.png)
The water in hospitals should be safe. Unfortunately, poor water management in healthcare facilities places patients (and those who visit them) at risk of severe illness or even death every day.
The Center for Disease Control and Prevention (CDC) linked healthcare-associated infections (HAIs) to waterborne pathogens like Legionella. Pathogens like these account for 30% of HAI cases. The CDC has begun focusing on antimicrobial resistance (AMR) in water and the risk to public health.
Along with the public health risks, HAIs take an economic toll on the healthcare system. That's why building managers and medical administrators must prioritize water management in healthcare facilities. What's your plan?
Key Takeaways:
- In 2022, new water management standards went into effect, requiring medical facilities and other organizations to find methods for reducing pathogenic agents from water supplies.
- You will need to establish a team of people at your facility to organize the water management program. This team will need to map out your building water system.
- Your team will need to identify hazards, opportunistic pathogens, and their source of entry. They will also need to conduct infection control risk assessments.
- Control point identification and measurements and setting control limits will ensure accurate samples and testing.
- Establish an outbreak and contingency plan should infections occur. You must also determine if your water management plan is effective.
Water Management in Hospitals and Healthcare Facilities
In 2018, an outbreak of a potentially fatal waterborne bacteria called Legionella led to a reform in testing public water sources. Researchers discovered that additional critical control points were needed when testing water supplies for waterborne pathogens.
Making the water safe at healthcare facilities became the priority of health organizations around the country. In January 2022, new water management standards went into effect, requiring organizations to minimize pathogenic agents from water supplies.
Furthermore, medical facilities must prove they have an effective Water Management Plan to earn their accreditations. The CDC has a Healthcare Facility Water Management Program checklist to assist these organizations in developing an all-hazard approach to water management in healthcare facilities.
The goal is to make public water safe, especially in medical facilities. Some of the population's most vulnerable citizens receive care in these institutions. It's essential to have a uniform method for mitigating the risks water poses to those treated in (or visiting) these facilities.
Healthcare Facility Water Management Program Checklist
The purpose of the CDC water management program checklist is to make water safer and to know how to manage an outbreak. Installing sustainable bathroom fixtures will help mitigate risks, especially when replacing old, lead-based fixtures from aging facilities.
When developing your water management program, understand that you may need a comprehensive plan depending on the complexities of your building plumbing systems. Also, these plans must include areas in the system for identifying control points and methods for monitoring these areas.
Here's how to get started developing your water management plan:
Establish Your Team
When establishing your team, determine what methods of communication will work best for all involved. Communication should facilitate dialogue between water utility providers and the local health department representative (when needed).
Define roles and responsibilities for everyone on the team. You should have:
- Facility administrator (member of the c-suite, director, or owner)
- Facility manager
- Engineer
- Infection prevention staff
Map Out Your Building Water Systems
Your water management team will want to map out the building's water systems. They will need to do this for every building on the medical campus. There must be text descriptions and a flow diagram that describes each water system component.
Identify External Hazards
Next, the water management program team will need to identify external hazards – anywhere with a compromised water supply – and outline plans to mitigate these events and manage them if infection occurs. Events to monitor include:
- Determination of trace amounts upon building entry
- Locations of any water main breaks
- Low-pressure events
- Hydrant flushing requirements (and schedule)
- When there is a "boil water advisory"
- Whether there is any nearby construction
Identify Opportunistic Pathogens
Opportunistic pathogens are responsible for many hospitalizations and deaths each year and cost an estimated $2.39 billion in healthcare expenses. They attack those with already-compromised immune systems. Your team must be able to identify how these opportunistic pathogens are infecting patients.
Biofilm-associated pathogens include pseudomonas, Legionella, nontuberculous mycobacteria, Salmonella, and Escherichia coli, to name a few. Common places opportunistic pathogens grow and spread include:
- Water storage tanks
- Areas of stagnation
- Hand-held showerheads
- Faucets with aerators
- Commodes
- Sinks
- Areas with temperatures that support microbial growth
Conduct an Infection Control Risk Assessment (ICRA)
An ICRA works to prevent the spread of infection among patients in healthcare settings. The CDC offers an ICRA tool to help your facility determine areas where greater prevention is necessary and assess prevention practices, policies, and protocols. Keep in mind, you will also need an environmental assessment to determine all potential hazards.
Identify Control Points and Measurements
Water management teams should also identify control point locations and assess how to apply control measures using the ICRA and environmental assessments. Here are some examples of how to monitor control measures:
- Water temperature
- Heterotrophic plate count (HPC)
- Total Organic Carbon
- Residual disinfectant
Your team must also review trend data. They must be able to report abnormal results, determine the frequency of monitoring, and set control limits. That includes eliminating any unused branches of the plumbing system.
Establish an Outbreak Plan
If an outbreak occurs, your team must possess the ability to detect, investigate, and respond to infection events. They must also be able to link it to a specific water source. They will do this by collecting epidemiologically linked samples.
The team will need to notify the Health Department, arrange for molecular typing, and reassess water control methods. Your water management program team can determine the plan's effectiveness during this time.
Healthy Buildings Begin with Sustainable Plumbing Products
Bacteria in municipal water supplies pose a significant risk to anyone receiving treatment at hospitals, clinics, and healthcare facilities. Protect vulnerable patients with the BioArmor® UV-C Disinfection System from Chicago Faucets.
Learn more about this amazing chemical-free system:
At Chicago Faucets, our mission is to help establish healthy buildings for a more sustainable future. Not only do we make durable plumbing products. Our manufacturing process involves sustainable practices that are more eco-friendly because we care about the environment and public health and safety.
Contact us today to learn more about how we can help you operate a healthier healthcare facility.
