HEALTHCARE WATER SYSTEMS
Professionals come together to tackle infection control
In the context of the recent update to British Standard (BS) 8580-2: Risk assessments for Pseudomonas aeruginosa and other waterborne pathogens, Armitage Shanks recently brought together in London experts from across the healthcare sector to discuss what the changes mean in practice, and the role of the multidisciplinary team in preventing and responding to waterborne pathogens. Anil Madan, UK Non- Residential Marketing manager for Ideal Standard and Armitage Shanks, reports.
The event, held at Armitage Shanks’ London Specification and Design Centre in Clerkenwell, fostered open discussion on the realities of water safety. The impact of healthcare-associated infections (HCAIs) is significant, and the numbers speak for themselves: millions of occupied hospital bed days and a cost to the NHS measured in billions.1
That’s before you consider the
harm and distress caused to patients, many of whom are already seriously ill. The contribution of waterborne pathogens to this burden is significant, and will undoubtedly increase as accelerating antibiotic resistance supercharges them against efforts to treat resulting infections. Water supply systems used in healthcare settings are vast, cover entire hospital estates, and supply water in numerous different settings. This is a complex environment, which has the potential to create a paradise of temperature and moisture conditions for these pathogens if not managed correctly. The risk of pathogens entering the system not only stems from the physical breadth of the pipe networks – there are multiple points of risk along every access point, water outlet, and drain – but also from the system’s manufacturing, testing, installation, and maintenance. This puts a burden of responsibility on healthcare professionals to ensure proactive water safety, and also anyone who has contact with the water supply system – including manufacturers, engineers, construction managers, and cleaning and maintenance workers.
Setting the standard – BS 8580-2 An update to BS 8580-2 was issued in January 2022, in an effort to acknowledge and engage everyone with a stake in preventing waterborne infection, and to do this with the imperative of regulatory responsibility as opposed to aspirational best practice. The Standard revisits the risk assessment process, and provides a step-by-step guide that is accessible for those conducting them, whether they are
a healthcare professional or not. The guidance is primarily intended
for use by the Water Safety Groups (WSGs), a team of experts required by the Department of Health and Social Care to develop, implement, and maintain a Water Safety Plan (WSP) in each healthcare setting. These groups exist because water safety goes beyond individual responsibility. However, the Standard contains more detailed guidance to steer WSGs towards contamination risks in areas that their WSP may not currently consider – associated equipment, system components, and individual fittings. Equally, there is increased consideration of external risk factors that can encourage growth and transfer of pathogens too.
Engaging a diverse cross-section Acknowledging the need to engage a diverse cross-section of roles involved in manufacture, construction, use, maintenance, and beyond, the Standard puts the emphasis on these clear risk assessment processes, which produce unambiguous results. Red/amber/green
rating systems are encouraged, rather than numerical scales – a score of 20 can be misinterpreted, but a risk rating of ‘red’ leaves no room for doubt. The ‘bottom line’ of the Standard is a
broadening of the base of responsibility. The gold standard suggested is a multidisciplinary approach that can foresee risks that could occur, while working to guard against infection at every stage.
Armitage Shanks’ Water Safety Forum – the multidisciplinary team’s role In practice, the scope of people who have contact with water systems in healthcare settings, the terms on which they work, and the diversity of training and experience, are all substantial barriers to ensuring that this multidisciplinary approach can be adopted. These hurdles need to be overcome in a sector which is arguably more time-pressed than any other. So, where to start? To build a broader knowledge base, Armitage Shanks invited a wide range of stakeholders to a Water Safety Forum
Armitage Shanks’ Contour 21 basin shown in a healthcare setting. October 2022 Health Estate Journal 29
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