I. Maintenance personnel who must enter the negative pressure isolation room of an EID patient, a nursing unit without negative pressure isolation rooms where EID patients are located, and when working with the vacuum system, the sewer system, or the ventilation system in an area where EID patients are located will wear All Barrier Protection (ABP) personal protective equipment (PPE).
A. Fit-tested N-95 mask.
B. Goggles.
C. Gown.
D. Two pair of gloves.
II. Maintenance personnel who enter a ventilation system contaminated or possibly contaminated with droplet nuclei from one or more EID patient rooms will wear a powered air purifying respirator (PAPR), two pair of gloves and a gown.
III. Heavy work gloves should be worn over the 2 pair of latex gloves as needed.
IV. Preparation to work in a high risk area or with a high risk system.
A. The minimum number of maintenance personnel should be used for each maintenance task compatible with safety and efficiency.
B. If contact with contaminated fluids is possible, a waterproof apron and boots (over street shoes) should be worn.
C. The minimum number of tools and amounts of materials should be taken into the contaminated area where the maintenance work will be done.
D. Care should be exercised to prevent injuries while handling tools.
V. Disinfection of tools and PPE prior to leaving the work area.
A. Prior to departure from a worksite, maintenance personnel will wipe all surfaces of tools and materials not used for repairs with a disposable Caviwipe until the surfaces are clean. After the surfaces are clean, Cavicide will be applied to the surfaces using a disposable Caviwipe. The cavicide will be left on the disinfected surfaces to dry.
B. After the tools and any materials have been decontaminated, they will be handed out of the room (or area) to a person wearing an N-95 masks standing outside the door.
1. The tools and repair material should be placed on the floor away from areas where there is pedestrian traffic.
2. The person outside the room should wash hands with an antimicrobial soap and water or apply an alcohol hand gel.
a. The mask should then be removed in the proper way to avoid self contamination
b. Then hands should be washed again with an antimicrobial soap and water or an alcohol hand gel applied.
C. Removal of PPE by maintenance personnel prior to leaving the room or area.
1. PPE will be removed starting with removal of all gloves (work and latex gloves).
2. Then goggles and gown will be removed.
3. If an apron and boots were worn and no contaminated fluids soaked through the gown to the apron and the boots had no contact with contaminated substances, the maintenance personnel may leave the room/area, wash their hands with an antimicrobial soap and water or apply an alcohol hand gel, remove their N-95 mask and wash their hands as above or apply an alcohol hand gel.
4. If the apron and/or boots have been contaminated, the surface(s) of the item(s) must be cleaned off and then disinfected with Caviwipes.
a. The disinfected item(s) will then be handed out of the room/area to a person outside wearing an N-95 mask as above in B.
b. After handing out the decontaminated item(s) the maintenance worker(s) will leave the room, wash their hands with an antimicrobial soap and water or apply an alcohol hand gel, remove the N-95 mask and again wash hands as above or apply an alcohol hand gel.
VI. Follow up of maintenance personnel after they have worked in an area where EID patients are located or with a system contaminated by EID patients (ventilation system, sewer system, and vacuum system).
A. After working in a room or area where EID patients are located, each maintenance worker should sign up on the sheet on the door of the patient’s room or the door leading into the area.
B. Each day after working with ventilation, sewer and vacuum systems that may have been contaminated by EID patients, maintenance workers should call the Department of Healthcare Epidemiology to register for follow up for early detection of an EID. (See Policy 3.9 Post Exposure Monitoring of UTMB Employees for an Emerging Infectious Disease (EID).
VII. Accidental exposures to an EID.
A. Accidental exposures to an EID might be caused by, but would not be limited to, accidental loss or slippage of PPE, (e.g. loss of respiratory protection), extensive soilage by EID contaminated fluids, and a sharps injury with a tool.
1. If an exposure or possible exposure to an EID occurs, the Department of Healthcare Epidemiology should be contacted immediately 24/7.
2. Contact information
a. Week days – office (409) 772-3192
b. Nights, weekends, holidays – emergency pager – (409) 643-3133.
