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Best Practices in Water Problems

  • • Keep water temperatures cool or cold in all decorative uses of water, perform frequent cleaning and maintenance, and do not put near high-risk patients.
  • • All water sources where water will be standing or new pipes have been installed should be checked frequently and thoroughly cleaned and maintained in proper order. Bacterial testing should be done where appropriate.
  • • Avoid long runs of pipes and potential dead ends so that water will not collect and microorganisms start to grow.
  • • Make all valves for shutting off and restarting water flow readily accessible and always serviceable.
  • • Clean thoroughly all hydrotherapy tanks between uses by patients and then thoroughly sanitize and air dry. Maintain 15 ppm chlorine residual in the water of hydrotherapy tanks. Routinely culture the tanks especially around the faucets and drains to determine if there is bacterial growth.
  • • Evaluate water used in laboratories and pharmacies on a periodic basis to determine if they are contaminated in any way.
  • • Determine on a monthly basis if water used in hemodialysis contains toxins or bacteria and if so determine the source and eliminate it.
  • • Establish contingency plans for obtaining a substantial quantity of water if there is a break in the potable water system.
  • • Evaluate the pressure and temperature of water fixtures periodically to determine if what is coming out of the unit meets the needs of the special area and if not make necessary corrections.
  • • After a break in the line, if thermal shock treatment is available where the water temperature can be safely raised to between 160°F and 170°F (71-77°C) and kept at this level through 5 minutes of flushing, do so, if not add chlorine overnight so that there is a residual of 2 ppm throughout the system.
  • • In the event of flooding, emergency preparedness plans must be used to produce immediate action to move patients to safe areas, provide emergency generators, provide adequate quantities of potable water, correct the flooding situation, and then use intensive cleaning prior to the return of patients to the area.
  • • Use environmental surveillance and culture potable water on a monthly basis for all types of containers, especially cooling towers, evaporative condensers, showerheads, around faucets and drains, and respiratory therapy equipment, where Legionella or other bacteria or fungi may be possibly growing. If found, institute immediate treatment procedures and retest.
  • • Where microorganisms and chemicals have been removed, use specially treated water in hemodialysis procedures.
  • • Clean thoroughly and disinfect with chlorine solutions, all ice storage chests and ice making machines on a regular basis to avoid growth of microorganisms and use scoops or direct flow of the ice into cups or containers which are kept very clean and sanitized.
  • • Do not store samples of bodily fluids, lunches, chemicals, or anything else in ice storage chests.
  • • Clean thoroughly and disinfect with chlorine all whirlpools and other hydrotherapy tanks, hydrotherapy pools, birthing tanks, and other equipment after each patient usage.
  • • Where water holding reservoirs are used in equipment, have them checked microbiologically on a periodic basis. Determine when it is necessary to flush the water out, clean the equipment, and replace the water.
  • • Frequently change the water in plants and cut flowers in patient care areas to prevent the growth of microorganisms which may already be present on the vegetation.
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