EC 11 - Water Intrusion at a Same Day Surgery Center

Tuesday, June 27, 2023

10:36 AM – 10:55 AM

Location: W103 A/B; Orange County Convention Center

CE: .33

CNE Credits: 0.33
CME Credits: 0.33

Presenter(s)

Amy Priddy, DNP, RN, CIC, FAPIC

Director Infection Prevention
Park Nicollet Health Services
St. Louis Park, Minnesota

Disclosure(s): No financial relationships to disclose

PDF

Co-Author(s)

MC

Mary (Betsy) Crosby, RN, BSN

Same Day Surgery Center Patient Care Manager
Park Nicollet Health Services
Charles Gallagher, MA, CEM

Emergency Preparedness Program Manager
Park Nicollet Health Services
St. Louis Park, Minnesota

Co-Author(s)

Karoline Sperling, MPH, MLS, CIC, FAPIC

Manager, Infection Prevention
Park Nicollet Health Services
St Louis Park

Co-Author(s)

Jennifer Davidson Feliu, MSA, BN, RN

Infection Preventionist
Park Nicollet Health Services
JC

James Colburn, PE

Engineering & Facility Director
Park Nicollet Health Services
Penny Polis, BSN

Director: Surgical Servies - Same Day Surgery Centers
Park Nicollet Health Services
Plymouth , Minnesota
CC

Chad Coleman, n/a

Environmental Services Senior Supervisor
Park Nicollet Health Services

Moderator(s)

Mohamed N. Elhadidi, Msc, MBA,FISQua,CIC,LTC-CIP (he/him/his)

Chief of infection control
Dallah healthcare
Riyadh

Disclosure(s): No financial relationships to disclose

Co-Moderator(s)

Marissa Broadley, MPH, MSEd, RN, CIC, CPHQ, CPPS, LSSGBH (she/her/hers)

Director, Infection Prevention
Albany Med Health System - Saratoga Hospital
Saratoga Springs, New York

Disclosure(s): No financial relationships to disclose

Background: Water intrusion in healthcare facilities is a complex, time sensitive issue. Priorities include mitigation of safety risks and resuming normal operations as soon as possible. On 10/31/22 at 0500, staff arrived to discover flooding at our six-suite same day surgery center (SDSC) that impacted sterile processing, post anesthesia, and sterile supply storage areas. A failed backflow preventer valve released approximately 15,000 gallons of sanitary water into the SDSC, causing damage to ceilings, walls, and floors and requiring immediate action.

Methods: Incident command structure was promptly initiated by emergency preparedness and included surgery leadership, facilities and engineering, clinical engineering, environmental services, construction teams, and infection prevention. Other immediate actions included on-site multidisciplinary assessment of damage, rescheduling patient procedures, communicating to staff and leaders, retaining a water damage contractor, obtaining pressure and humidity reports for sterile supply areas, performing a sterile item risk assessment, and moving sterile items. Ongoing actions included assessing further water damage, measuring surface moisture levels, repairing damaged areas using appropriate controls defined by infection control risk assessments, and terminal cleaning. Teams worked around the clock on repairs, inspections, and cleaning. Twice daily updates were held and patient rescheduling plans were determined daily. The incident command team assessed the response and produced an after-action report.

Results: Damage to the SDSC was extensive. 159 patients had procedures rescheduled or relocated to another facility in our system. The SDSC reopened for normal operations on 11/7/22, seven days after the flood. The after-action report showed that response strengths included incident command structure and communication, on-site assessments, and verification that impacted areas were dry. Opportunities included implementing a system for early valve failure detection and communicating to the healthcare team.

Conclusions: Immediate action, a multidisciplinary team that included infection prevention, and strong communication supported a successful response to SDSC flooding and safely resuming normal operations.

Learning Objectives:

List key collaborators to include in a healthcare facility response to water damage.
Describe the role of the Infection Preventionist in responding to facility water damage.
Discuss the use of a sterile item risk assessment in water damage events.