When most people think of going to the hospital, they think of a place they go to get better. Rarely does anyone stop to think that the hospital could be the place where one goes and gets sick. But according to a study by the Alliance for Aging Research, 99,000 Americans die each year from hospital-acquired infections.
It’s a jarring reality, particularly when it’s coupled by the fact that there is no national Infection Control Risk Assessment (ICRA) construction containment standard to which healthcare facilities must adhere during construction. Nearly every day, there is some sort of construction or renovation taking place at hospitals across the country. This means that harmful pathogens can get airborne and infect patients that may already have compromised immune systems. Add COVID-19 to this, and the outlook is even grimmer.
To remedy this issue, the United Brotherhood of Carpenters and Joiners of America (UBC), as well as the Eastern Atlantic States Regional Council of Carpenters (EASRCC), have developed a national ICRA program with the assistance of industry partners and a team of experts. The EASRCC and UBC have implemented this ICRA program to help train construction workers on proper procedures to contain work sites during construction or renovation across the United States and Canada.
“It’s really up to the facilities to do their homework and pay attention to who they hire to do construction and mitigate exposure,” says Tom Bender, Infection Control Risk Assessment Director with the Eastern Atlantic States Regional Council of Carpenters.
“It’s important that medical facilities look at the ICRA training their contractors and subcontractors have and determine if it’s at least equivalent to the UBC 24-hour best practice course and even more specifically, to enlist a workforce that has undergone a true rigorous hands-on ICRA curriculum.”
It's a huge initiative involving many stakeholders with an even larger mission to create a cleaner, safer, construction zone. A lot of coordination goes into the ICRA training, Bender explains, as Carpenters travel from across the country to a special facility in Nevada. Once there, they learn how to seal their construction area off from the rest of the facility and patients, how to control air flow by creating negative pressure within their construction zone so no debris or harmful contaminants can escape, and how to use HEPA machines to clean the air as they work, among many other things.
Once trained the EASRCC instructors help train other trade workers through a Train the Trainer program to the same standards and procedures to reduce the secondary acquired infections at healthcare facilities. These trainers are then able to customize up to 20-percent of the curriculum to the specifics of their trade.
“Being able to customize this training for different trades adds a layer of proficiency and technicality that is helpful later when workers apply these techniques in real-world conditions,” Bender explains. “You have an electrician teaching another electrician how to do proper electrical work in a contained environment, and not a generalist or someone from a different trade.”
The Eastern Atlantic States Carpenters began their ICRA program in Pittsburgh in 2008. Ten years later in 2018, there had been approximately a 20-percent reduction in secondary infections in Pennsylvania. While the program cannot take credit for the full decline, notes Bender, the timing and practices correlate – indicating that the training is working to create safer environments at healthcare facilities.
“The impact of this program is huge,” Bender says. “While we can’t know specifics because of various privacy regulations, we have seen the overall numbers dip. The more we train our workers, and the more healthcare facilities hire us, the safer we will all be collectively.”