Infection Control & Water Seminars

Understanding how thermostatic controls operate

This short paper looks at the risks that Pseudomonas aeruginosa infections pose to our most vulnerable patients; not only the direct effects of infection, but also its role in spreading antimicrobial resistance in our hospitals.. Environmental testing for the bacterium in relation to hospital water services is recommended in national guidance as part of the overall control strategy. This paper looks at some of the potential pitfalls associated with this type of testing, and offers insights into how testing can be achieved more cost effectively and with greater assurances of patient safety.

One third of WCs in public buildings leak. Repairs and maintenance are costly and time consuming and labour costs and water treatment costs are increasing. Cistern-less WC flush systems can save water, reduce maintenance time and prevent bacterial development.
- A recent healthcare case study found that direct flush WCs reduced water consumption 7-fold
- Cistern-less systems are easy to install for new projects and retro-fit, and they require less maintenance
- Direct flush technology reduces the potential for water stagnation and bacterial development

As we move towards smart buildings, we have the ability to create intelligent water systems. These not only monitor conditions to reduce the risks associated with complex hot and cold water installations. They use the information gathered to complete an action to improve system management, whether that’s automated flushing of pipe work, or making data driven small adjustments to water flows on a circulating hot water system.

3 key learning points –

1. What is hydronic balancing
2. Effects of getting it wrong
3. Benefits of digital water management solutions

The presentation will discuss how the South Eastern HSC Trust implemented chemical free water treatment within closed loop LTHW Systems to help reduce the corrosion within the pipework.
The benefits for the Trust will also be discussed this will include financial, environmental and operational benefits.

Understanding the risk of infection transmission within drinking water.
• How UV-C purification, carbonless filtration and advances in design and technology mitigate the risk of infection within drinking water.
• The benefits of providing safe and hygienic drinking water to patients and staff.

Presentation focused on the important features Monocholramine and its superior action within water services.

• Toilet plume generation and its potential for spreading pathogens – Review of current information.
• Unlocking new potential - Vacuum drainage design, construction, operation and flexibility
• Royal Cornwall Hospital – Learnings, project concept to patient experience.

Different regulations and guidelines require a maximum temperature for cold water in plumbing installations between 20 to 25°C to control the growth of Legionella and other water-borne pathogens to minimize the health risk of the water consumers.
Even though these requirements exist, the cold-water temperatures in most installations are checked / controlled inadequate.
Reasons for increased cold-water temperatures are:
- Global warming leads to increased environmental and ground temperatures.
- Increased energy tightness of building envelopes.
- Low / reduced water consumption (water saving fixtures in standard sized installations).
- Design & installation errors.
There are different solutions available to tackle the problem and its different reasons. Before active measures are taken, passive measures should be realized:
- Separate hot from cold pipework.
- Design an installation with minimum water content.
- Sufficient water exchange / no stagnation.
- Cold water circulation and cooling.
As every building is unique, the application of each single or a combination of above solutions can lead to the optimum operation and best economic installation:
- Good comfort - minimal time to tap.
- Good water quality / hygiene.
- Optimum invest and operating cost ratio.
- Space saving.
Experience shows that the water exchange by normal cold water consumption is usually too low to maintain a temperature below required limits. And additional water exchange measures can lead to a high amount of water being wasted to maintain temperature. This depends on the building layout and how well the installation is designed. In such cases a cold water circulation including cooling is a very effective solution. This has been proven in several installations already

Over recent years, new microbiological techniques have amplified both the number and types of organisms identified as part of routine water hygiene monitoring. Increased demands are being placed on Estates staff to further develop water hygiene strategies based on clinical risk rather than a site-wide approach.

A variety of techniques are used to maintain water hygiene across healthcare estates, ranging from simple temperature monitoring of hot and cold services, through to secondary disinfection of biocides such as copper-silver ions, hydrogen peroxide and chlorine dioxide. Often these solutions are delivered across the estate, from a single dosing and control point, backed up by manual testing and monitoring at sentinel outlets across the estate.

In this presentation, Alistair Cameron, CEO of Scotmas Group, a leading provider of chlorine dioxide based disinfection solutions to the NHS examines how new low cost, multi-parameter monitoring equipment available from a variety of manufacturers can be integrated into secondary disinfection systems in order to provide a proportionate response to microbiological challenges in different clinical risk areas.