WATER SYSTEM SAFETY
sinks and the introduction of ‘water-free’ patient care.7 Pat Cattini also highlighted the retrospective analysis of 552 ICUs, by Fucini et al, which found that sinks in patient rooms in ICUs are associated with higher rates of hospital- acquired infection.4
“I was concerned about the vulnerable cancer patients
that will be going into our new unit,” commented Pat Cattini. “The New Hospital Programme is asking for 100% single rooms, and that means that there’s going to be a lot of water outlets to clean, flush, and maintain. Of course we need our water outlets; we need to provide water for hand hygiene and for personal hygiene – particularly mouth care, which we’ve been hearing so much about during this conference. “The evidence is that water is still the best thing to deal
with norovirus and C. difficile. So, we don’t want staff to not have access to water – although I would argue that, for many things, alcohol hand rubs are the gold standard. However, we do need to start thinking differently. “What about the products of the future?… We know
that there are at least two companies now producing hypochlorous acid products, which can be used as a hand disinfectant, which they claim to be effective against C. difficile and norovirus. “So, it may be that we have an alternative to handwashing basins for clinical staff. We need to understand and balance our risks, and we need to think very carefully,” Pat Cattini commented. In another new building, recently opened
at the Trust, it was found that there were excess handwash basins – resulting in some not being used on a regular basis. This may increase the potential risks associated with waterborne infection and ‘dead legs’. Hence, the IPC team proposed a
derogation for the next build which would reduce the number of outlets. This included removing the handwash basin from the patient bed space (in response to the Fucini paper),4
and from the clean utility room.
Concern over sink availability The Estates team flagged this as a ‘derogation’ from the HBN, and was concerned about proceeding without authorisation. There was also a concern that staff would be unhappy with no sink in the bedroom, and anxiety around the fact that there was no sink availability in the drug room to cope with a chemotherapy spill. The request was presented and approved by the Trust’s executive team, and endorsed by the New Hospital Programme.
Risk assessments were undertaken to ensure the appropriate mitigations were in place, and additional training provided for staff on water hygiene, so that they fully understand the reasons for caution with water outlets. The Trust is also planning a trial of a novel product based on hypochlorous acid hand sanitiser, which could have the potential to reduce the need for water outlets in the future. “We asked to take out the clinical
handwash basin in the patient’s bedroom, leaving a sink that could be used for hand washing of soiled hands in the patient’s bathroom. That would be the patient’s sink
April 2025 Health Estate Journal 39
that they wash, shave, and brush their teeth in,” Pat Cattini explained. “We also asked for no handwash basin in the clean
utility/drug preparation rooms. You shouldn’t have wash basins in a pharmacy setting where you are preparing drugs. Too often we see a counter where nurses are
Biofilm formation stages, in a development and dispersion outline diagram.
AdobeStock / VectorMine
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