DESIGN & CONSTRUCTION
Figure 3: Two published studies highlighting unrecognised transmission of waterborne derived patient infections.1,2
The study on the left
using whole genome sequencing demonstrated transmission of waterborne organisms in three out of four hospitals, none of which realised they had a problem. The more recent paper on the right looked at 552 ICUs across Germany, and by comparing infection rates between rooms containing a clinical handwash station and rooms where it was on the outside, the authors were able to show that having a clinical handwash station in the room was associated with a higher rate of healthcare-associated infection, including Pseudomonas aeruginosa.
B Identifying all the water systems, specialist water services (hydrotherapy pool, RO systems), novel water system components, and monitoring or treatment systems.
These assessments are in effect ‘critical control points’, as failing to identify an area requiring expertise places both the project and patient safety at risk. These risk assessments need to be conducted with the appropriate rigour, and recorded. Although yet to be formally recognised, it is advised that the periphery of the
water system be regarded as an area requiring competency in its own right. This assessment will provide the range of expertise/competency necessary to deliver the project.
2. Identifying whether individuals have the necessary competencies As discussed elsewhere in this article, individuals must be appointed by training / expertise, and not by job title. Competence must be accompanied by the individual having sufficient time for
the project, as well as coming under the project governance / management structure. This is particularly important with NHS personnel, who may be unreasonably expected to carry out their day-to-day duties in the existing hospital and absorb the new work. Such practices are dangerous to both the old and new facility under construction. Lack of training /expertise cannot be masked / substituted by following guidance. (This is contrary to historical / current practices).
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® April 2024 Health Estate Journal 29
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