Definition
An ICRA is multidisciplinary, organizational, documented process that after considering the facility’s patient population and program addresses the following based on owner/agency input and planning.
- Focuses on reduction of risk from infection,
- Acts through phases of facility planning, design, construction, renovation, facility maintenance, and
- Coordinates and weighs knowledge about infection, infectious agents, and care environment, permitting
- the organization to anticipate potential impact.
Design and Planning
The design area requires “long-range planning” for new or renovated buildings and adds a new element “finishes and surfaces” a critical feature over the lifetime of the facility. Considerations include:
- Number, location, and type of airborne infection isolation and protective environment rooms.
- Location of special ventilation and filtration such as emergency department waiting and intake areas.
- Air handling and ventilation needs in surgical services, airborne infection isolation and protective environment rooms, laboratories, local exhaust systems for hazardous agents, and other special areas.
- Water systems to limit Legionella and other waterborne opportunistic pathogens.
- Finishes and surfaces.
Construction
The building and site areas anticipated to be affected by construction shall include consideration of the following:
- Impact of disrupting essential services to patients and employees.
- Determination of the specific hazards and protection levels for each.
- Location of patients by susceptibility to infection and definition of risks to each.
- Impact of potential outages or emergencies and protection of patients during planned or unplanned outages, movement of debris, traffic flow, cleanup, and testing and certification.
- Assessment of external as well as internal construction activities.
- Location of known hazards.
- Patient placement and relocation.
- Standards for barriers and other protective measures required to protect adjacent areas and susceptible patients from airborne contaminants.
- Temporary provisions or phasing for construction or modification of heating, ventilating, air conditioning and water supply systems.
- Protection from demolition.
- Measures taken to train hospital staff, visitors and construction personnel
- Inspect the installation of infection control measures with the owner’s authorized representative and provide continuous monitoring of their effectiveness throughout the project.
Infection Control Risk Assessment
Matrix of Precautions for Construction & Renovation
IC Matrix – Class of Precautions: Construction Project by Patient Risk
Note: Infection Control approval will be required when the Construction Activity and Risk Level indicate that Class III or Class IV control procedures are necessary.
Risk Mitigation and Management Starts with Planning but Continuous Monitoring is Essential for Success.
- Class II through IV ICRA projects MUST have continuous monitoring for risk assessment and management.
- This is where eGate can help!
New Wireless IoT Sensors Monitor ICRA Barriers in Real-Time
The latest cloud-connected IoT sensors can be a great tool for construction managers. They are easy to install without complex wiring and can send immediate mobile alerts when the jobsite conditions change. This works well also for dust control programs.
The best wireless dust sensors can measure and report several air particle size classes at the same time. For example, one may want to have a separate alert for airborne particles that are size PM5.0 or smaller, as they are the most severe health risk. The larger particles, up to PM40, may not be causing health problems but can be harmful to clinical equipment and create extra cleaning needs after the project.
Differential pressure (DP) sensors are installed between the negative and positive pressure spaces. They will send an alert when the pressure differential drops below the desired threshold or can also send a trigger to the ventilation machines for adjusting power automatically as needed.
Traditional methods of monitoring pressure differentials using telltale flags, smoke testing, or local manometers, cannot compete with wireless IoT sensors anymore. When using smoke testing or other manual methods, you have to be onsite to perform such tests. With wireless IOT sensors, you will gain peace of mind as the sensors are performing the monitoring for you 24/7. You can forget ICRA barriers – until a mobile alert will trigger your attention to a potential leak or failure.
eGate Dust and Differential Pressure Sensors Trigger Remote Alerts
As an example of state-of-the-art Dust and DP sensors, here are two sensor products manufactured by e-Gate.io. Both products are directly connected to the internet and real-time alerting platform, by using wireless carrier data connection to the cloud. (c) 2022 eGate Smart Building Innovation Corp. – All Rights Reserved – www.e-gate.io.

eGate KOMBI-DP
- Sensor measures differential pressure (DP), ambient Temp/RH, CO2 and VOC values.
- DP measurement method is using a flow-through sensor to measure the pressure difference between two spaces.
- A thin plastic tube is extended from the sensor connector, over maximum 1 meter
(3 ft) length, to the other side of the wall, so that the sensor can monitor the pressure difference of two spaces. - The DP measurement accuracy is +/-0.2 Pascal (0.0008 Inch w.c) + 4% from reading
- Battery powered, battery life is up to 5 years with 15min measurement interval
- Wireless LoraWAN connection, works together with the eGate Cloud data platform with mobile phone connection and open API interface

eGate DUST40
- Sensor measures air particles sizes 0.35…40µm, divided in 16 particle size categories reported in µg/m3 units (in compliance with OSHA limits)
- Detects dust particles that are hazardous for health: PM1.0 – PM10 particle size
- Detects dust particles that impact jobsite cleanliness: PM10 – PM40 particle size
- The dust sensor technology used is particle size distribution with Laser Diffracted/Scattered Light.
- Dust40 also measures ambient air Temp and RH%
- Power supply: Micro-USB connector, 5V, 200 mA
- Wireless LoraWAN connection, works together with the e-Gate Cloud data platform with mobile phone connection and open API interface

Author, eGate Guest Expert:
Brian Gaudiano
CEO, Omega Building Co.
CEO, Sitebiotics, Inc.
Pitssburgh, PA
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