiier_ :•droves':::•::•:: ::•a+id: " "" es; a1 'e:i�e'iii'rei{•ifi:iii....iira• tie• Btbpolfiiid " ...... flitiil':{ §:iitie' ..... ....... ...... .......... •: � : d: :•Retitoxe:'Or•i;;olat4:F•1�!A� : OYwFr (•fr{;ar�a:•>•vrla�:a+rark• ►'# ��in�•:4c'�:► ego: i3ray. Qritaantt�� 'n�t�r�:•:al4ha:•::;•::•::•: :• :duct's Steal•'::::•::: ::�: ; :• ::•:::•: :• ::•::: :•: � ::•:: � :•::::•:::•: � : � :•: ::•:::•::• :' •:::. � :::::::::.::: � :. � :. � :. � :::::::::•::::•:::. � . � .':::::::::.:: . Y.. : : :: •:}a::•::•::Goriplee:aH'cle• bthieis:{ aefiie c5rsttii�kY ( sea• Bat�a•seGtii)::•::•:•:•: � :• •' • •::•::•:•: ::; :: :. , .. . . . .. :: . ..:.. ' .. .. •ris. . .. :.. .. � .. .:. . ::'::.:. :t. ::•::••a):::••.Rtgepp'iPd.a �Frj;s t4rq i9iintti9. cB�t:i.rQ?)Pttip.arid.rei�ava.l.f . po Gg:::: :•:::•:: �1n :red•kia�:iniecfioiis:vi!a§�a i;�:regiilar:tias}i:� as: aj? Propiiafe: j•: piiol :lo:}eaurii;.vuoi{csri'e;:.:If..:.......................................- .................. :•:• ::•:Bari= aTspoi;adte:P.P.E•is: ti;;edi;: bli#ari:l+ifti);dlsltifeofa fit• viii,i 'r:tb:•ranieSvfiiff:fr`di��'Y. dills' sire: -: ::•::•::•::::•::••::::•::::::•: '� :3 • � :•� �vlairtiaiii•ti:• • • aUuta� afr•� •less . ie:within�wiirlc •ire'; � � klss� PrEPA:.. .. d' aIr' fttratbii�aiilts ::::•::•::•::•:::•::•: ::.:; ,.,�f.:.: Vaetiiirn :woli�sitauuitii:HEt?q:firte' tali• v•a §:ileeifeii•:ariit•af•slid:bf' pia® ct::: ::•:::•;:::;;:•::•::::::::•:;;: ;•:5) :•::: YVai•:' rfia} isVlibilt9lte:•: V�iU?: dFSR�v�I•: tllsliifebteiit :•etter:ve0tiuriiD}$::•::•:::•: ;•: � :•: � :::�:::•:::•: � ::•::•::•::: � :::�:; :•:•:;• :•: fi• :. . :. :fi)o�itot•'reiiiove :tialiiie • ••'f'rotrr :work :> areas :iiiltit: ccsiri'r • • iii . ... 'ei;t :ts :cieaiit;fd�ti � �Envrrruimenfal :•::• •:'::•: :s'ervice's: ::: e::• I7eiribde :tiai'riel'.:riiateria{s:aiiii� •::•::•::•:::idib'ri'ifeb : "'� "• "refid ' :' ii§a•t•ias:b'ee � : �'• ®:•::•: "•'d'•::•:•'•: :• ..................... tconstru ns.ca ly:,(attisi: a • • , • • • • , • • • n cl arle;�:l•;di §iii %eta . :•:: :•:;byEtivi{�alxtleft�t•:�:er�, sees• A: epartm�' �:• tt�•mMi�,lzo':aoro~�a3r4laGptl:• set: 4t+ i> �:: aritt�iila�e :�r�:•1j9f1t�Y:ss�le4 ��:�:�: : •.caiitaineis:•fa:•iemovat:fiot rt: woniisrfe::•: '•::':::•:::•::•::•::::•::•:':• •:. � :.: � ::. � ::: :.:::: � . � :.: � :. � :•::. � :.: � :: •::::::::::•. � ::::. . . :. � .: -'-:4.)' •::•::•:Gover salt §: F: lei; eptaeites• iis13ii• tCr :traiispoi2:rrriiisttilicfion deans::::::::::•:.:::: � ::::.: � :::•.: � :.•:::::::.:::•. ....... •' a):;15o evei ....'rrg .....ijsses ........ ..:... . m a ..... I.... n* ... .... inrrn - ::I.)•::: :.:•See r:hateei:pi; 66; -.bd6i itiW'A'n''d'':tihi6Wr.* elf• dpiofiiatety- When- tt'►ieiy.ON,etiato'.V.6 lei's :::•:.........::::::: P .................................................... .................•............. CONSTRUCTION ACTIVITY! INFECTION CONTROL MATRIX :' :'2) ::'::; Cox' Strt? ct' `mteroom.•pgjalcan #:to;wortkslt ,;;i4r{ term •1s•tcg;T>t :gseti7oremovq :RPE:whentpaving: ; :::•::•::tile:war}islte : ;P?faoe:a.l iw., trash.carrtarner ln•ihe anteroom to d se of PPE use a .red lasficba " (. i? . 3: .....I.......... •. ::::::. . .................. :::;ta Itde :tilebritairief. {f : �iiittiaviilYes' iiiaCari :3ls:adtit8ii►liiattt<c1: with:tl7dl:biai[Y:tTtitds ( {e:pHirlliiing :::::::: ::: Infection Control consultation is required when the construction activity and risk level Indicate ::............................................................................................................. ............................... % that Class Ill and Class IV control procedures are necessary :''", war roc) ::::.::::::::::•::•::::::::; :.....:.-.%.................:..........:.......-......... ••.:::::::::::::::::::::::::: ;::::::::::::; ::::::::::::::::::... ........ . •3 :::•:.Lleail•PPE:is:fo:tie:ich outside of:t}i ®:arifeiiioiri iiriii i §:ta tie: nn halals entsltri ilia . .p .0 �: CONSTRUCTION ACTIVITY ISK LEVEL TYPE TYPE TYPE TYPE rcAn arBrr u)+n Mn Gros 1 I If II 111 Gros 2 f 11 111 IV Grew 3 g Ill III IV Gros 4 It Ill •::tV'.•:::� �:�:: IV D. Infection Control Construction Permits 1. infection Control Construction Permit Is required when the construction activity and risk level indicate that Class III and Class IV control procedures are required. a. When an Infection Control Construction Permit Is required it must be obtained from the Epidemiology /Infection Control Department before beginning any demolition or construction work. Decision regarding classification of construction activity (Class 1, 2, 3, or 4) rests with the Epidemiology/Infection Control Department. b. The infection Control Construction Permit must be displayed at the entrance to the work area during the entire construction period. c. At the completion of work the Infection Control Construction Permit must be returned to the Epidemiology /Infection Contro l Department. CITY OF SOUTJ -i MiAMi BUILDING DEPT, STRUCTURAL 3ECTi0N APPROVED BY: 1 , 1. >111111111111111111 1. Lu WE- � vY , J !i 1. s we� ® � t>�t i4' �- a �h sssvtr.•taasa m Coo l� �s s` o .- � o c') V- 0 ti o co �• I d' M c>3 ti E ro rn N to O i I- d � p 1' o) r-- r t) , ti r` 4M 0 C.4 tD 't 0 m 01 alp O "? -C tt1M �� Co HMO � 'aN= O'�tJre- Z st an 0 0 m 1p :3 ay�"cc) F> = ai W 7 •r t9 LLtL-7Odt'nt- -Q Co I C 411C 1 C-d- 4111111111111111110 1111111111111111111111 4D 40 cc 9 M9 0 8 wagoin CC 43 E `* I Ce CO co y W I'letin as 11111111111111111, ca 10-S .Q C 'O 3-: Comm. No: 08067 Date: Drawn: * Revised: � 2007 HARV q ARD DULLY, ICRA i. i ` G�l U � 2pn� - 2007 rllrtettL - ^ ^ •. ^ i: 0� I. Applies to ail renovation /construction activities involving general and prime contractors, b. PPE Stations (fully stocked) must be provided at entrance of woriksite. All personnel entering subcontractors, material suppliers, vendors, working on site, and /or All Baptist Hospital of Miami staff., worksite are required to wear appropriate PPE and to remove same when exiting the workslte. Infectton Control Practitioners, Hospital Administration and other critical staff members. 2.13lood /Body Fluid Exposures _ , .. ^ ----- _ _ _ -1 . ^ Mimi C. RESPONSIBILITIES: a. When exposure to blood ! body fluids or materials conttlininet(id with sam9is antit:1pated at a ; All Baptist Hospital of Miami Operations and Maintenance Departments: minimum fluid resistant gloves must be worn. Fluid resistant g:Fwns, masks, gogules /shields must; ,,,� a. Adhere to American Institute of Architects (AIA) guidelines as referenced above in planning and be wom If splashing / splattering of blood /body fluids flt;rl aintaninaCaJ"c:qu:pmea: Pplur�lbliy i ^ performing all construction !renovation projects sewage pipes is likely to occur. b. Adhere to protocols outlined in this policy b. If tearing of gloves is likely due to the nature of the worikmon- disposable, heavy duty, fluid resistant c. Notify Epidemiology /Infection Control Department and review project with Epidemiology /Infection gloves must be used. These gloves may be disinfected. after use with EPA approved hospital Control Department when construction /renovation activity and risk level indicate that Class III and disinfectant. Class IV control procedures are necessary. 