FROM PLUMBING TO PATIENTS
J. Darrel Hicks
Owner at Safe, Clean and Disinfected
July 8, 2024
On July 3, 2024 the Centers for Disease Prevention and Control (CDC) published “Considerations for Reducing Risks: Water in Healthcare Facilities.”
Water management programs in healthcare facilities are an important way to help protect vulnerable patient populations as well as staff and visitors. The Centers for Medicare & Medicaid Services, The Joint Commission, The Veterans Health Administration, and CDC consider it essential that hospitals and nursing homes have a water management program that is aligned with American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE) industry standards1 and limit Opportunistic Pathogens of Premise Plumbing from growing and spreading in their facility.
There is a compelling number of scientific studies implicating poorly designed sinks in the patient-care environment. These poorly designed sinks are part of an entire system of outdated premise plumbing that is a superhighway for pathogens in a hospital.
Since the advent of indoor plumbing, the impact on health and sanitation has been monumental, no doubt. However, since the discovery of the p-trap nearly 200 years ago, very little has been done to build upon that original design.
Sinks, particularly the pipes that drain them, are ideal places for bacteria to proliferate. The “bugs” form what are known as biofilms-colonies where they gang together and attach to the surface of pipes below the sink drain.
On April 11, 2024, the American Journal of Infection Control published the infection prevention steps taken to control a months-long multispecies outbreak of carbapenemase-producing Enterobacterales (CPE) that occurred in a pediatric ward at the Toho University Omori Medical Center in Tokyo in 2017.
This study highlights the vulnerability for contamination through sinks and other water sources: even replacing all sinks in the ward did not stop this outbreak.
The full article is here: https://apic.org/transmission-risk-of-multidrug-resistant-bacteria-appears-highest-in-hospital-sinks
Besides replacing all the sinks in the ward, other measures implemented by the infection control team-composed of doctors, nurses, pharmacists, and microbiologists included recommending hand disinfection after using sinks, introducing disposable tools for cleaning sinks, prohibiting mouth-washing with sink water, enacting disinfection and drying procedures to any items exposed to sink water, and more.
“After months of intense infection control protocols, we were at last able to declare an end to this outbreak,” said Sadako Yoshizawa, MD, PhD, Associate Professor in the Department of Microbiology and Infectious Diseases at Toho University Omori School of Medicine, and corresponding author of this study. “Our experience highlights the importance of focusing on sinks and other water-related areas in hospital wards, as these are critical for CPE transmission and therefore major fronts in the fight against antibiotic resistance.”
Conclusion: This report highlights the importance of biofilms and of sink and patient room design in the propagation of an outbreak and suggests some strategies to reduce the risks associated with hospital sinks.
Outbreaks of hospital sink-related infections involve a diverse spectrum of microorganisms (e.g., gram negative pathogens). They can be attributed to defects in sink design and hospital wastewater systems that promote the formation and dispersion of biofilm.
The CDC toolkit encourages facilities to conduct a water infection control risk assessment that should consider the various pathways that might lead to patients becoming exposed to waterborne pathogens, in relation to ingestion, hygiene, and clinical care. Healthcare facilities can use a Water Infection Control Risk Assessment (WICRA) to evaluate water sources, modes of transmission, patient susceptibility, patient exposure, and program preparedness in their facilities.
Reduce Exposure to Sinks and Drains
Emphasis should be placed on optimizing best practices in sink design and placement to prevent infections. Hospitals should consider developing a rational surveillance and prevention strategy based on the current design and state of their sinks.
As more and more hospitals become aware of the potential for bacteria and “super bug” contamination from their plumbing systems, the industry is responding by developing new fixtures and systems that reduce or eliminate the potential of infection. These include implementing UV lights, low-splash sinks, and exhaust in fixtures, as well as automatic injection of sanitizing agents.
Of course, these more sophisticated fixtures’ planning, design and installation require infrastructure to support their associated strategies. Electrical and exhaust connections, along with new piping systems and other central systems, bolster the different strategies that are designed to reduce infection in the care environment. Reimagining an entire system from the ground up can drive up construction costs, but in the end reduce the overall costs of healthcare.
Existing drain disinfection chemistries and technologies are not effective at killing bacteria in drains and they depend on employees who perform the service. Efforts to disinfect drains have included complete replacement of the sink or its components, installing self-cleaning traps, disinfection with processed steam, enhanced manual cleaning, descaling of pipes, and disinfection with chlorine-based solutions or other liquid disinfectants. It’s important to note that liquid disinfectants do not encounter the surface of the drain long enough to meet the contact time needed to kill the bacteria.
INTRODUCING THE SAFE HEALTH SOLUTIONS
ReSET265 SINK’S FEATURES
· CURVED SURFACE-this sink has implemented a curved surface to reduce splash by coordinating and matching the exact location of the surface with the discharge location of the faucet. This design eliminates the splash that contaminates clothing/uniforms and the surfaces up to 36” surrounding the sink.
· EXHAUST-First sink to ever incorporate exhaust through the basin into a negative pressure air chamber (ante room) above the sink trap.
· GERMICIDAL ULTRA-VIOLET LIGHT-First sink to implement continuous automated disinfection by utilizing germicidal ultra-violet lights within the negatively pressurized chamber (ante room) to kill bacteria located within the drain trap and within the ante room before they have a chance to contaminate the sink basin used by patients or hospital staff.
· SANITIZING AGENT-First time a sink using one or more sanitizing agent injectors at various locations throughout the open cavity and/or into the exhaust port to help clean the surfaces of the open cavity and the exhaust port.
· SMART CONTROLS-A central control system has been implemented to provide monitoring and control to ensure that the features of the sink are functioning according to their intended design.
Click here to view a short video to see the ReSet265 sink in action.
SO, WHAT’S NEXT
1. Contact Us-We’d love to answer any questions you have and provide custom pricing for your specific needs.
2. Schedule an Install-After placing an order, our sinks are ready to be installed by a plumbing company of your choice.
3. Start Saving Lives-Initial research has shown this sink to be effective at killing and 99% of germs in hospital sink drains while preventing the formation of biofilm that has been implicated in patient morbidity and mortality.
For more information on the pricing of our sinks and a custom solution for your hospital, complete the form and somebody will quickly respond.
Or call Tom Hicks (402) 981-6365