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The Importance of Conducting a Comprehensive ICRA

Conducting an Infection Control Risk Assessment (ICRA) in a healthcare organization is essential for minimizing the risks of acquiring and transmitting infections.

Conducting an Infection Control Risk Assessment (ICRA) in a healthcare organization is essential for minimizing the risks of acquiring and transmitting infections. The Joint Commission (TJC) has identified the need to conduct an ICRA when significant changes occur in the environment, community, or patient population as documented in the Infection Control (IC.01.03.01) and the Environment of Care (EC.02.06.05) standards. This is particularly true when conducting construction activities, especially demolition, where the risk of airborne dust and mold is the greatest and functionality of supporting utility systems can be jeopardized. Since the infection prevention program relies on the environment to provide controls for patient care, conducting an ICRA requires the cooperation between Infection Prevention, Engineering, and Nursing.

The Center for Medicare and Medicaid Services (CMS) also requires an active program of prevention and control to avoid sources and transmission of infectious and communicable diseases (Condition of Participation 482.42). Therefore, an organization must have a program to conduct and assess risks, implement measures to control, mitigate, or eliminate identified risks, monitor control measures to determine their success, and institute modified or new measures to achieve that goal when necessary. The size, in square footage or cost, does not dictate the need or exclusion of the ICRA, but whether or not the activity will impact negatively on a patient is the criteria.

In addition, the Centers for Disease Control and Prevention (CDC) also identifies the need for conducting an ICRA during construction in the guidelines, “Recommendations for Environmental Infection Control in HealthCare Facilities Recommendations,” (Air Section II). It states that:

  • Before the project gets under way, perform an ICRA to define the scope of the activity and the need for barrier measures
  • Determine if immune-compromised patients may be at risk for exposure to fungal spores from dust generated during the project
  • Develop a contingency plan to prevent such exposures

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