infection control
Rada business director, Eoin McQuone, discusses the recent revisions by the Department of Health (DOH) to memorandum HTM 04-01: Safe water in healthcare premises and what this means for preventing waterborne infections and delivering efficiencies in healthcare facilities
Prevention is better than cure
I
n recent years, healthcare-associated infections (HCAIs) have become better understood because of exhaustive
investigations, wider engagement within the water systems community, and a number of well-documented cases. The World Health Organization
(WHO) points to the scale of the challenge: with more than six million cases of HCAIs occurring in the US and Europe each year. Around 136,000 of these cases will
result in the death of a patient; with 5,000 lives lost every year in England and Wales. In England alone this is estimated to
cost the NHS £1billion a year, with infected patients costing three times more to treat than those who are uninfected.
Taking control We know hospital water systems can become a source of pathogens and
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bacteria, and are a probable source of nosocomial infections. Of the multiple Gram-negative
bacteria that persist in healthcare, Pseudomonas aeruginosa and Legionella are the best understood and most well documented. It should come as no surprise, then,
that combating these is a crucial part of managing, operating and maintaining a healthy water system; and the latest guidelines have brought this into sharp focus. Last year, the Department of Health
updated and relaunched its existing documents relating to guidance for safe water in healthcare premises – HTM 04:01 (Parts A-C) 2016. The guidance distinguishes between
control regimes to reduce the risk of Legionella and the growth and colonisation of other waterborne organisms within hospital water
systems, and control regimes for Pseudomonas aeruginosa and other waterborne pathogens. Importantly, what the revised
memorandum does do is move facilities towards a more-holistic management of water and promote good practice in the design, commissioning, and operation of water services in healthcare premises. But what do these guidelines look
like for healthcare professionals on the frontline?
Keeping records As outlined in HTM 04-01 Part A 2016, the risk of a waterborne infection outbreak developing can be reduced by storing water at a temperature of at least 60°C and distributing it so that it reaches outlets at 55°C within one minute. For example, Legionella bacteria
multiply at temperatures between 20°c-45°C, but are killed at higher
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