3.Class III and Class IV Construction/Renovation Activi•lies require the following PPE d. Notify Environmental Services Department prior to beginning project regarding requirements for a. During demolition and/or construction that generates a high level of dust: personnel and supplies to ensure project and adjacent areas are cleaned /disinfected /pest 1) Cover suit controlled. 2) Head covers e. Notify all affected departments /services when there is planned /unplanned disruption In water 3) Shoe covers supply and assist in providing alternate sources 4) Dust/mistlfume mask f. Provide general and prime Contractors, Subcontractors, Material Suppliers, Vendors, working on site, 5) Gloves/goggles are required if exposure to bloodlbody fluids is likely (see above) with a copy of this Policy b. Isolation Rooms g. Ensure that there is a fully stocked Personal Protective Equipment (PPE) station at the entrance to 1) Construction /renovation should not take place in an occupied Isolation Room unless the worts is the worlksite deemed to be of an emergency nature. Every attempt must be made to transfer the Isolation patient h. Ensure that barrier materials as required are constructed and maintained properly, HEPA filtered to another room before work begins. If this is impossible: vacuum and portable HEPA filter units for control of airborne contamination are provided unless a) PPE must be worn in accordance with Isolator Precautions Sign. otherwise contracted b) Evaluate job and take minimum tools / equipment into room. i. Obtain Infection Control Construction Permit (when indicated) from Epidemiology /Infection Control c) Equipment /tools to be removed from room must be deemed with approved disinfectant prior Department before construction / renovation begins. Infection Control Permit must be obtained to removal. whether work is performed by external contractor or by All Baptist Hospital of Miami Facilities POM d) Tools /equipment taken into latex isolation roam may not contain rubber. employees (see Appendix A for Infection Control Construction Permit) c. Containment Material and Disinfectant Specifications fcr Prevention of Environmental Contamination J. When an infection Control Construction Permit is required obtain signatures of responsible party from 1) Sheet plastic - polystyrene, 6 mil thickness. general Contractor and any prime contractor, or AD Baptist Hospital of Miami Facilities POM project a) Barrier doors -solid core wood in metal frame, painted. manager as appropriate. 2) Portable HEPA Filtration Units - provide primary, secondary and HEPA filters. 1. All Baptist Hospital of Miami Facilities POM employees will attend an education session on infection 3) HEPA filtered vacuum cleaner Control Protocols for Construction and Renovation, prior to beginning work when Class Ili or Class IV 4) Exhaust Hoses -heavy duty, flexible steel reinfonxid, ventilation blower hose. control procedures are required. 5) Adhesive walk -off mats - provide minimum size triers of 24 inches x 36 Indies. 2.Inspect project during the course of construction, at completion and prior to occupancy of area ( 6) Disinfectant - utilize disinfectant supplied by Environmental Services Department. with Epidemiology /Infection Control Department representative) to ensure that infection control 4,8arriers guidelines and protocols outlined In this policy have been met (See Quality Control and Enforcement a. Class I Sections of this policy) 1) No barriers required b. Class II 2.Epidenilology !Infection Control Department 1) Seal unused doors with duct tape a. Review all construction / renovation plans where activity and risk level indicates that Class 111 and 2 Block off and seal air vents Class IV control procedures are required. Determine class with All Baptist Hospital of Miami Facilities ties POM input Provide written recommendations, :............................................:.......................................................•......... ...........,...•............... as appropriate, consistent with AIA Guidelines. ::•7• :• :•:A{I: lit:• Dlsl' SS• 1{•: t71G: S•:•::•:: �:•:::•::•::•:::•::;:•::: :�::•:'•:::::•::::•::•:::•:•::� ::•:::•::•::•::::•:::'::•::'•::•:::•::•:::•::: :�::::•:_:•::•:�:•::•::::•:::•: b. Provide infection Control Construction Permit as required (see Appendix A) :;•::•a :•lZiitf • tit••• lastia •tiaiTiB'r.•i3icti>;ridGi' �:from�•�oortor:i�ailiii ':•: with 'seairis•sea}eii.wittl:duoEtia' er:to:::'::: :' : :': c. Provide education on infection control protocol for construction and renovation to general Contractor ..::...:.....1....:-:-:, . . .•:: • • " ..prevenf•iliist:a' rid• iieiiri§: ftroi'ri•:e'scapiiig:iic•i9iym+; alt •tiari•Ters:eriect ®il•itviifl: 'fits:6iivi# lest :b�:ssaleii::::•::::•::::::•: and rime contractors and their and / or All Baptist Hospital of Miami Facilities M ' t n •:' � :....................' ...... ..............................' ..................... • .;.......... �...................... am a once P personnel, . � :: T . o... t a 1 m. ..fi l nr•. � ::::: :. he ' •a a d: its :: � .. s. �.ia..fttei's.•itl�t:ais...q... . ' .e...a #.alltv;tors#ia.. a'.st�rY+!!.. swill ...#?�....d•.a�:��i?........... / Engineering ro act manager and personnel as appropriate. �' P •' ••..........b'•:iAirtf..: " ic• barriers.• are. t�o-be • "stied:at:.ernstration•of•ceil ":';:alive... s •.ctiasesand�:•::•::•::::•:.:•: r. d. Make periodic visits to work sites ensure that ...................... .. ............ ................... to Infection Control Protocol Is being followed and report ;•;;.; ;.: ctbllirig�spt�es •iii•:stbji:t'na✓sitieiit• iii• aii.aiid: i{ etiiis•: v�rfterI •iittiizli�q:as:a:'rsfsiiti•: air•" leil(uii•: /.•�uct�::•::::�::::• :•::•: deficiencies to the All Baptist Hospital of Miami Facilities Project Manager See Appendix B Infection *-::::::,-::%:::* """"""""""""" """"""""""""""""" " " "" " """"" "' ( APP �; .......... ............................... :::: c •: fin'• 'ram • ' n '• tI ' •ceitln• cr•'a ss• rots roe . n' . . ).......... t3P®!?irtg &.�...... �4@ j.. #4►. �•?tiS..!�....... 9>•...... iii ...1?S! ...!&.S}�.QI?fi....S(! .. i?�4i?lQd•:•:::•::;•:::•: Control Protocol Monitor " " " " ' ) •::::a1iedS:foi':• walk:• ii6ove •:cei}in: "';: "avrile:.......... ire: eiiciii§ iir: e:• aitiiiiid :[acJd'er'"sealir'r";off•;ope .,....;fifEeii•::•::•: ::•:::::: . ........................ .......9s. W........ T? o> a.'• sfY. re..................................... ... ... ..9..........n!n9,............. e. Inspect act at completion and riot ar project p to occupancy of area (with All Baptist Hospital of Miami .. t •tl• : •: •�i • • • • .and. h isr. tin fi( ntit::•::•::•::•::::::•:::•::•::•:::•::::•:::::•::•::::•::•::•::•:::•:: �:•::•:::: �:::•::•: �:•::•: �:•:::•: ::•:�::::'::::::•::•:::::::•:•: Facilities ProectManager) to ensure that infection control guidelines n rotocolsoutlintsdin •'`'`"' �"""""" "9"""""""""""""""""" ""�"""""""" " """""""""""" """" """" " "." "' 1 9 and (AIA) P ' : :: •d :An ce1 'acre s• an Is'• lsrred•1br• rove atlo 'at3 d' I •areas•s;hatl••ba• faced: � . � :: s this have been met See ail Con a Enforcement s i policy Qu Control and Section of this of ( tY policy ) :•: iinrrier}'iatei" :titih ® ":tiiiatfentteil� ::•: � :•::•::•::•::•::•::• :::•:::•:::•::•::•::•::•::•::•: �::•:::: �::•:::•::•:::•:::•::•::•::•::•::::•:: •::•::•:::•::•::•:::•:::.:::•:: •y: • n 3.EnvlronmentalServicesDe rot ::;. . ..:.::::::.::.: �..:::•:............................................................... ... �::.:•.....::::••:::.� :::•.� :•. Department ::::::•: �•? :•:::Ali af:Gtass :ilJ tiaml�s;•P.�::•::::.::•:::•. � •• ••::::. � ::::• :::::::::::::. � ::::::•%%,.1:.1.%1.%1.1.: :. .: :::::. � ::::. �::. �. a. Provide t and o me contractors and All Baptist Hospital of Miami Facilities PO personnel: general Pri P M :•:a :� .'rife'* " "'•:is:: 'fo" . a:. "tti" tie" "ilia . "•ari•:dii'iit3 .. "riiiriuir'1:::::•: approved disinfectant. I ,) A t•1orr1 regirii+eid............. ba•riiad of:{iatYe..y)e... en•,.•• ha'. ie........ a ...pP!M9�;�P�?► ................ :•:0t•2:telat•�9 :• b. Contract for insect /rodent control at wo sit d a I .... ............................................................................... ............................... . rk a an adjacent teas during and after completion of ... ...... .................................................................................... ............................... ::' �r: �' iafffc.; I�esinctions:::.:•:::::. �. �::::::. �::::: .:�.�::::•:.�::::::::::•::.�:.� :•::.:: �::::.:: �. �. � .�::.�:::::.:�.�.�::::::::::.�. project •:•: a::• 7�. atiei�ii•! tiasitar.• 7: siaff�ira�a�iiti§' t�tie: �reiiliiiif• srbkiiid :coii:'striiet%iii�aiea::� .. propiiate:• direidir ?ri:::•::•:::•::::•::::•::•: o. Clean and disinfect areas adjacent to worksfte Burin the """""""""""""""""""""""""""""""'•"""' ' 9 project. �. .•s :p;'•'S its•' � p ................ ............................... .� . . mifst.... in. tIr� 'laria>':'ta...Caril.�'nl��.�; .•.:'.:':.':.:'.:.'.:'. � .':.':.'.'::.':. � .'::.'::.':.::':.':.': ':.:::':.'.:::'. � .':.:':::.:':.::':.:'. 1 Perform final cleaning /disinfection of area at completion of the project •:: B: Vsiitilalavi 'r:::•::::•::•::•::•::•::•::� •::•:•::•::::•::•::•::::::•:::•::::::•::: �:::: �::•::•::::•::•:::•::•:•::•::?:•::•::•::•::•::•::::•::• :::::::•::::::•:::•:::•::•:::•: 4.Perforrnance Requirements /for General and Prime Contractor :� � ��: �jg� (ata•11°ie:•HVAC:systittri:tb: pre�ierit•: tkfittartiinettori• af: iTlicl: sysfairi: wtieili•: oiaitsirtic�k�iri :l•:renouatibii:•::•::•::•::::• a. Review Baptist Hospital of Miami Facilities Infection Control Protocol for Construction and Renovation, """"""""""""""""""""""""""""""" """"""""""""""""" """""""""""""' :: regpires;' �I��s ;•[I;t•g{r4:(�/;�nt{a1:{�r��@d( lies• pr,•; At; Erergitlrls; abatementr�........................................ irftischafgeii ,�ta•}}�cipid �:•; :;:•; prior to beginning work. :•: areas •sh'ali•i;a•}aEt?A:filtereif:: � :•:::::•:::•:::•::•::::•::� ::•::: �:• :::•::::•::•::::•:::•::•:•:::• • •:••• •'••::•:::•:::•:: b. Review and sign (when indicated) Infection Control Construction Permit, prior to beginning work ......................'..........'............'......... ....'.......................... .'.. ....... .........'............. ...... ........ :•:;b::•:Me nfaitf :•i1 ' at}ve:tsih: i'.9s5idl°e:ilW z '•f{EF.tA•e' iii "' }. aih: filttatlarl :iiriifs:Vit�iirivJOilslite. fot•::::•::•::•:::�::•::•:: c. All on site management /employees will attend an education session on Infection Control Protocols � ¢ � q per' """"""' ::•coiistru ... »'l.tnrxovatlo.. . uiriri •'•f>,t' as's'tli' and: l�: control... roceiiiiras�oi ' :As......ilius•atiaterri 'lit::::. % . � ::. � :: for Construction and Renovation prior to work. • •ctJa ................1}:�1..... ti..............................: P.......... ...........Pif!9............... p................. , beginning �;: HEP. A: siiili)? P.® d:. afrlil3iatiiiniriachiites: sEiail: jiroznde: a{ r, flov�lrita: coitsfriietiiin: aGea•:► iitliiss :iFraii:•1:Oi1•::•::'::•::• d. Adhere to Baptist Hospital f Miami o Facilities Infection Control Protocol for Construction and ::•: F: P. 1N•: ei: b: �l#{ 9��tltta��: �iVftl{•: dctbt;# •:fi!{iy!•s>k8ti:::•::::'.•::•: •::•::•:: •::•:::::•::•::•::::::•::::•:..........:.....-:..........:.....,:.",:.*.,.,.,.,.*::.,.,.I :: � ::•:::•::::::•:: �:•:•::• �•::•: �::•::� •: Renovation. '... •........... ....... '� : c::'_ Ariterriorri •iccrosiiiicfea :wgeii� ....strkietrorr•i'nern vatielir :r•e ...ires•Eidss•liit•irontrol:..rii ..tirea•mu' • ••ilia•: � :::::. e. Submittals by General Contractor ........ ... .... ... cPrr ......... o ...... .�? .......................... P.. �.......... �............ :� maiiitairieii�at •:rtis�ativei:piessiirei iri; lief atioii: toacljacerit :,i'rsa's:neif':t'1rid'er: con' sfrtietieili: F :r:erie�:vaiiofii:::•::::::•::•: 1. Specify details of barriers, air handling equipment (portable HEPA filter units) products and •; :7' ..,• Ru9#:> �ltaliiarit• �• CH3ari► fi�•::•::•:;•::•::•:•::•::•::•:::•::•:::•: �::•: •:;:�::;•:•:•::•:::::�•::•::•:: �:;:�:::•:•::•:::•::::•::•: �:•:::•: �•:::•::•:�:•::::.:•: �: materials to be used to control potential contamination generated by construction /renovation :. - ::•e, :; Adhesive ;:watk* 6fE�mats"si.ai[•i;kt3pt ctei3�i:aiid:ciiaiiged:des{i.r, etas :iiecessaiii•;ia'{i!ayerit:.:: :.:::•::•::•::::•::':: activities. .. ... .. ::::::.a6Wmllf6tl6rr:6i:ii6'sf ............ ::::: • •:::::::•:. 2. C. Infection Control Consultation and Infection Control Construction Permit Requirements ::�;:::�$Y:��•.��: Gaff{ Qr: S# l�tl• A0•:►; 4fi'{ Q1! 8i}•: f} p► 11�di2( CoIyr:: GI�N9g: Gilt61d: 9.a�tb:9:b:>tt{{9r{S:•: :•::•::• 3. Construction /renovation activities require consultation with the Epidemiology! Infection Control • :...................... ... ..............., ....... .......................... .......................*:.,.,.1.1.