A practical approach to ensuring safe water

The Pall Medical-sponsored event provided plenty of ‘food for thought’ for estates and facilities personnel responsible for hospital water systems, and clearly demonstrated how difficult and persistent a foe organisms such as Pseudomonas aeruginosa and Legionella pneumophila, which, if left unchecked, pose significant patient health risks, can be.

Infection with Pseudomonas aeruginosa has long been considered an endemic hazard for vulnerable patients on intensive and augmented care units, but the problem was catapulted into the limelight earlier this year with the tragic deaths of four babies in neonatal units in Northern Ireland (HEJ – May and June 2012). As investigations firmly established the source of infection as tap water, a flurry of new guidance – from the Regulation and Quality Improvement Authority (RQIA) in Northern Ireland,1 and the Department of Health (DH) in England and Wales2 – set out definitive guidelines that acknowledge the potential role of contaminated hospital water in the transmission of Pseudomonas to patients. The latest DH advice,2 published in late March, builds on previous 2010 guidelines, issued following earlier incidents in augmented care wards, where tap water was identified as the source of persistent colonisation with pseudomonad bacteria. The new guidelines emphasise the importance of water monitoring via regular sampling, risk assessment, water safety plans, and best practice hand hygiene. If potential water contamination problems are detected, recommendations include use of an alcohol hand rub to supplement handwashing, and of sterile or filtered water, or water from a known, bacteriafree source. Point-of-use (POU) filters are also recommended, long-term in some cases.

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