Making sense of standards - IPAC Canadas/CSA... · Z8000 –Design and Construction Z8001 – Commissioning Z8002 –Operation and Maintenance Z10535-1 Patient lifts – (mfring)

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Making sense of standards

Jeffrey Kraegel, CSA

IPAC-SWO – September 15, 2017

CSA Health Care Facility Standards

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Today’s Topics

• Introduction to CSA

• CSA and health care

• Health care facility standards

• Infection Prevention and Control aspects

What is CSA?

• Canada’s first and largest accredited standards development organization (SDO)

• Independent, not-for-profit

• 9,000 members

• Over 2,000 standards in 54 technical areas.

• 40% of standards referenced in legislation.

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What is CSA doing for health care?

Health Care Technical Committees

• Perioperative Safety

• Medical Gas Systems

• Medical Laboratory Quality Systems

• Child Resistant Packaging

• Health Care Facilities

• Kidney Dialysis

• Medical Device Reprocessing

• Quality Management and General Aspects for Medical Devices

• Application of Electricity in Health Care

• Technology for Persons with a Disability

• Systems for the Transportation of Persons with Disabilities

Standards Development - Committees

• Technical Committee members come from major stakeholder

groups, including

– Hospital staff - operations / maintenance / engineering

– Architects, Consulting engineers, Designers

– Infection Prevention and Control Professionals

– Government/Regulatory Authorities

– General Interest (e.g. consumers, professional associations)

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• Inclusive, not exclusive, participation

• Respect for diverse interests

• Accountability

• Consensus achievement

Consensus is defined as substantial agreement

“Consensus implies much more than a simple majority, but not necessarily unanimity.”

Standards Development - Principles

TC Reaches Consensus

Technical Content Approval

Public Review

Internal Review

Dissemination Maintenance

Request/ Evaluation/Authorization

Assign toCommittee

Notice ofIntent

Meetings/Draft

Final Edit/ Publication

ProceduralApproval

Canadian Standards - Process

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Standards Development - Essentials

• Members determine the contents of Standards

through a consensus process.

• The 60-day Public Review process makes each

draft available to all stakeholders, so any

necessary changes or additions can be made

before the Standard is voted on and published.

• Staff support the committees in their work and

are responsible for the development process.

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Health Care Facility Standards:

• establish a common set of requirements for equipment and processes in health care facilities

• are a way to share best practices among health care professionals

• are aimed at protecting staff as well as patients

Health Care Facility Standards - Purpose

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Standards Development – Philosophy

• Focus on Safety

• Be practical (committee room reality vs. on-the-

ground reality)

• Be clear and consistent

• Be committed – Take a stand

• Watch for unintended consequences

• Respect the user

The committee always has the last word.

Health Care Facility Standards

• Z8000 Canadian Health Care Facilities

• Z8001 Commissioning of Health Care Facilities

• Z8002 Operation and Maintenance of Health Care Facilities

• Z317.1 Special Requirements for Plumbing Installations in Health Care Facilities

• Z317.2 Special Requirements for Heating, Ventilation, and Air-Conditioning (HVAC) Systems in Health Care Facilities

• Z317.5 Illumination Systems in Health Care Facilities

• Z317.10 Handling of Waste Materials in Health Care Facilities and Veterinary Health Care Facilities

• Z317.11 Area Measurement for Health Care Facilities

• Z317.13 Infection Control During Construction, Renovation, and Maintenance of Health Care Facilities

• Z317.14 Wayfinding in Health Care Facilities

• Z10535-1 Hoists for the Transfer of Disabled Persons – Requirements and Test Methods

• Z10535-2 Hoists for the Transfer of Disabled Persons – Installation, on-site testing, and maintenance

• Z7396-1 Non-flammable Medical Gas Systems

• Z32 Electrical Safety and Essential Electrical Systems in Health Care Facilities

• (proposed) Post-Occupancy Evaluation for Health Care Facilities

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HCF Standards Today

Z317.2HVAC

Z317.5Illumination

Z317.13IC Construction

Z317.11Area Measurement

Z317.10Waste Handling

Z317.1Plumbing

Z318.14Wayfinding

(under development)