*., . � ta. tie;• elan® wifheitti ®i{a•NEFs�C:#ikeried•: vacuum •or•with:stwef::Top.:.:.:.:.::*.**."*.**",.,*,:, •:::•::::•:; ;•::• ::: ; ; :•; :•:::•; :::; :•;:•:• • • Department based upon the activity type (Types A - D) described below and the level of risk to ::�:c;:1'tUtieri:ari� :vae{itiining:•is: clonal •it•:riii{sfi:b;s•:w�Fi�:a: HEi? i': 61fei• ed:• uai:: iiuni:•::•:::•:•::•::•:::•::•::•::•::• ::•::•::•::'::•::•::•::•:::•::: patients/ visitors /staff described in the Infection Control Risk Group (below). . """"• """"""' ""' : �: t1: �: V�UI�� ?'VW#;:t&f?�i�:jitY�:Cl9ait �itd: i�i�! 1f�: Ci•:(• U81{ r9:• �1? prOX� :4:di;�tifQif+fC�):� ►�:8i1�;# :�:•::•::•: 4. Before a project begins consult the Construction Activity /Infection Control Matrix (below) to •; :�•�� "•the: •'rio ' ' • and:• aitei •:tlaiii:eis•}iaJe•kieei�i• roirioiied::•::•::•::•::•::•:::•::•::•::•::•::•::•:::• :::'::•::::•::•::•::•::•::::•:: determine whether an Infection Control Consultation and Infection Control Construction Permit is :•::.:.......' .......... g " "' p" �..........' .......................................................... ............................... :•: e�: mein; 3ttiiotiar):• de} Si{ s: sfiaH• iia•: plt�d�:Ul:tii�hi}yse'a{ed•:tor► tame' is•:klieftire:re'rriovei:iydiii• hie :•idcciiie:•sitt�•}f•::•:::•:: required. First, etetmine the type of construction 1 renovation activity (see chart below); then • :..... ............ ... . ... ....... ... .. � .... ............ .................'. .... . ...... .......... ... .... .... ....... ... ....'............. %1.1.%, travetln 'threw tern• areas: •:::::. � . � • ," :. "* :. � ::.:•:::.: . determine the Infection Control Risk Group (see chart below), then consult the Construction Activity :•:B:Ililatei•:Sti "' P / Infection Control Matrix (below). "" ::�:a ?:6:apGst�Hi>srHCBI :bf : Mia} iii• Matiiut;# iti9ilaa� :sttiff:t►At{fieg:ail':t 1ft6�ied•:ddD:$itmaitts•'L• net• lilt .4s':ai4tl:•it�isC•in:•:::::•::: 'bvisiori•of�sifem�rte: sources• of: water�::•:::::::•:•::•::•::•::� :••:::•::•:::•:::•;::•::•:;• i::•::•:::•::•: �:;:•::•:::•::• :i::::•::•::•::•:::•:;•:::•:;:• TYPE Inspection and Non - Invasive Acttvitles. Includes but 1s not limited to removal of ceiling tiles A for visual Inspection (limited to 1 file per 50 square feet), painting (hilt not sanding) wall covering, electrical trim work. minor to a r g, probing and activities that do not generate dust or require cutting of watts or access to ceilings other than for visual inspection. TYPE Small-scale, short duration activities that create minimal dust. Includes but is not limited to 8 installation of telephone and computer cables, access to chase spaces, cutting of walls or ceiling where dust migration cars be controlled. ::::ay.FE•.:: ... AnY.•1xvrK•# lea #:gQ!t�►:ota!o:a•►ttzalai•cO: niter?: iexQl: 4? :�p4t•?�:ra�ix�s:•t�'tia1iiian: �r.:tetr�x�l:• oI'•a....f.X...b... . i • a .1 ed. lwfdita'': bfl .:.......nfa�,�:....'...bles:� . .'t...' . ..... r.assem ..{ rod' liiieii• kiniC •is•iia.ltrrn'teci•:tia•sariiii ................. . i/ g• fiPp?o rig•::•:::•: ::wlt's•fo'r:phiritiiii:br vaaif:cayerm�; :ieriroving:flo cayEUiii�s i eilin�.'tHes aiidctseiniark ;: iiew " :w H'• r• n• I a C f1 t r' { . tk'• v ' ' In' to tv m1 •t1r•' ••outs `•rti' •+; . a..s.. i?a#lo .,�:1?... .. 4( I? Gtw ..aric....a!ac'i.�ait........ �b>�. �`.ai�.. 1 ...a ..b� ..:�a# ! >�� . 95 j�l: � . {� ............................ ...................................... ............................... TYPE Major demolition and construction projects. includes but is not limited to activities that D require consecutive work shifts, heavy demolition or removel of a complete ceiling system and new construction. Any work that requires disruption of water supply for more than 1 hour. :•: N; �:• St1{ fieri• ft9asitile;: sefieclrile •iriferiu'ttbn:fbi•:ldw:vvidter:u ... Iii• tiiilis::•::•::•:::::•::•::•::•::•::::•::: �:::•::• ::•:::•::•::::::•::•::•::::•::• :� ��:�tasii:;�vaier:sla ' `:tit(e:�': • triii:tr�PM, ' ai:of.{ . �..,.. ..:�r� :...:r • • �: ors' � .1 ' �ts::�:: :: ?;: :' • ............ DI?tY . fr . n'ut#G:Gta;�t#• t>$ t#h:�tY, d.. PtIP aii:�:aria•r� . :-- ...... trawl Bolistiticfeli'(•reriovafe' ••a1'eas;.into.sersria;s::: • : � . � .::: � ::.: � *.*.,.,.%,.,.,.,.*:.*:.*.,.*.*:.*.,:.,:.* . :. ::. ::. � ::.:1.1:.,.*.*.,.'.'.,.*.*.*.*.,.*.,. '•:d:: Adhie' re:fo:l�tA�yillcleliiies.•'re:. :: i�ig •tierifii�iioi'r:bfi�4aiei:feiri' ieiatiii�esr: rise: af.• fasicei:ae'ratitiis•itiid:•:::•: � :•::•:: n '/• ' 1v ...... aaictafaw'Pro. v� . t��s... ..el#;•::::•::•::;•: � :•:::::� •::;.:-.,.,.%,.,.,.*: •:::•:'•::•:;•::•: � •::;•::•::•::•:•:::•:'•:'•:� ::•:;•:::::•:;; :•::� •: �:•::•:::::•::•::;•: F. infection Control Procedures by Class of Construction! Renovation Activity 1. Class 1 a. Execute work methods to minimize raising dust from construction /renovation operations b. Immediately replace an y ceiling the displaced for Inspection a Refer to above procedures for cleanup and disposal 2,Class 11 a. Water mist work surfaces to control dust while cutting b. Seal unused doors with duct tape c. Place walk off mat at entrance and exit of area d. Block off and seal air vents e. Contain construction debris before transport In tightly a) vered containers f. Wet mop and ! or vacuum the area with HEPA filtered vacuum before leaving work area VIN a surfaces with approved disinfectant 9 P PP INFE N CONTROL K GROUPS ,:• 3: CI0$$: 1{ 4:•::•:::•::•:::•:::::::.....::......:: ...........:::::::::::::::::::::::::::::::::::::::::: ::::::::::::::::::::::::::::::: t;TW CONTRO S G OU 5 :'a� •i?ii'evs" •' in •'3ri••Class :i'at;d:ti': slid jii' :aijditlorr :ttie fottotiiii ........................ ............................... ...�...9 ..................... t .....,......... • .... r.4............. !?9 :::::::::::::::::::::: ::::::::::::::::::::::::::::::: •'ti•':Dbfaih- lhf6iMi :•i^;ciillrol:Ciirisfilii:tiarl PatM fiairii• E • idemrci&i r'1•N64fl6d.ru f fi:l Ty4iiirlirieiif :::::::: :: GROUP/ GROUP 2 GROUPS :;;•;;•;; ;G,,,,,•P•4:•;..;•;:•: LOWEST RISK MEDIUM RISK IAEDIUM -HIGH RISK ::•::}ll�akl?::Fi{QK:: 1. O Ito A see 1, r re AU other 1. Ce to At patient care Emergency n t. a Unoccupied Wards areas {e.g. caltlitmrahab. 2. Hadlo opyrMRt 2. At Ota ambulatory true ctlrlica 3 Peat Aneatheati care tJnh 1, Otroctl4[1S unlit; and un&ke ■lrotad in Group 3 4. Labs & delivery (non OR) outpatient clinics for or4 6. NaImalNawbomNtsserles cancer patients 2. Outprdlertt clinics {exk opt G [>ESY Surgery 4. Transplant units and for oncology end surgery} 7. Nuclear FAttdlc}ne adpnNeM cUnlca 3. Admior agxscharge 8. physiotherapy lank areas S, Wnr� and outpatient slits 9. Echocartiivlogy olinir� fur patients with tQ. Pump"faam AIDSarotlt4e• tt, Ltdtorotxice immunodotlaoray 12. ¢enoralA4edtsurgunits 6. Dialysis Units sitter titan Iftase /latest in 7. Tertiary Cara nurseries Group 4 A. Labor 8 DeIWRry 13. pediatrics Oporatlrtg Rooms 14. Geriatrics 4. Al Cardiac Cathrrr¢atlor 16. Long term clue & Arglography areas in. CarkifovaswlnrrCatdiob gy patients it. Anesthesia and pump areas 1 2. AN Ertdoscapp ero¢s 13. Pharmacy 1 our ttdrn x o y elves t4. 