IHEEM REGIONAL CONFERENCE 2018
manufactured pre-cast sandwich panels, and pre-fitted MEP service modules, to help speed construction and enhance quality control. In the presentation’s second section, Katie Evans explained how the project has made extensive use of Bimcollab issue management software, which had so far been used to address some 13,000 project issues, 12,000 of which were already closed. 3D modelling has also been used extensively on this impressive scheme.
Conflicting and arcane advice Continuing to focus on fire safety were Mazin Daoud, Fire Safety engineer at Sodexo and chair of the new Fire Technical Platform, and Mike Ralph, until recently the company’s Technical Services director (Healthcare), but, since early September, Chief Engineer at NHSI. The Sodexo speakers focused on the need to adopt a risk-assessed, evidence- based maintenance approach to fire safety, arguing that advice and stipulations in different regulatory documents and standards can appear conflicting. Focusing on ‘non-compliance’, they questioned what the phrase actually meant, and what those seeking clarification on ‘compliance’ or ‘non-compliance’ should ask, and emphasised that when the term ‘non-compliant’ was used, it was vital to ask ‘With what?’, and ‘How?’. They felt that, ‘often’, the phrase ‘non- compliant’ was used ‘simply to frighten people into getting something done’. Illustrating how unclear and arcane some guidance could be, they quoted from a British standard: ‘As a code of practice this British Standard takes the form of guidance and recommendations. It should not be quoted as if it were a specification, and particular care should be taken to ensure that claims of compliance are not misleading.’ Another section from CLG guidance states: ‘In this guide reference is made to British Standards, Department of Health Firecode, and standards provided
David Leverton, Project technical lead at Laing O’Rourke, and his colleague, lead digital engineer, Katie Evans, discussed the design and construction of the £350 million Grange University Hospital at Llanfrechfa Grange near Cwmbran.
by other bodies. The standards referred to are intended for guidance only, and other standards could be used. Reference to any particular standard is not intended to confer a presumption of conformity with the requirements of the Regulatory Reform Order 2005.’
Fire door safety
In a comprehensive conference address, Maz Daoud and Mike Ralph also focused on a ‘risk-based approach to fire door safety’, arguing that, when considering the optimal frequency of planned preventative maintenance for fire doors, there were three main factors to consider: n Criticality; how important are these fire doors?
n Usage; how often do they get used? n Damage; how susceptible are they to it?
The presentation also considered threshold gaps on doors used in healthcare premises, and questioned whether threshold seals or drop-down smoke seals should be fitted to all such doors. Another topic covered was the need for a risk-based approach to inspecting fire compartmentation, particularly given the size of some NHS hospital estates. The final focus was on
the IHEEM Fire Safety Technical Platform’s plans to draw up new technical guidance on the installation and maintenance of fire compartmentation, fire dampers, and fire doors (see also pages 30-34).
Infection issues with drains The penultimate presentation, by Tracy Gauci, co-ordinator of the Welsh Branch of the Infection Prevention Society, Patron to the Association of Healthcare Cleaning Professionals, and deputy Clinical director at Gama Healthcare, was entitled ‘It’s all going down the drain’. The speaker focused on the infection risks and potential for bacterial proliferation ‘once the water leaves the sink, and goes down the drain’ in the clinical environment, considering elements such as the drainage/waste outlet, strainer, P Trap, and near patient drain, and pointing out that handwash sink drains are ‘increasingly implicated as a reservoir/source of antibiotic-resistant gram negative bacteria in hospital outbreaks’.
Sodexo colleagues, Maz Daoud (left), and Mike Ralph, focused on the need to adopt a risk-assessed, evidence-based maintenance approach to fire safety.
Among the key Gram negative bacteria, she explained, were Escherichia coli, Klebsiella, Acinetobacter, Pseudomonas aeruginosa, and Enterobacter, while among the infections such microorganisms caused were pneumonia, bloodstream and urinary tract infections, wound or surgical site infections, and meningitis. Tracy Gauci said: “These Gram-negative bacteria are often resistant to multiple antibiotics, and good both at finding new ways to become resistant, and at sharing those resistance mechanisms that allow other bacteria to become drug-resistant. Some GNB – the Enterobacteriacae – are often referred to as the new ‘superbugs’.” The RGN, who has a BSc in Infection Control, and an MSc in Healthcare Management, drew particular attention to the increasing antibiotic resistance of Carbapenem- resistant Enterobacteriacae (CRE) and Carbapenemase-producing enterobacteriaceae (CPE)... ‘the new superbugs’. She went on to highlight some of the key guidance on the topic in
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