Z7396-1Medical Gas

SystemsZ32

Electrical Safety

Z8000 – Design and Construction

Z8001 –Commissioning

Z8002 – Operation and Maintenance

Z10535-1Patient lifts –

(mfring)

Z10535-2Patient lifts –(install & test)

Infrastructure Systems and processes

HCF Standards – IPC-related

Z317.2HVAC

Z317.5Illumination

Z317.1Plumbing

Z7396-1Medical Gas

SystemsZ32

Electrical Safety

Z8000 – Design and Construction

Z8001 –Commissioning

Z8002 – Operation and Maintenance

Z10535-1Patient lifts –

(mfring)

Z10535-2Patient lifts –(install & test)

Infrastructure Systems and processes

Z317.13IC Construction

Z317.11Area Measurement

Z317.10Waste Handling

Z318.14Wayfinding

(under development)

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Supporting IPC in health care facilities

1. Do no harm / Make it tough for the bugs

– Prevent

– Inactivate or remove

– Limit growth

– Contain

2. Make it easier to do the right thing

– Infrastructure and equipment support administrative solutions

(e.g. hand hygiene, airborne isolation).

3. Get proactive

– Surfaces and technologies to actively combat infectious micro-

organisms

Topic: Design and Construction

Canadian Health Care Facilities (Z8000)

Infection prevention and control aspects

• OASIS principles– Operations

– Accessibility

– Safety

– Infection prevention and control

– Sustainability

• Infection Control Risk Assessment

• Adjacencies and separations

• Materials and design

• Single patient rooms

• No sharing of patient washrooms

• Hand hygiene sinks and waterless HH stations

• Provisions for human waste disposal

• MDR design

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What is a Health Care Facility?

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Teaching Health Care Facility Specialty Health Care Facility

Small Rural Health Care Facility Walk-in Health Care Facility

Topic: HCF Commissioning

Commissioning of Health Care Facilities (Z8001)


• Make sure that the IPC aspects of construction are

correct and in place

• Make sure mechanical equipment supporting IPC has

been tested and is working correctly

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Topic: Operation and Maintenance

Operation and Maintenance of HCFs (Z8002)


• Worker training – standard precautions

• Worker training – infection control during maintenance

• Integration of operation and maintenance activities with the overall

IPC policy and procedures

• Maintenance and periodic testing of interior separations and

pressure differentials for pressure-critical areas

Topic: Plumbing in HCFs

Plumbing in HCFs (Z317.1)

Infection Prevention and Control Aspects

• System cleanliness

• Hot water loops

• Minimize opportunities for water to stagnate

• Specialized water systems (e.g. R/O)

• Hand hygiene sink design

• Backup systems

• System disinfection

• Toilet design

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Topic: HVAC

HVAC in Health Care Facilities (Z317.2)

Infection Prevention and Control Aspects

• Directional air flow and relative pressurization

• Temperature, and humidity

• Prevent condensation and pooling of water

• Cooling tower maintenance

• System cleanliness

• Filters

Topic: Waste Handling

Waste Handling (Z317.10)


• Defining and classifying types of waste

• Segregating and disposing of biomedical waste

• Spill management

• Sharps and other special waste categories

• Occupational health and safety

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IPC in Construction, Renovation and Maintenance

• Intended for:

– Infection Prevention and Control Professionals

– Planning and Project Management

– Facility and Maintenance Managers

– Architects and Engineers

– Medical and Nursing Staff

– Commissioning Teams

– Constructors

– Environmental Services Staff

– Occupational Health and Safety

Z317.13 Essentials

• Plan a Proactive Approach

• Build Multi-skilled Infection Control Team

• Assess and Manage the Risks

Z317.13 - Infection Control During Construction, Renovation,

and Maintenance of Health Care Facilities

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QUESTIONS?

Documents

Making sense of standards - IPAC Canadas/CSA... · Z8000 –Design and Construction Z8001 – Commissioning Z8002 –Operation and Maintenance Z10535-1 Patient lifts – (mfring)