5leriie pro cessktg room 1 n' •:. b.9ft►1:9.a1}tsStt(Il�'t#ts'tl$ :•: •:c::•lSiii;:ori•:dover'siik;•: head: arid• Billie': aoJeis;•: diistir :riiist:r!•fiiilae•'irias(i:..` • r:to: e�r'tetiri "•aiaiksiier_ :•droves':::•::•:: ::•a+id: " "" es; a1 'e:i�e'iii'rei{•ifi:iii....iira• tie• Btbpolfiiid " ...... flitiil':{ §:iitie' ..... ....... ...... .......... •: � : d: :•Retitoxe:'Or•i;;olat4:F•1�!A� : OYwFr (•fr{;ar�a:•>•vrla�:a+rark• ►'# ��in�•:4c'�:► ego: i3ray. Qritaantt�� 'n�t�r�:•:al4ha:•::;•::•::•: :• :duct's Steal•'::::•::: ::�: ; :• ::•:::•: :• ::•::: :•: � ::•:: � :•::::•:::•: � : � :•: ::•:::•::• :' •:::. � :::::::::.::: � :. � :. � :. � :::::::::•::::•:::. � . � .':::::::::.:: . Y.. : : :: •:}a::•::•::Goriplee:aH'cle• bthieis:{ aefiie c5rsttii�kY ( sea• Bat�a•seGtii)::•::•:•:•: � :• •' • •::•::•:•: ::; :: :. , .. . . . .. :: . ..:.. ' .. .. •ris. . .. :.. .. � .. .:. . ::'::.:. :t. ::•::••a):::••.Rtgepp'iPd.a �Frj;s t4rq i9iintti9. cB�t:i.rQ?)Pttip.arid.rei�ava.l.f . po Gg:::: :•:::•:: �1n :red•kia�:iniecfioiis:vi!a§�a i;�:regiilar:tias}i:� as: aj? Propiiafe: j•: piiol :lo:}eaurii;.vuoi{csri'e;:.:If..:.......................................- .................. :•:• ::•:Bari= aTspoi;adte:P.P.E•is: ti;;edi;: bli#ari:l+ifti);dlsltifeofa fit• viii,i 'r:tb:•ranieSvfiiff:fr`di��'Y. dills' sire: -: ::•::•::•::::•::••::::•::::::•: '� :3 • � :•� �vlairtiaiii•ti:• • • aUuta� afr•� •less . ie:within�wiirlc •ire'; � � klss� PrEPA:.. .. d' aIr' fttratbii�aiilts ::::•::•::•::•:::•::•: ::.:; ,.,�f.:.: Vaetiiirn :woli�sitauuitii:HEt?q:firte' tali• v•a §:ileeifeii•:ariit•af•slid:bf' pia® ct::: ::•:::•;:::;;:•::•::::::::•:;;: ;•:5) :•::: YVai•:' rfia} isVlibilt9lte:•: V�iU?: dFSR�v�I•: tllsliifebteiit :•etter:ve0tiuriiD}$::•::•:::•: ;•: � :•: � :::�:::•:::•: � ::•::•::•::: � :::�:; :•:•:;• :•: fi• :. . :. :fi)o�itot•'reiiiove :tialiiie • ••'f'rotrr :work :> areas :iiiltit: ccsiri'r • • iii . ... 'ei;t :ts :cieaiit;fd�ti � �Envrrruimenfal :•::• •:'::•: :s'ervice's: ::: e::• I7eiribde :tiai'riel'.:riiateria{s:aiiii� •::•::•::•:::idib'ri'ifeb : "'� "• "refid ' :' ii§a•t•ias:b'ee � : �'• ®:•::•: "•'d'•::•:•'•: :• ..................... tconstru ns.ca ly:,(attisi: a • • , • • • • , • • • n cl arle;�:l•;di §iii %eta . :•:: :•:;byEtivi{�alxtleft�t•:�:er�, sees• A: epartm�' �:• tt�•mMi�,lzo':aoro~�a3r4laGptl:• set: 4t+ i> �:: aritt�iila�e :�r�:•1j9f1t�Y:ss�le4 ��:�:�: : •.caiitaineis:•fa:•iemovat:fiot rt: woniisrfe::•: '•::':::•:::•::•::•::::•::•:':• •:. � :.: � ::. � ::: :.:::: � . � :.: � :. � :•::. � :.: � :: •::::::::::•. � ::::. . . :. � .: -'-:4.)' •::•::•:Gover salt §: F: lei; eptaeites• iis13ii• tCr :traiispoi2:rrriiisttilicfion deans::::::::::•:.:::: � ::::.: � :::•.: � :.•:::::::.:::•. ....... •' a):;15o evei ....'rrg .....ijsses ........ ..:... . m a ..... I.... n* ... .... inrrn - ::I.)•::: :.:•See r:hateei:pi; 66; -.bd6i itiW'A'n''d'':tihi6Wr.* elf• dpiofiiatety- When- tt'►ieiy.ON,etiato'.V.6 lei's :::•:.........::::::: P .................................................... .................•............. CONSTRUCTION ACTIVITY! INFECTION CONTROL MATRIX :' :'2) ::'::; Cox' Strt? ct' `mteroom.•pgjalcan #:to;wortkslt ,;;i4r{ term •1s•tcg;T>t :gseti7oremovq :RPE:whentpaving: ; :::•::•::tile:war}islte : ;P?faoe:a.l iw., trash.carrtarner ln•ihe anteroom to d se of PPE use a .red lasficba " (. i? . 3: .....I.......... •. ::::::. . .................. :::;ta Itde :tilebritairief. {f : �iiittiaviilYes' iiiaCari :3ls:adtit8ii►liiattt<c1: with:tl7dl:biai[Y:tTtitds ( {e:pHirlliiing :::::::: ::: Infection Control consultation is required when the construction activity and risk level Indicate ::............................................................................................................. ............................... % that Class Ill and Class IV control procedures are necessary :''", war roc) ::::.::::::::::•::•::::::::; :.....:.-.%.................:..........:.......-......... ••.:::::::::::::::::::::::::: ;::::::::::::; ::::::::::::::::::... ........ . •3 :::•:.Lleail•PPE:is:fo:tie:ich outside of:t}i ®:arifeiiioiri iiriii i §:ta tie: nn halals entsltri ilia . .p .0 �: CONSTRUCTION ACTIVITY ISK LEVEL TYPE TYPE TYPE TYPE rcAn arBrr u)+n Mn Gros 1 I If II 111 Gros 2 f 11 111 IV Grew 3 g Ill III IV Gros 4 It Ill •::tV'.•:::� �:�:: IV D. Infection Control Construction Permits 1. infection Control Construction Permit Is required when the construction activity and risk level indicate that Class III and Class IV control procedures are required. a. When an Infection Control Construction Permit Is required it must be obtained from the Epidemiology /Infection Control Department before beginning any demolition or construction work. Decision regarding classification of construction activity (Class 1, 2, 3, or 4) rests with the Epidemiology/Infection Control Department. b. The infection Control Construction Permit must be displayed at the entrance to the work area during the entire construction period. c. At the completion of work the Infection Control Construction Permit must be returned to the Epidemiology /Infection Contro l Department. CITY OF SOUTJ -i MiAMi BUILDING DEPT, STRUCTURAL 3ECTi0N APPROVED BY: 1 , 1. >111111111111111111 1. Lu WE- � vY , J !i 1. s we� ® � t>�t i4' �- a �h sssvtr.•taasa m Coo l� �s s` o .- � o c') V- 0 ti o co �• I d' M c>3 ti E ro rn N to O i I- d � p 1' o) r-- r t) , ti r` 4M 0 C.4 tD 't 0 m 01 alp O "? -C tt1M �� Co HMO � 'aN= O'�tJre- Z st an 0 0 m 1p :3 ay�"cc) F> = ai W 7 •r t9 LLtL-7Odt'nt- -Q Co I C 411C 1 C-d- 4111111111111111110 1111111111111111111111 4D 40 cc 9 M9 0 8 wagoin CC 43 E `* I Ce CO co y W I'letin as 11111111111111111, ca 10-S .Q C 'O 3-: Comm. No: 08067 Date: Drawn: * Revised: � 2007 HARV q ARD DULLY, ICRA i. i ` G�l U � 2pn� - 2007 of a complete ceiling system and new construction. Any work that requires disruption of water supply for more than 1 hour. :•: N; �:• St1{ fieri• ft9asitile;: sefieclrile •iriferiu'ttbn:fbi•:ldw:vvidter:u ... Iii• tiiilis::•::•::•:::::•::•::•::•::•::::•::: �:::•::• ::•:::•::•::::::•::•::•::::•::• :� ��:�tasii:;�vaier:sla ' `:tit(e:�': • triii:tr�PM, ' ai:of.{ . �..,.. ..:�r� :...:r • • �: ors' � .1 ' �ts::�:: :: ?;: :' • ............ DI?tY . fr . n'ut#G:Gta;�t#• t>$ t#h:�tY, d.. PtIP aii:�:aria•r� . :-- ...... trawl Bolistiticfeli'(•reriovafe' ••a1'eas;.into.sersria;s::: • : � . � .::: � ::.: � *.*.,.,.%,.,.,.,.*:.*:.*.,.*.*:.