WATER SYSTEM SAFETY


the removal of washing basins’. “However,” she said, “we need to carefully think about how we use them going forward.”


References 1 Pseudomonas bacteria found in 459 water outlets of new maternity unit – Dodds. 26 November 2024. https://www. thenational.scot/news/national/24751698.pseudomonas- bacteria-found-459-water-outlets-new-maternity-unit--- dodds/


2 21 patients infected by bacteria in the water supply at Royal Papworth Hospital, 7 September 2020. https://www. cambridge-news.co.uk/news/local-news/21-patients- infected-bacteria-water-18893946


3 Water at two Glasgow hospitals had ‘widespread contamination’, BBC News, 22 February 2019. https://www. bbc.co.uk/news/uk-scotland-glasgow-west-47336555


4 Fucini GB, Geffers C, Schwab F, Behnke M, Sunder W, Moellmann J, Gastmeier P. Sinks in patient rooms in ICUs are associated with higher rates of hospital-acquired infection: a retrospective analysis of 552 ICUs. J Hosp Infect. 2023 Sep;139:99-105. doi: 10.1016/j.jhin.2023.05.018. Epub 2023 Jun 10. PMID: 37308060.


Pseudomonas aeruginosa bacteria cultured in a petri dish.


expected to prepare IV medication – often the space is very tight and cluttered, and there’s a handwash basin nearby. “We also suggested that we put no handwash basins


in the clinical consulting room, as in those settings, alcohol rub is sufficient.” She further highlighted concerns over water coolers and fountains within haematology and cancer settings. The potential benefits of the project include: n Reduced patient infection risk from water outlets and drain splashes.


The Infection Prevention Society


The Infection Prevention Society (IPS) is a charity with 2,000 members, all working together to prevent infections that can be avoided. Its goal is to create a world where no one is harmed by a preventable infection. It works with


healthcare professionals, policymakers, and the public, to share knowledge, support good practices, and improve infection prevention in healthcare. This helps make care safer for patients, their families, and healthcare workers. IPS’s next annual


conference, Infection Prevention 2025, will be held in Brighton on 29– 30 September. To find out more, visit https:// ip2025conference.co.uk/


n Reducing the cost of treating patient infection – extra bed days, extra antibiotics, and lower mortality.


n Reduced installation costs of unnecessary sinks. n Reduced ongoing maintenance cost for cleaning (about £1,000 per year).


n Reducing the additional cost of six-monthly water sampling in augmented care.


n Reducing the cost of filters where outlets are positive (£30-45 each).


The IPC team linked in with the New Hospital Programme expert, Dr. Michael Weinbren, for advice and support. They presented an options appraisal which was accepted by the Trust prior to meeting with representatives from the NHP for their sign off. Risk assessment documents were produced to ensure appropriate mitigations were in place.


“Innovation towards patient safety” Ultimately, the team from the New Hospital Programme considered that the reduction of water outlets was an “innovation towards patient safety”, rather than a derogation, and perceived that it was a good opportunity to veer away from outdated guidance to improve patient safety. The new technical bulletin, released in August 2024,


endorses this risk-based approach for water hygiene, and states: “Wash-hand basins and clinical sinks should not be fitted in high-risk patient rooms where the risk assessment indicates there is too high a risk of infection from outlets and associated drainage.” It adds that: “It is important that all parties involved


understand that buildings that are compliant are not necessarily safe.” In conclusion, Pat Cattini commented that ‘it may seem an anathema for an infection control nurse to advocate


40 Health Estate Journal April 2025


5 Halstead FD, Quick J, Niebel M, Garvey M, Cumley N, Smith R, Neal T, Roberts P, Hardy K, Shabir S, Walker JT, Hawkey P, Loman NJ. Pseudomonas aeruginosa infection in augmented care: the molecular ecology and transmission dynamics in four large UK hospitals. J Hosp Infect. 2021 May;111:162-168. doi: 10.1016/j.jhin.2021.01.020. Epub 2021 Feb 1. PMID: 33539934.


6 Garvey MI, Williams N, Gardiner A, Ruston C, Wilkinson MAC, Kiernan M, Walker JT, Holden E. The sink splash zone. J Hosp Infect. 2023 May;135:154-156. doi: 10.1016/j. jhin.2023.01.020. Epub 2023 Mar 3. PMID: 36870392.


7 Hopman J, Tostmann A, Wertheim H, Bos M, Kolwijck E, Akkermans R, Sturm P, Voss A, Pickkers P, Vd Hoeven H. Reduced rate of intensive care unit acquired gram-negative bacilli after removal of sinks and introduction of ‘water-free’ patient care. Antimicrob Resist Infect Control. 2017 Jun 10;6:59. doi: 10.1186/s13756-017-0213-0. PMID: 28616203; PMCID: PMC5466749.


8 Garvey MI, Bradley CW, Holden KL, Hewins P, Ngui SL, Tedder R, Jumaa P, Smit E. Use of genome sequencing to identify hepatitis C virus transmission in a renal healthcare setting. J Hosp Infect. 2017 Jun;96(2):157-162. doi: 10.1016/ j.jhin.2017.01.002. Epub 2017 Jan 16. PMID: 28196726.


9 Garvey MI, Bradley CW, Holden E. Waterborne Pseudomonas aeruginosa transmission in a hematology unit? Am J Infect Control. 2018 Apr;46(4):383-386. doi: 10.1016/ j.ajic.2017.10.013. Epub 2017 Nov 28. PMID: 29195780.


10 Halstead FD, Quick J, Niebel M, Garvey M, Cumley N, Smith R, Neal T, Roberts P, Hardy K, Shabir S, Walker JT, Hawkey P, Loman NJ. Pseudomonas aeruginosa infection in augmented care: the molecular ecology and transmission dynamics in four large UK hospitals. J Hosp Infect. 2021 May;111:162-168. doi: 10.1016/j.jhin.2021.01.020. Epub 2021 Feb 1. PMID: 33539934.


11 Garvey MI, Bradley CW, Wilkinson MAC, Bradley C, Holden E. Engineering waterborne Pseudomonas aeruginosa out of a critical care unit. Int J Hyg Environ Health. 2017 Aug;220(6):1014-1019. doi: 10.1016/j.ijheh.2017.05.011. Epub 2017 May 31. PMID: 28592358.


Acknowledgement n This article, titled ‘Should we have less sinks in


hospitals?’, first appeared in the March 2025 edition of The Clinical Services Journal. HEJ acknowledges the help of its author – CSJ’s editor, Louise Frampton, and the Infection Prevention Society, in allowing its re- publication here.


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