ASHE Infection Control Risk Assessment Questions and Answers — Questions and Answers
Question 1: A major renovation project involving heavy demolition (Type D) is planned for a vacant wing directly adjacent to a hospital's bone marrow transplant unit (Highest Risk Group). According to the standard ICRA matrix, which Class of Precautions is required?
- Class II
- Class III
- Class IV or V (Correct answer)
- Class I
Correct answer: Class IV or V
The ICRA matrix matches the construction activity type with the patient risk group to determine the required level of precautions. A Type D activity (major demolition) in or adjacent to a Highest Risk group (such as immunocompromised patients in a transplant unit) requires the most stringent level of controls, which corresponds to Class IV or V, depending on the specific matrix version used (e.g., ASHE ICRA 2.0 introduced Class V).
Question 2: When developing a comprehensive ICRA for a hospital renovation, which of the following individuals is considered an essential, core member of the multidisciplinary team?
- Infection Preventionist (Correct answer)
- Hospital's Chief Financial Officer (CFO)
- Medical Equipment Planner
- City Building Inspector
Correct answer: Infection Preventionist
A multidisciplinary team is crucial for a successful ICRA. The Infection Preventionist (IP) is a core member, bringing expertise on pathogen transmission, patient risk factors, and required mitigation strategies. While others may be involved, the IP's role is fundamental to the entire process.
Question 3: For a Class IV ICRA project, what is the primary purpose of establishing an anteroom and maintaining negative air pressure within the construction zone?
- To provide a secure storage area for tools and materials.
- To create a sound buffer between the construction zone and adjacent occupied spaces.
- To meet OSHA requirements for worker break areas.
- To contain construction dust and airborne pathogens, preventing their escape into patient care areas. (Correct answer)
Correct answer: To contain construction dust and airborne pathogens, preventing their escape into patient care areas.
The primary infection control purpose of this combination is containment. Negative air pressure ensures that air flows from the clean patient areas into the construction zone, not the other way around. The anteroom serves as an airlock, allowing workers to enter/exit while minimizing the escape of contaminated air and dust.
Question 4: At which stage of a healthcare construction or renovation project should the initial Infection Control Risk Assessment (ICRA) be performed?
- After the construction contract has been awarded but before work begins.
- In the earliest planning and design phases, before the project is bid. (Correct answer)
- During the commissioning phase, just before patient occupancy.
- Upon the first discovery of mold or other contaminants during demolition.
Correct answer: In the earliest planning and design phases, before the project is bid.
The ICRA must be performed as early as possible in the project lifecycle, specifically during planning and design. This allows the required infection control measures to be properly designed, budgeted, and included in the construction documents for bidding, ensuring the contractor is aware of and accounts for all requirements from the start.
Question 5: An ICRA is best described as a 'living document' because it must be:
- Reviewed and updated if the project scope, site conditions, or patient risk levels change. (Correct answer)
- Filed with the local health department annually for the life of the building.
- Signed and dated by every construction worker who enters the site.
- Maintained in a waterproof container on the construction site at all times.
Correct answer: Reviewed and updated if the project scope, site conditions, or patient risk levels change.
The ICRA is not a one-time assessment. It must be treated as a living document that is continuously monitored and formally reviewed and updated by the multidisciplinary team whenever there are significant changes to the project, such as an expanded scope of work, unexpected site conditions (like the discovery of mold), or changes in the adjacent patient population.
Question 6: According to the most widely used ICRA matrix definitions, which of the following activities would be classified as a Type A construction activity?
- Sanding of walls for painting in a corridor.
- Demolition of a non-load-bearing wall.
- Removing a single ceiling tile for a brief visual inspection. (Correct answer)
- Major duct work replacement above the ceiling grid.
Correct answer: Removing a single ceiling tile for a brief visual inspection.
Type A activities are defined as inspections or non-invasive tasks that generate minimal to no dust. Removing a single ceiling tile for a visual inspection fits this description perfectly. Sanding (Type C), demolition (Type C/D), and major duct work (Type C/D) all create significantly more dust and disruption.
ASHE Infection Control Risk Assessment Questions and Answers
A major renovation project involving heavy demolition (Type D) is planned for a vacant wing directly adjacent to a hospital's bone marrow transplant unit (Highest Risk Group).
According to the standard ICRA matrix, which Class of Precautions is required?