*.,:.,:.* . :. ::. ::. � ::.:1.1:.,.*.*.,.'.'.,.*.*.*.*.,.*.,. '•:d:: Adhie' re:fo:l�tA�yillcleliiies.•'re:. :: i�ig •tierifii�iioi'r:bfi�4aiei:feiri' ieiatiii�esr: rise: af.• fasicei:ae'ratitiis•itiid:•:::•: � :•::•:: n '/• ' 1v ...... aaictafaw'Pro. v� . t��s... ..el#;•::::•::•::;•: � :•:::::� •::;.:-.,.,.%,.,.,.*: •:::•:'•::•:;•::•: � •::;•::•::•::•:•:::•:'•:'•:� ::•:;•:::::•:;; :•::� •: �:•::•:::::•::•::;•: F. infection Control Procedures by Class of Construction! Renovation Activity 1. Class 1 a. Execute work methods to minimize raising dust from construction /renovation operations b. Immediately replace an y ceiling the displaced for Inspection a Refer to above procedures for cleanup and disposal 2,Class 11 a. Water mist work surfaces to control dust while cutting b. Seal unused doors with duct tape c. Place walk off mat at entrance and exit of area d. Block off and seal air vents e. Contain construction debris before transport In tightly a) vered containers f. Wet mop and ! or vacuum the area with HEPA filtered vacuum before leaving work area VIN a surfaces with approved disinfectant 9 P PP INFE N CONTROL K GROUPS ,:• 3: CI0$$: 1{ 4:•::•:::•::•:::•:::::::.....::......:: ...........:::::::::::::::::::::::::::::::::::::::::: ::::::::::::::::::::::::::::::: t;TW CONTRO S G OU 5 :'a� •i?ii'evs" •' in •'3ri••Class :i'at;d:ti': slid jii' :aijditlorr :ttie fottotiiii ........................ ............................... ...�...9 ..................... t .....,......... • .... r.4............. !?9 :::::::::::::::::::::: ::::::::::::::::::::::::::::::: •'ti•':Dbfaih- lhf6iMi :•i^;ciillrol:Ciirisfilii:tiarl PatM fiairii• E • idemrci&i r'1•N64fl6d.ru f fi:l Ty4iiirlirieiif :::::::: :: GROUP/ GROUP 2 GROUPS :;;•;;•;; ;G,,,,,•P•4:•;..;•;:•: LOWEST RISK MEDIUM RISK IAEDIUM -HIGH RISK ::•::}ll�akl?::Fi{QK:: 1. O Ito A see 1, r re AU other 1. Ce to At patient care Emergency n t. a Unoccupied Wards areas {e.g. caltlitmrahab. 2. Hadlo opyrMRt 2. At Ota ambulatory true ctlrlica 3 Peat Aneatheati care tJnh 1, Otroctl4[1S unlit; and un&ke ■lrotad in Group 3 4. Labs & delivery (non OR) outpatient clinics for or4 6. NaImalNawbomNtsserles cancer patients 2. Outprdlertt clinics {exk opt G [>ESY Surgery 4. Transplant units and for oncology end surgery} 7. Nuclear FAttdlc}ne adpnNeM cUnlca 3. Admior agxscharge 8. physiotherapy lank areas S, Wnr� and outpatient slits 9. Echocartiivlogy olinir� fur patients with tQ. Pump"faam AIDSarotlt4e• tt, Ltdtorotxice immunodotlaoray 12. ¢enoralA4edtsurgunits 6. Dialysis Units sitter titan Iftase /latest in 7. Tertiary Cara nurseries Group 4 A. Labor 8 DeIWRry 13. pediatrics Oporatlrtg Rooms 14. Geriatrics 4. Al Cardiac Cathrrr¢atlor 16. Long term clue & Arglography areas in. CarkifovaswlnrrCatdiob gy patients it. Anesthesia and pump areas 1 2. AN Ertdoscapp ero¢s 13. Pharmacy 1 our ttdrn x o y elves t4. 5leriie pro cessktg room 1 n' •:. b.9ft►1:9.a1}tsStt(Il�'t#ts'tl$ :•: •:c::•lSiii;:ori•:dover'siik;•: head: arid• Billie': aoJeis;•: diistir :riiist:r!•fiiilae•'irias(i:..` • r:to: e�r'tetiri "•aiaiksiier_ :•droves':::•::•:: ::•a+id: " "" es; a1 'e:i�e'iii'rei{•ifi:iii....iira• tie• Btbpolfiiid " ...... flitiil':{ §:iitie' ..... ....... ...... .......... •: � : d: :•Retitoxe:'Or•i;;olat4:F•1�!A� : OYwFr (•fr{;ar�a:•>•vrla�:a+rark• ►'# ��in�•:4c'�:► ego: i3ray. Qritaantt�� 'n�t�r�:•:al4ha:•::;•::•::•: :• :duct's Steal•'::::•::: ::�: ; :• ::•:::•: :• ::•::: :•: � ::•:: � :•::::•:::•: � : � :•: ::•:::•::• :' •:::. � :::::::::.::: � :. � :. � :. � :::::::::•::::•:::. � . � .':::::::::.:: . Y.. : : :: •:}a::•::•::Goriplee:aH'cle• bthieis:{ aefiie c5rsttii�kY ( sea• Bat�a•seGtii)::•::•:•:•: � :• •' • •::•::•:•: ::; :: :. , .. . . . .. :: . ..:.. ' .. .. •ris. . .. :.. .. � .. .:. . ::'::.:. :t. ::•::••a):::••.Rtgepp'iPd.a �Frj;s t4rq i9iintti9. cB�t:i.rQ?)Pttip.arid.rei�ava.l.f . po Gg:::: :•:::•:: �1n :red•kia�:iniecfioiis:vi!a§�a i;�:regiilar:tias}i:� as: aj? Propiiafe: j•: piiol :lo:}eaurii;.vuoi{csri'e;:.:If..:.......................................- .................. :•:• ::•:Bari= aTspoi;adte:P.P.E•is: ti;;edi;: bli#ari:l+ifti);dlsltifeofa fit• viii,i 'r:tb:•ranieSvfiiff:fr`di��'Y. dills' sire: -: ::•::•::•::::•::••::::•::::::•: '� :3 • � :•� �vlairtiaiii•ti:• • • aUuta� afr•� •less . ie:within�wiirlc •ire'; � � klss� PrEPA:.. .. d' aIr' fttratbii�aiilts ::::•::•::•::•:::•::•: ::.:; ,.,�f.:.: Vaetiiirn :woli�sitauuitii:HEt?q:firte' tali• v•a §:ileeifeii•:ariit•af•slid:bf' pia® ct::: ::•:::•;:::;;:•::•::::::::•:;;: ;•:5) :•::: YVai•:' rfia} isVlibilt9lte:•: V�iU?: dFSR�v�I•: tllsliifebteiit :•etter:ve0tiuriiD}$::•::•:::•: ;•: � :•: � :::�:::•:::•: � ::•::•::•::: � :::�:; :•:•:;• :•: fi• :. . :. :fi)o�itot•'reiiiove :tialiiie • ••'f'rotrr :work :> areas :iiiltit: ccsiri'r • • iii . ... 'ei;t :ts :cieaiit;fd�ti � �Envrrruimenfal :•::• •:'::•: :s'ervice's: ::: e::• I7eiribde :tiai'riel'.:riiateria{s:aiiii� •::•::•::•:::idib'ri'ifeb : "'� "• "refid ' :' ii§a•t•ias:b'ee � : �'• ®:•::•: "•'d'•::•:•'•: :• ..................... tconstru ns.ca ly:,(attisi: a • • , • • • • , • • • n cl arle;�:l•;di §iii %eta . :•:: :•:;byEtivi{�alxtleft�t•:�:er�, sees• A: epartm�' �:• tt�•mMi�,lzo':aoro~�a3r4laGptl:• set: 4t+ i> �:: aritt�iila�e :�r�:•1j9f1t�Y:ss�le4 ��:�:�: : •.caiitaineis:•fa:•iemovat:fiot rt: woniisrfe::•: '•::':::•:::•::•::•::::•::•:':• •:. � :.: � ::. � ::: :.:::: � . � :.: � :. � :•::. � :.: � :: •::::::::::•. � ::::. . . :. � .: -'-:4.)' •::•::•:Gover salt §: F: lei; eptaeites• iis13ii• tCr :traiispoi2:rrriiisttilicfion deans::::::::::•:.:::: � ::::.: � :::•.: � :.•:::::::.:::•. ....... •' a):;15o evei ....'rrg .....ijsses ........ ..:... . m a ..... I.... n* ... .... inrrn - ::I.)•::: :.:•See r:hateei:pi; 66; -.bd6i itiW'A'n''d'':tihi6Wr.* elf• dpiofiiatety- When- tt'►ieiy.ON,etiato'.V.6 lei's :::•:.........::::::: P .................................................... .................•............. CONSTRUCTION ACTIVITY! INFECTION CONTROL MATRIX :' :'2) ::'::; Cox' Strt? ct' `mteroom.•pgjalcan #:to;wortkslt ,;;i4r{ term •1s•tcg;T>t :gseti7oremovq :RPE:whentpaving: ; :::•::•::tile:war}islte : ;P?faoe:a.l iw., trash.carrtarner ln•ihe anteroom to d se of PPE use a .red lasficba " (. i? . 3: .....I.......... •. ::::::. . .................. :::;ta Itde :tilebritairief. {f : �iiittiaviilYes' iiiaCari :3ls:adtit8ii►liiattt<c1: with:tl7dl:biai[Y:tTtitds ( {e:pHirlliiing :::::::: ::: Infection Control consultation is required when the construction activity and risk level Indicate ::............................................................................................................. ............................... % that Class Ill and Class IV control procedures are necessary :''", war roc) ::::.::::::::::•::•::::::::; :.....:.-.