Dust, debris and running Aspen’s hospital
Aspen, CO Colorado
ASPEN ” As Aspen’s hospital gears up for a major expansion, officials there also are girding themselves for a battle against an unseen foe ” microbes and viruses that might be disturbed by construction activity.
Officials at the hospital acknowledge that the potential for airborne infections probably will get more complicated should Aspen Valley Hospital start in earnest on a massive redevelopment program.
But there already are plans in place to deal with it, said John Schied, director of facilities management at AVH.
The hospital announced last month that it intends to embark soon on a $100 million remodeling and expansion project. According to the current plans, the hospital would continue its normal level of operations throughout the construction project, which will not commence before late 2008 and is anticipated to take seven years or more.
Still to be arranged is the financing for the project, and detailed development plans will not be submitted until next year.
But Schied, working with hospital administrators and nurses, has developed a plan to prevent viruses and bacteria from sneaking into the hospital once construction begins.
Kathy Gibbard, infection control coordinator for the hospital, is part of the “infection control risk assessment” team. The team, she said, analyzes each project for its potential to allow viruses and bacteria to get into the hospital, and helps develop counter measures.
“What we’re trying to protect people from is the dust and the debris,” she said.
But, she conceded, the actual microbes and bacteria that grow on the dust and debris are too numerous to catalogue and study in detail. Instead, officials take a look at the conditions under which the organisms might migrate inside and, once lodged in a patient’s wound or lungs, grow potentially lethal bugs.
“What kind of bug would you grow? I don’t know,” she said. “It depends on the debris involved.”
Patients are always being poked and prodded by needles, catheter tubes, breathing tubes and intravenous devices, which “are things that could potentially cause an infection,” she continued. The infection control plan is intended to prevent those bugs from doing just that.
Schied’s methods might seem rather low-tech to some, because they largely involves duct tape, plywood and plastic sheeting. But Schied said the physical components of his plan are based on special knowledge and, among other techniques, make use of large-capacity fans that Schied brought with him to AVH from previous hospital jobs.
He said his infection control plan, a nine-page document last reviewed in August of this year, also is based on nationally accepted standards recommended by the Center for Disease Control and Prevention.
The fans, coupled with plastic sheathing duct-taped around wall openings created by construction crews, are called “negative air machines,” Schied said, meaning the air pressure within the protected areas is slightly higher than the air pressure outside the areas. That way, if a break occurs, air will be forced outside, as though the building were exhaling, rather than outside air rushing in.
And the air that is pumped into the hospital runs through special filters he said are the same as filters used to maintain “clean” air quality in other sensitive enterprises, such as computer labs.
The system already has been used to seal off the hospital’s operating rooms during an earlier remodeling project in 2003. The same methods are now being used in the expansion and updating of the obstetrics wing, due for completion in 2008.
“The OR is the most sensitive [part of the hospital] in terms of potential infection,” Schied recalled. Although he said that his barriers to dust and airborne contaminants “worked very well,” he conceded that there are no filters available that are “fine enough … to capture viruses or bacteria.”
But the measures planned, he said, should keep microscopic organisms at bay during the construction.
“You have to custom build for each area [of the hospital],” Schied said, whether the project involved the use of “rigid barriers” such as plywood to augment the plastic.
The system’s effectiveness is monitored regularly at several levels, beginning with the construction workers and contractor and ending with Schied, Booker and two different committees concerned with safety and infection control.
“We’ve got a lot of eyes keeping an eye on things,” Schied said.
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