Kidd Francine, Buttner Clark, Kressel Amy B
Department of Infection Control, University of Cincinnati College of Medicine, Ohio, USA.
Am J Infect Control. 2007 Jun;35(5):347-50. doi: 10.1016/j.ajic.2006.07.011.
In the 21st century, one of the most challenging tasks for the infection control practitioner (ICP) is establishing collegiality and trust with contractors, architects, maintenance and engineering personnel. We describe how an urban teaching hospital's infection control program cooperated with contractors during a large demolition, construction, and renovation project in order to protect its large population of immunosuppressed patients.
Most contractors are not accustomed to taking special precautions during demolition. Because of a previous Aspergillus outbreak in our heart transplant population, we already had an established infection control (IC) training program for contractors. We expanded and codified it in response to a major hospital renovation. The IC, in-house Design and Construction, and outside contractors meet before the initiation of all major renovation projects to anticipate IC concerns and proactively plan for infection control interventions. Now, all contractors and maintenance staff are required to receive IC training at the time of their employment. A hospital identification badge with attached sticker that indicates the IC training date is required. Infection Control Risk Assessments (ICRA) are initiated by project managers and completed jointly with IC. The ICPs make rounds on all projects at least weekly and large projects are visited daily. We established a team comprised of ICP, project manager, construction manager, and area nurse manager to monitor and make recommendations for improvement continually during the project. Staff are educated about construction so they can help monitor airflow and cleanliness.
Our contractors are more compliant with our IC specifications since they now understand why we insist on them. Through the years of major construction, the workers have jumped on the bandwagon. It is not unusual for construction or maintenance staff to contact IC for advice. There were four years of extensive construction without any hospital acquired Aspergillus infections. In the 5th year, after a neighboring institution started demolition and new construction, we identified two possible nosocomial infections and took immediate steps to make more corrections. There have been no further infections.
The IC compliance is based on trust, education, and on-going monitoring. Proactive education and collaboration lead to long-term relationships, trust and patient safety.
This article describes how a large teaching hospital's infection prevention program achieved compliance from contractors during a large renovation.
在21世纪，感染控制从业者（ICP）面临的最具挑战性的任务之一是与承包商、建筑师、维护和工程人员建立合作关系并赢得他们的信任。我们描述了一家城市教学医院的感染控制项目在一个大型拆除、建设和翻新项目中如何与承包商合作，以保护其大量免疫抑制患者。
大多数承包商在拆除过程中不习惯采取特殊预防措施。由于我们心脏移植患者群体此前爆发过曲霉菌感染，我们已经为承包商制定了一个既定的感染控制（IC）培训项目。我们根据一次大型医院翻新工程对其进行了扩展并编纂成册。感染控制人员、内部设计与施工人员以及外部承包商在所有重大翻新项目启动前会面，以预见感染控制方面的问题并积极规划感染控制干预措施。现在，所有承包商和维护人员在入职时都必须接受感染控制培训。需要佩戴带有表明感染控制培训日期贴纸的医院识别徽章。感染控制风险评估（ICRA）由项目经理发起，并与感染控制人员共同完成。感染控制从业者至少每周对所有项目进行巡查，大型项目则每天巡查。我们成立了一个由感染控制从业者、项目经理、施工经理和区域护士长组成的团队，在项目期间持续监测并提出改进建议。对员工进行施工方面的教育，以便他们能够帮助监测气流和清洁情况。
我们的承包商现在更遵守我们的感染控制规范了，因为他们现在明白我们坚持这些规范的原因。经过多年的大型建设，工人们也纷纷响应。施工或维护人员向感染控制人员咨询建议的情况并不少见。历经四年的大规模建设，没有出现任何医院获得性曲霉菌感染。在第5年，附近一家机构开始拆除和新建工程后，我们发现了两例可能的医院感染病例，并立即采取措施进行更多整改。此后再没有出现感染病例。
感染控制的合规性基于信任、教育和持续监测。积极主动的教育与合作能带来长期的关系、信任和患者安全。
本文描述了一家大型教学医院的感染预防项目在一次大型翻新工程中如何使承包商做到合规。