%.................:..........:.......-......... ••.:::::::::::::::::::::::::: ;::::::::::::; ::::::::::::::::::... ........ . •3 :::•:.Lleail•PPE:is:fo:tie:ich outside of:t}i ®:arifeiiioiri iiriii i §:ta tie: nn halals entsltri ilia . .p .0 �: CONSTRUCTION ACTIVITY ISK LEVEL TYPE TYPE TYPE TYPE rcAn arBrr u)+n Mn Gros 1 I If II 111 Gros 2 f 11 111 IV Grew 3 g Ill III IV Gros 4 It Ill •::tV'.•:::� �:�:: IV D. Infection Control Construction Permits 1. infection Control Construction Permit Is required when the construction activity and risk level indicate that Class III and Class IV control procedures are required. a. When an Infection Control Construction Permit Is required it must be obtained from the Epidemiology /Infection Control Department before beginning any demolition or construction work. Decision regarding classification of construction activity (Class 1, 2, 3, or 4) rests with the Epidemiology/Infection Control Department. b. The infection Control Construction Permit must be displayed at the entrance to the work area during the entire construction period. c. At the completion of work the Infection Control Construction Permit must be returned to the Epidemiology /Infection Contro l Department. CITY OF SOUTJ -i MiAMi BUILDING DEPT, STRUCTURAL 3ECTi0N APPROVED BY: 1 , 1. >111111111111111111 1. Lu WE- � vY , J !i 1. s we� ® � t>�t i4' �- a �h sssvtr.•taasa m Coo l� �s s` o .- � o c') V- 0 ti o co �• I d' M c>3 ti E ro rn N to O i I- d � p 1' o) r-- r t) , ti r` 4M 0 C.4 tD 't 0 m 01 alp O "? -C tt1M �� Co HMO � 'aN= O'�tJre- Z st an 0 0 m 1p :3 ay�"cc) F> = ai W 7 •r t9 LLtL-7Odt'nt- -Q Co I C 411C 1 C-d- 4111111111111111110 1111111111111111111111 4D 40 cc 9 M9 0 8 wagoin CC 43 E `* I Ce CO co y W I'letin as 11111111111111111, ca 10-S .Q C 'O 3-: Comm. No: 08067 Date: Drawn: * Revised: � 2007 HARV q ARD DULLY, ICRA i. i ` G�l U � 2pn� - 2007 vered containers f. Wet mop and ! or vacuum the area with HEPA filtered vacuum before leaving work area VIN a surfaces with approved disinfectant 9 P PP INFE N CONTROL K GROUPS ,:• 3: CI0$$: 1{ 4:•::•:::•::•:::•:::::::.....::......:: ...........:::::::::::::::::::::::::::::::::::::::::: ::::::::::::::::::::::::::::::: t;TW CONTRO S G OU 5 :'a� •i?ii'evs" •' in •'3ri••Class :i'at;d:ti': slid jii' :aijditlorr :ttie fottotiiii ........................ ............................... ...�...9 ..................... t .....,......... • .... r.4............. !?9 :::::::::::::::::::::: ::::::::::::::::::::::::::::::: •'ti•':Dbfaih- lhf6iMi :•i^;ciillrol:Ciirisfilii:tiarl PatM fiairii• E • idemrci&i r'1•N64fl6d.ru f fi:l Ty4iiirlirieiif :::::::: :: GROUP/ GROUP 2 GROUPS :;;•;;•;; ;G,,,,,•P•4:•;..;•;:•: LOWEST RISK MEDIUM RISK IAEDIUM -HIGH RISK ::•::}ll�akl?::Fi{QK:: 1. O Ito A see 1, r re AU other 1. Ce to At patient care Emergency n t. a Unoccupied Wards areas {e.g. caltlitmrahab. 2. Hadlo opyrMRt 2. At Ota ambulatory true ctlrlica 3 Peat Aneatheati care tJnh 1, Otroctl4[1S unlit; and un&ke ■lrotad in Group 3 4. Labs & delivery (non OR) outpatient clinics for or4 6. NaImalNawbomNtsserles cancer patients 2. Outprdlertt clinics {exk opt G [>ESY Surgery 4. Transplant units and for oncology end surgery} 7. Nuclear FAttdlc}ne adpnNeM cUnlca 3. Admior agxscharge 8. physiotherapy lank areas S, Wnr� and outpatient slits 9. Echocartiivlogy olinir� fur patients with tQ. Pump"faam AIDSarotlt4e• tt, Ltdtorotxice immunodotlaoray 12. ¢enoralA4edtsurgunits 6. Dialysis Units sitter titan Iftase /latest in 7. Tertiary Cara nurseries Group 4 A. Labor 8 DeIWRry 13. pediatrics Oporatlrtg Rooms 14. Geriatrics 4. Al Cardiac Cathrrr¢atlor 16. Long term clue & Arglography areas in. CarkifovaswlnrrCatdiob gy patients it. Anesthesia and pump areas 1 2. AN Ertdoscapp ero¢s 13. Pharmacy 1 our ttdrn x o y elves t4. 5leriie pro cessktg room 1 n' •:. b.9ft►1:9.a1}tsStt(Il�'t#ts'tl$ :•: •:c::•lSiii;:ori•:dover'siik;•: head: arid• Billie': aoJeis;•: diistir :riiist:r!•fiiilae•'irias(i:..` • r:to: e�r'tetiri "•aiaiksiier_ :•droves':::•::•:: ::•a+id: " "" es; a1 'e:i�e'iii'rei{•ifi:iii....iira• tie• Btbpolfiiid " ...... flitiil':{ §:iitie' ..... ....... ...... .......... •: � : d: :•Retitoxe:'Or•i;;olat4:F•1�!A� : OYwFr (•fr{;ar�a:•>•vrla�:a+rark• ►'# ��in�•:4c'�:► ego: i3ray. Qritaantt�� 'n�t�r�:•:al4ha:•::;•::•::•: :• :duct's Steal•'::::•::: ::�: ; :• ::•:::•: :• ::•::: :•: � ::•:: � :•::::•:::•: � : � :•: ::•:::•::• :' •:::. � :::::::::.::: � :. � :. � :. � :::::::::•::::•:::. � . � .':::::::::.:: . Y.. : : :: •:}a::•::•::Goriplee:aH'cle• bthieis:{ aefiie c5rsttii�kY ( sea• Bat�a•seGtii)::•::•:•:•: � :• •' • •::•::•:•: ::; :: :. , .. . . . .. :: . ..:.. ' .. .. •ris. . .. :.. .. � .. .:. . ::'::.:. :t. ::•::••a):::••.Rtgepp'iPd.a �Frj;s t4rq i9iintti9. cB�t:i.rQ?)Pttip.arid.rei�ava.l.f . po Gg:::: :•:::•:: �1n :red•kia�:iniecfioiis:vi!a§�a i;�:regiilar:tias}i:� as: aj? Propiiafe: j•: piiol :lo:}eaurii;.vuoi{csri'e;:.:If..:.......................................- .................. :•:• ::•:Bari= aTspoi;adte:P.P.E•is: ti;;edi;: bli#ari:l+ifti);dlsltifeofa fit• viii,i 'r:tb:•ranieSvfiiff:fr`di��'Y. dills' sire: -: ::•::•::•::::•::••::::•::::::•: '� :3 • � :•� �vlairtiaiii•ti:• • • aUuta� afr•� •less . ie:within�wiirlc •ire'; � � klss� PrEPA:.. .. d' aIr' fttratbii�aiilts ::::•::•::•::•:::•::•: ::.:; ,.,�f.:.: Vaetiiirn :woli�sitauuitii:HEt?q:firte' tali• v•a §:ileeifeii•:ariit•af•slid:bf' pia® ct::: ::•:::•;:::;;:•::•::::::::•:;;: ;•:5) :•::: YVai•:' rfia} isVlibilt9lte:•: V�iU?: dFSR�v�I•: tllsliifebteiit :•etter:ve0tiuriiD}$::•::•:::•: ;•: � :•: � :::�:::•:::•: � ::•::•::•::: � :::�:; :•:•:;• :•: fi• :. . :. :fi)o�itot•'reiiiove :tialiiie • ••'f'rotrr :work :> areas :iiiltit: ccsiri'r • • iii . ... 'ei;t :ts :cieaiit;fd�ti � �Envrrruimenfal :•::• •:'::•: :s'ervice's: ::: e::• I7eiribde :tiai'riel'.:riiateria{s:aiiii� •::•::•::•:::idib'ri'ifeb : "'� "• "refid ' :' ii§a•t•ias:b'ee � : �'• ®:•::•: "•'d'•::•:•'•: :• ..................... tconstru ns.ca ly:,(attisi: a • • , • • • • , • • • n cl arle;�:l•;di §iii %eta . :•:: :•:;byEtivi{�alxtleft�t•:�:er�, sees• A: epartm�' �:• tt�•mMi�,lzo':aoro~�a3r4laGptl:• set: 4t+ i> �:: aritt�iila�e :�r�:•1j9f1t�Y:ss�le4 ��:�:�: : •.caiitaineis:•fa:•iemovat:fiot rt: woniisrfe::•: '•::':::•:::•::•::•::::•::•:':• •:. � :.: � ::. � ::: :.:::: � . � :.: � :. � :•::. � :.: � :: •::::::::::•. � ::::. . . :. � .: -'-:4.)' •::•::•:Gover salt §: F: lei; eptaeites• iis13ii• tCr :traiispoi2:rrriiisttilicfion deans::::::::::•:.:::: � ::::.: � :::•.: � :.•:::::::.:::•. ....... •' a):;15o evei ....'rrg .....ijsses ........ ..:... . m a ..... I.... n* ... .... inrrn - ::I.)•::: :.:•See r:hateei:pi; 66; -.bd6i itiW'A'n''d'':tihi6Wr.* elf• dpiofiiatety- When- tt'►ieiy.ON,etiato'.V.6 lei's :::•:.........::::::: P .................................................... .................