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WASHROOM INFECTION CONTROL


Improving hygiene and maintaining infection control


Recently, handwashing has taken on a significant role to prevent the spread of pathogens and maintain the nation’s collective health. Personal hygiene has become the number one priority, and in healthcare facilities this applies to caregivers that use scrub-up troughs and handwash stations, as well as to other staff, patients, and visitors, that use washroom facilities. Carole Armstrong, Marketing manager at Delabie UK, looks at some of the latest technological and design solutions for improving hygiene and maintaining infection control.


Hygiene has a major role to play in healthcare washrooms to reduce the risk of contamination, both for the users and for the installation. Caregivers are acutely aware of the importance of handwashing routines in reducing the risk of contamination. Patients and visitors to healthcare facilities are now also more alert to NHS advice to reduce the spread of pathogens by washing hands thoroughly and correctly.


Ergonomic designs promote hygiene In all areas, the key is to prevent retro- contamination by removing any manual contact with the mixers or taps. Simple ergonomics play an essential role. The space under the spout must be sufficient to allow thorough cleaning without inadvertently touching the basin, wall, or taps. An increased drop height reduces the risk of transfer from the hands to the tap, and prevents splashback of contaminated water droplets from the waste. Similarly, the actual method of operating the tap is important. Long, so- called ‘medical’ control levers can be operated by a fist or elbow, which is ideal for patients with reduced mobility. In clinical areas, knee- and foot-operated valves remove the need for manual contact once washing has taken place. However, in public spaces, electronic controls optimise hygiene, removing any physical contact before and after washing, and preventing any transfer of pathogens back to the hands.


Hygiene by design


Not only are our hands facing more scrutiny when it comes to hygiene, but rigorous cleaning protocols are being


Left: A wall-mounted pressure-balancing tap in a clinical setting. Right: A thermostatic mixer for a baby unit.


applied more frequently to ensure that all surfaces are pathogen-free too. Product design therefore plays an important role in cleaning at the point-of-use. For example, wall-mounted mixers and taps are much easier to clean from all angles, even underneath, and simple shapes, with minimal joins or welds, mean fewer niches where dirt can collect and bacteria proliferate.


System hygiene is equally important, especially when it comes to waterborne pathogens such as Legionella spp. and Pseudomonas aeruginosa. Legionella develops in standing water at temperatures of between 25˚C and 45˚C. Pipework and cisterns are susceptible to Legionella development, especially where there is corrosion, sediment, and scale.


The bacteria adhere to any surface and form a protective structure – biofilm – which also provides a source of nutrients. Pseudomonas bacteria develop at temperatures of between 4˚C and 46˚C, with optimal growth between 30˚C and 37˚C. They also need a source of oxygen, colonising the outlet and taking refuge in the biofilm. Ironically, thermal treatments recommended to control Legionella can destabilise the biofilm and release these pathogens into the system, increasing the infection risk. Solutions can be designed into the system to promote hygiene and prevent contamination.


Delabie says that smooth interiors significantly reduce biofilm build-up. 56 Health Estate Journal June 2020


Solutions for point-of-use hygiene Maintaining system hygiene at the point- of-use is relatively straightforward with the right product design. In principle, the water needs to pass from the inlet via the mixing mechanism to the outlet as simply and quickly as possible. At the inlets, copper tails are recommended in healthcare, as the interior walls are smooth, reducing the risk of bacteria adhering. The same applies for the mixer interior.


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