What are the barriers to safe water in healthcare?

Jimmy Walker, of water hygiene and safety consultancy, Walker on Water, who previously worked for Public Health England as a scientific leader in Water Microbiology and Decontamination, and Dr Mike Weinbren, a Consultant Medical Microbiologist at Sherwood Forest Hospitals NHS Foundation Trust, discuss some of the fundamentals of best practice in keeping hospital water supplies in a safe, clean, and hygienic condition, and minimising the risk of their colonisation with potentially harmful waterborne bacteria.

Water systems in healthcare buildings are inherently complex, and the quality of the water is difficult to control. Water delivered by the water supply company will be wholesome, to comply with quality requirements and ensure that it does not present a health hazard. However, wholesome water is not sterile, and may contains many different types of bacteria, including Legionella spp, Pseudomonas aeruginosa, and non-tuberculous mycobacteria, albeit in low numbers. Once these organisms enter the building water system, they can proliferate to an extent that they will pose a risk to the occupants, and particularly the immunocompromised or those in high dependency units. This article sets out to discuss and graphically demonstrate the barriers to safe water in healthcare, and to describe inherent risks and hazards, including of human factors, and how a well-managed and trained Water Safety Group can identify and control these issues.

Introduction