•............. CONSTRUCTION ACTIVITY! INFECTION CONTROL MATRIX :' :'2) ::'::; Cox' Strt? ct' `mteroom.•pgjalcan #:to;wortkslt ,;;i4r{ term •1s•tcg;T>t :gseti7oremovq :RPE:whentpaving: ; :::•::•::tile:war}islte : ;P?faoe:a.l iw., trash.carrtarner ln•ihe anteroom to d se of PPE use a .red lasficba " (. i? . 3: .....I.......... •. ::::::. . .................. :::;ta Itde :tilebritairief. {f : �iiittiaviilYes' iiiaCari :3ls:adtit8ii►liiattt<c1: with:tl7dl:biai[Y:tTtitds ( {e:pHirlliiing :::::::: ::: Infection Control consultation is required when the construction activity and risk level Indicate ::............................................................................................................. ............................... % that Class Ill and Class IV control procedures are necessary :''", war roc) ::::.::::::::::•::•::::::::; :.....:.-.%.................:..........:.......-......... ••.:::::::::::::::::::::::::: ;::::::::::::; ::::::::::::::::::... ........ . •3 :::•:.Lleail•PPE:is:fo:tie:ich outside of:t}i ®:arifeiiioiri iiriii i §:ta tie: nn halals entsltri ilia . .p .0 �: CONSTRUCTION ACTIVITY ISK LEVEL TYPE TYPE TYPE TYPE rcAn arBrr u)+n Mn Gros 1 I If II 111 Gros 2 f 11 111 IV Grew 3 g Ill III IV Gros 4 It Ill •::tV'.•:::� �:�:: IV D. Infection Control Construction Permits 1. infection Control Construction Permit Is required when the construction activity and risk level indicate that Class III and Class IV control procedures are required. a. When an Infection Control Construction Permit Is required it must be obtained from the Epidemiology /Infection Control Department before beginning any demolition or construction work. Decision regarding classification of construction activity (Class 1, 2, 3, or 4) rests with the Epidemiology/Infection Control Department. b. The infection Control Construction Permit must be displayed at the entrance to the work area during the entire construction period. c. At the completion of work the Infection Control Construction Permit must be returned to the Epidemiology /Infection Contro l Department. CITY OF SOUTJ -i MiAMi BUILDING DEPT, STRUCTURAL 3ECTi0N APPROVED BY: 1 , 1. >111111111111111111 1. Lu WE- � vY , J !i 1. s we� ® � t>�t i4' �- a �h sssvtr.•taasa m Coo l� �s s` o .- � o c') V- 0 ti o co �• I d' M c>3 ti E ro rn N to O i I- d � p 1' o) r-- r t) , ti r` 4M 0 C.4 tD 't 0 m 01 alp O "? -C tt1M �� Co HMO � 'aN= O'�tJre- Z st an 0 0 m 1p :3 ay�"cc) F> = ai W 7 •r t9 LLtL-7Odt'nt- -Q Co I C 411C 1 C-d- 4111111111111111110 1111111111111111111111 4D 40 cc 9 M9 0 8 wagoin CC 43 E `* I Ce CO co y W I'letin as 11111111111111111, ca 10-S .Q C 'O 3-: Comm. No: 08067 Date: Drawn: * Revised: � 2007 HARV q ARD DULLY, ICRA i. i ` G�l U � 2pn� - 2007 ... .... inrrn - ::I.)•::: :.:•See r:hateei:pi; 66; -.bd6i itiW'A'n''d'':tihi6Wr.* elf• dpiofiiatety- When- tt'►ieiy.ON,etiato'.V.6 lei's :::•:.........::::::: P .................................................... .................•............. CONSTRUCTION ACTIVITY! INFECTION CONTROL MATRIX :' :'2) ::'::; Cox' Strt? ct' `mteroom.•pgjalcan #:to;wortkslt ,;;i4r{ term •1s•tcg;T>t :gseti7oremovq :RPE:whentpaving: ; :::•::•::tile:war}islte : ;P?faoe:a.l iw., trash.carrtarner ln•ihe anteroom to d se of PPE use a .red lasficba " (. i? . 3: .....I.......... •. ::::::. . .................. :::;ta Itde :tilebritairief. {f : �iiittiaviilYes' iiiaCari :3ls:adtit8ii►liiattt<c1: with:tl7dl:biai[Y:tTtitds ( {e:pHirlliiing :::::::: ::: Infection Control consultation is required when the construction activity and risk level Indicate ::............................................................................................................. ............................... % that Class Ill and Class IV control procedures are necessary :''", war roc) ::::.::::::::::•::•::::::::; :.....:.-.%.................:..........:.......-......... ••.:::::::::::::::::::::::::: ;::::::::::::; ::::::::::::::::::... ........ . •3 :::•:.Lleail•PPE:is:fo:tie:ich outside of:t}i ®:arifeiiioiri iiriii i §:ta tie: nn halals entsltri ilia . .p .0 �: CONSTRUCTION ACTIVITY ISK LEVEL TYPE TYPE TYPE TYPE rcAn arBrr u)+n Mn Gros 1 I If II 111 Gros 2 f 11 111 IV Grew 3 g Ill III IV Gros 4 It Ill •::tV'.•:::� �:�:: IV D. Infection Control Construction Permits 1. infection Control Construction Permit Is required when the construction activity and risk level indicate that Class III and Class IV control procedures are required. a. When an Infection Control Construction Permit Is required it must be obtained from the Epidemiology /Infection Control Department before beginning any demolition or construction work. Decision regarding classification of construction activity (Class 1, 2, 3, or 4) rests with the Epidemiology/Infection Control Department. b. The infection Control Construction Permit must be displayed at the entrance to the work area during the entire construction period. c. At the completion of work the Infection Control Construction Permit must be returned to the Epidemiology /Infection Contro l Department. CITY OF SOUTJ -i MiAMi BUILDING DEPT, STRUCTURAL 3ECTi0N APPROVED BY: 1 , 1. >111111111111111111 1. Lu WE- � vY , J !i 1. s we� ® � t>�t i4' �- a �h sssvtr.•taasa m Coo l� �s s` o .- � o c') V- 0 ti o co �• I d' M c>3 ti E ro rn N to O i I- d � p 1' o) r-- r t) , ti r` 4M 0 C.4 tD 't 0 m 01 alp O "? -C tt1M �� Co HMO � 'aN= O'�tJre- Z st an 0 0 m 1p :3 ay�"cc) F> = ai W 7 •r t9 LLtL-7Odt'nt- -Q Co I C 411C 1 C-d- 4111111111111111110 1111111111111111111111 4D 40 cc 9 M9 0 8 wagoin CC 43 E `* I Ce CO co y W I'letin as 11111111111111111, ca 10-S .Q C 'O 3-: Comm. No: 08067 Date: Drawn: * Revised: � 2007 HARV q ARD DULLY, ICRA i. i ` G�l U � 2pn� - 2007 l Department. CITY OF SOUTJ -i MiAMi BUILDING DEPT, STRUCTURAL 3ECTi0N APPROVED BY: 1 , 1. >111111111111111111 1. Lu WE- � vY , J !i 1. s we� ® � t>�t i4' �- a �h sssvtr.•taasa m Coo l� �s s` o .- � o c') V- 0 ti o co �• I d' M c>3 ti E ro rn N to O i I- d � p 1' o) r-- r t) , ti r` 4M 0 C.4 tD 't 0 m 01 alp O "? -C tt1M �� Co HMO � 'aN= O'�tJre- Z st an 0 0 m 1p :3 ay�"cc) F> = ai W 7 •r t9 LLtL-7Odt'nt- -Q Co I C 411C 1 C-d- 4111111111111111110 1111111111111111111111 4D 40 cc 9 M9 0 8 wagoin CC 43 E `* I Ce CO co y W I'letin as 11111111111111111, ca 10-S .Q C 'O 3-: Comm. No: 08067 Date: Drawn: * Revised: � 2007 HARV q ARD DULLY, ICRA i. i ` G�l U � 2pn� - 2007 7 •r t9 LLtL-7Odt'nt- -Q Co I C 411C 1 C-d- 4111111111111111110 1111111111111111111111 4D 40 cc 9 M9 0 8 wagoin CC 43 E `* I Ce CO co y W I'letin as 11111111111111111, ca 10-S .Q C 'O 3-: Comm. No: 08067 Date: Drawn: * Revised: � 2007 HARV q ARD DULLY, ICRA i. i ` G�l U � 2pn� - 2007 � 2007 HARV q ARD DULLY, ICRA i. i ` G�l U � 2pn� - 2007