Water quality management plans Sarah Bailey #HFMC17 #HFMC17 - - PowerPoint PPT Presentation

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Water quality management plans Sarah Bailey #HFMC17 #HFMC17 - - PowerPoint PPT Presentation

Mar 25, 2024 318 likes •618 views

Water quality management plans Sarah Bailey #HFMC17 #HFMC17 #HFMC17 #HFMC17 #HFMC17 #HFMC17 #HFMC17 #HFMC17 http://www.qed.com.au/sites/default/files/ 39_104_Legionella_Risk_Management_Whitepaper.pdf #HFMC17 En health En health

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#HFMC17

Sarah Bailey

Water quality management plans

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#HFMC17

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#HFMC17

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#HFMC17

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#HFMC17

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#HFMC17

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#HFMC17

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#HFMC17

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#HFMC17

http://www.qed.com.au/sites/default/files/ 39_104_Legionella_Risk_Management_Whitepaper.pdf

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#HFMC17

  • En health guidelines released in 2015
  • Guidelines sit over the top of each States’ regulatory framework.
  • Applies to all water systems except Cooling Towers
  • Provide a template Risk Management plan online

En health

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#HFMC17

– System analysis – Components – Other connected systems – Outlets – Construction Materials – Temperature – Previous testing

En Health

Concentrate on proactively managing risk, rather than reacting to positive testing results

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#HFMC17

Why is it important? – Outbreaks – Hard to trace – Hard to diagnose – High mortality rate – High rate of ICU admission

What is Legionella?

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#HFMC17

  • Middle to Advanced age
  • Male
  • Smoking
  • Chronic heart or lung disease
  • Immunocompromised hosts / Diabetes
  • Hematologic malignancies
  • End-stage renal disease
  • Alcohol abuse

Risk factors

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#HFMC17

  • Cooling systems
  • Warm water systems
  • Showers
  • Decorative fountains
  • Humidifiers
  • Respiratory therapy equipment
  • Whirlpool spas
  • Ice machines
  • Potting soil
  • Compost
  • Roadside puddles
  • Commercial car wash systems

https://i.ytimg.com/vi/k6MsxVs9exg/maxresdefault.jpg http://www.airsolutionz.co.nz/wp-content/uploads/2013/10/cooling-towers.jpg http://homeprosontheweb.com/wp-content/uploads/2013/11/hard-water-shower-head.jpg

Sources

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#HFMC17

  • Temperatures of 20-42°C
  • Stagnation
  • Nutrient growth
  • Poor water quality
  • Scale and sediment
  • Presence of other organisms

Risks for Legionella proliferation

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#HFMC17 NSW Code of Practice for the Control of Legionnaires’ Disease 2004

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  • Stenotrophomonas maltophila
  • Serratia marcescens
  • Enterobacter spp.
  • Cryptosporidium
  • Non tuberculosis Mycobacteria (NTM)
  • Mycobacterium chimera

Other microorganisms of concern

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#HFMC17

  • Respiratory disease
  • Skin infections
  • Burns infections
  • Resistant to antibiotics
  • Water borne
  • Tap fittings
  • Mops and cloths
  • Flowers

Pseudomonas aeruginosa

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#HFMC17

  • Water quality
  • Supply
  • Emergency planning - supply
  • Uses of water
  • The distribution system
  • Design
  • Monitoring
  • Emergency planning - detections

Developing a risk management plan

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#HFMC17

  • Potable water quality – know your source
  • Above drinking water standards

– Assess the risk of the patients who are supplied

  • Oncology (Chemotherapy)
  • Newborns
  • Older people
  • Immunosuppressed patients
  • Respiratory patients.

Water quality

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  • What will you do if you have no supply?
  • Is your alternative water source safe for all uses?
  • How are you going to transition back to mains water?

Emergency Planning

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#HFMC17

Know your system – Schematics – Outlets – Bores – TMVs – Strainers – Pipework materials – New fittings

System knowledge

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#HFMC17

Take water quality into account at the design process – Warm and hot water systems – Don’t fill the building with water too soon – Selection of fittings – Where the services go

Design

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  • Showering
  • Drinking
  • Food preparation
  • Ice machines
  • Water features
  • Disinfection equipment
  • Condensed steam
  • RO water
  • Heater coolers
  • Humidifiers
  • Misters
  • Cooling
  • Heating

Uses of water

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  • Management training
  • Infection control training
  • Cleaning staff training
  • Plumbing staff and contractor training.

– Ownership of the wards and hospital – Reporting mechanism for problems

Ownership and training

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Operational monitoring – Ensures that the controls are effective

  • Eg, residual chlorine, temperature, pH, turbidity

Verification monitoring – To detect general colonisation – To determine effectiveness of control strategy

  • Legionella testing
  • Other microbial testing

Monitoring

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  • Know who needs to be notified
  • Have a plan in place

– Media liaison – Medical advice – Infection Control

Emergency management - Detections

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  • Removal of aerators from taps
  • No mist generating devices
  • Low aerosol producing showers
  • Microfiltration to remove bacteria from water
  • Aerosol management
  • Avoiding water chillers and ice machines

Exposure controls

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  • Whole of facility should be involved
  • Know your water distribution system
  • Know your supply
  • Testing is only part of the plan
  • Compliance doesn’t mean everything is OK
  • Living document

Overview