making sense of standards - ipac canadas/csa... · z8000 –design and construction z8001 –...
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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)
Infection prevention and control aspects
• 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)
Infection prevention and control aspects
• 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)
Infection prevention and control aspects
• 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?