ICRA compliance checklist for healthcare construction
A phase-by-phase working list for contractors and facilities teams — covering assessment, containment, air management, daily logs, and closeout evidence that stands up in a survey.
Checklists don’t replace judgment — they make sure judgment is applied consistently. Use this as a starting template, then align it with your facility’s ICRA policy and the risk class from your ICRA assessment. If you’re new to the framework, read what ICRA is first.
Pre-construction
- Complete the written ICRA assessment for the specific work area and phasing
- Assign and document the ICRA risk class with rationale (Class I–IV)
- Walk the site with infection prevention, facilities, and the contractor
- Identify adjacent patient care spaces, air handlers, and shaft penetrations
- Confirm construction traffic routes separate from clinical traffic
- Establish pressure monitoring locations and acceptable differentials
- Brief all trades on ICRA protocols before mobilization
- Post signage for work zones, PPE, and restricted access
Barriers & containment
- Install sealed barriers per the control plan (plastic vs. rigid as specified)
- Verify all penetrations in barriers are sealed (tape, mastic, gaskets)
- Keep doors to the work zone closed; use anterooms where required
- Protect finished surfaces along transport routes
- Stage sticky mats / tacky mats at entry points as specified
- Inspect barriers at least once per shift and after any disturbance
- Document barrier repairs with time and responsible party
Air management (Class III–IV and as specified)
- Establish negative pressure relative to adjacent occupied spaces
- Confirm HEPA filtration on exhaust; verify units are serviced
- Monitor pressure differentials on the defined schedule (each shift minimum for Class IV)
- Log readings with time, value, and initials; investigate out-of-range results
- Ensure alarms are set and tested where used
- Never exhaust filtered air into occupied clinical space or return air plenums
- Pause work if differentials cannot be maintained — escalate immediately
Daily operations & housekeeping
- Wet methods preferred over dry cutting, grinding, or sweeping
- HEPA vacuum only — no standard shop vacs in patient care areas
- Damp-wipe surfaces at end of shift; remove debris daily (never stored in corridors)
- Maintain clear egress and fire-rated separations
- Control noise and vibration windows per facility policy
- Supervisor reviews the daily ICRA log and signs off
- Infection prevention receives escalations same-day when deviations occur
Closeout & handoff
- Final clean: HEPA vacuum, damp-wipe, and wet methods on all surfaces
- Remove temporary barriers, negative air machines, and monitoring equipment
- Seal and verify any wall/ceiling penetrations disturbed by the work
- Complete final pressure and containment verification before reopening
- Assemble the ICRA binder: assessment, class, plan, logs, corrective actions
- Joint walkthrough with infection prevention and clinical stakeholders
- Document space return-to-service approval
Documentation that survives a survey
When accreditors or system auditors ask about ICRA, they want an evidence trail — not verbal assurances. Keep one project binder (digital or physical) containing:
- The signed ICRA assessment and assigned class
- The control plan and any approved revisions
- Daily pressure logs and barrier inspection records
- Photos of containment setup at key milestones
- Corrective actions for any deviation, with closure dates
- Closeout cleaning and return-to-service sign-off
Make ICRA your brand
Firms that run ICRA this cleanly differentiate on every bid. icra.builders — the domain that says so before you open your mouth. Available for acquisition; price on request.