WATER SYSTEM HYGIENE & SAFETY
A call for multidisciplinary competence in water safety
Elise Maynard, independent adviser for water safety, and Chair of the Armitage Shanks Water Safety Forum, emphasises the need for multidisciplinary competence when it comes to safely managing and maintaining healthcare premises’ water systems.
The UK government has announced that five hospitals constructed mostly using reinforced autoclaved aerated concrete (RAAC) will be rebuilt by 2030 as part of the New Hospital Programme, to ‘protect patients and staff safety’. The five hospitals are Airedale in West Yorkshire, Queen Elizabeth King’s Lynn in Norfolk, Hinchingbrooke in Cambridgeshire, Mid Cheshire Leighton, in Cheshire, and Frimley Park in Surrey. This is on top of two of the worst affected hospitals, West Suffolk Hospital in Bury St Edmunds, and James Paget Hospital in Norfolk. The NHS has asked the government to prioritise the rebuilding of these hospitals given the risks they pose to patients and staff – the full extent of which has come to light since the New Hospital Programme was first announced in 2020. These new assets need to be designed and built with patient safety as the principal, immovable priority. Nowhere is this more pertinent than with systems and equipment utilising water, for which the design, construction, and operation of the healthcare built environment is a serious risk factor. Hot and cold water systems need to be planned, built, and maintained correctly to minimise opportunities for contamination, and staying on top of every stage of the project is a near-impossible task that Water Safety Groups (WSGs) will always struggle to have a complete overview of. This is why a focus on education and specific practical competencies that may affect water safety must flow right from the beginning of the project through every stage of its lifecycle if we are to prevent contamination of water systems from occurring. Competence isn’t just about delivering
more training; rather, all stakeholders involved in the design, build, and maintenance processes need to be
The handwashing routine in a healthcare environment.
competent for their duties. They also need to be able to demonstrate these competencies via good, well-kept records. It isn’t just about knowing the risks; it’s about understanding how they relate to a contractor, cleaner, or clinician’s specific job role, and applying best practices across a range of different scenarios. BS 8680:2020, Water quality – Water safety plans – Code of practice contains some very helpful advice for the design process, and for checking the competency of contractors and service- providers.
Need for a multidisciplinary approach Another area where the need for this detail regarding competence has been expanded is in risk assessing for Pseudomonas aeruginosa, for which a new British Standard (BS 8580-2: 2022) was introduced. This standard, which was discussed at Armitage Shanks’ Water Safety Forum, makes clear the need for a multidisciplinary team approach to risk assessing the clinical environment, backed
up by a living Water Safety Plan that operates and evolves based on continual feedback. The new standard is also intended to address risks to patient safety that may arise during the commissioning and procurement stages of building design and refurbishment. Designing a new facility with sufficient
handwash basins in the right place was highlighted as an illustrative example of the need for broad knowledge, excellent communication, and proven competence. New assets are often designed with too many handwash basins, meaning that some are left unused, thus increasing the risk of water stagnation and contamination. In this case, it’s about finding the right balance between the need to encourage hand hygiene compliance without over-provision. This question demonstrates that, for designers, specifiers, and contractors, the right decision often isn’t always the most intuitive, and establishing the competence and confidence to put patients first requires input from clinicians
September 2024 Health Estate Journal 53
AdobeStock / karrastock
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68 |
Page 69 |
Page 70 |
Page 71 |
Page 72 |
Page 73 |
Page 74 |
Page 75 |
Page 76 |
Page 77 |
Page 78 |
Page 79 |
Page 80 |
Page 81 |
Page 82 |
Page 83 |
Page 84 |
Page 85 |
Page 86 |
Page 87 |
Page 88 |
Page 89 |
Page 90 |
Page 91 |
Page 92 |
Page 93 |
Page 94 |
Page 95 |
Page 96 |
Page 97 |
Page 98 |
Page 99 |
Page 100 |
Page 101 |
Page 102 |
Page 103 |
Page 104 |
Page 105 |
Page 106 |
Page 107 |
Page 108 |
Page 109 |
Page 110 |
Page 111 |
Page 112 |
Page 113 |
Page 114 |
Page 115 |
Page 116 |
Page 117 |
Page 118 |
Page 119 |
Page 120
