Mousavi Ehsan S, Bausman Dennis
Department of Construction Science and Management, Clemson University, Clemson, SC, USA.
HERD. 2020 Jan;13(1):179-190. doi: 10.1177/1937586719861557. Epub 2019 Jul 10.
The objective of the study was to identify current practices utilized by contractors in healthcare renovation projects.
Renovation in healthcare facilities comprises nearly half of all healthcare construction. Since a complete shutdown of the healthcare facility during renovation is typically not feasible, efforts must be taken to isolate ongoing functions of the hospital from activities in the construction zone. There are numerous documented cases of morbidity and mortality related to construction activities in the hospital. Hence, guidelines recommend negative pressurization of the construction zone to prevent the migration of dust and potential pathogenic agents into the functioning zone.
To accomplish the paper objective, a questionnaire was developed to address pressurization strategies, the use of backup systems and anterooms, and workforce training for healthcare projects. One hundred twenty-nine project managers and superintendents from top healthcare construction companies in the United States participated in the study.
Results show that owners influence pressurization strategy, but contractors typically assume a primary role in establishing pressurization levels, monitoring conformance, and training construction personnel. However, without solid evidence of effectiveness, pressurization levels often vary from Center for Disease Control standards.
Further research is needed to establish evidence-based practices and to develop training modules for construction crews to support these best practices. Promoting evidence-based training can improve patient safety and minimize adverse patient outcomes.
本研究的目的是确定承包商在医疗保健设施翻新项目中采用的当前做法。
医疗保健设施的翻新占所有医疗保健建设的近一半。由于在翻新期间完全关闭医疗保健设施通常不可行，因此必须努力将医院的日常功能与施工区域的活动隔离开来。有许多记录在案的与医院施工活动相关的发病和死亡案例。因此，指南建议对施工区域进行负压处理，以防止灰尘和潜在病原体迁移到功能区域。
为实现本文目标，设计了一份问卷，以探讨医疗保健项目的增压策略、备用系统和前室的使用以及劳动力培训情况。来自美国顶级医疗保健建筑公司的129名项目经理和主管参与了该研究。
结果表明，业主会影响增压策略，但承包商通常在确定增压水平、监测合规情况和培训施工人员方面发挥主要作用。然而，由于缺乏有效性的确凿证据，增压水平往往与疾病控制中心的标准不同。
需要进一步研究以建立基于证据的做法，并为施工人员开发培训模块以支持这些最佳做法。推广基于证据的培训可以提高患者安全并尽量减少不良患者结局。
