As a nursing home director, you can address the risk of Legionella through the development of a Water Management Plan. The general plan and the subsection devoted to emergency action (Emergency/Contingency Section) is usually the main focus for an institution’s risk reduction efforts. Although they are the current standard for preparing your strategy and tactics, it pays to take a broader perspective and to compare that section with your organization’s Emergency Water Supply Plan (EWSP).
The Emergency/Contingency section of a Water Management Plan is driven by one class of serious situation; the presence of aerosolized Legionella. That situation will be discovered either because a resident presents with Legionnaires or the detection of unacceptably high levels of Legionella in your water. In contrast, the EWSP is driven by any situation that disrupts your water supply.
The approach suggested for creating an EWSP (See full document here) includes an audit and understanding of alternatives, their costs and their times to implement. Comparing the approach between the EWSP and the emergency contingency plan may help you pick countermeasures.
Healthcare facilities can lose 67% – 99% of their capabilities within two hours of losing their water service (See Link above). Therefore, judging solutions by both their time to implement and their cost is vital.
You can rate your Water Management Plan’s recommended emergency actions with the same criteria. If a resident presents, or if unacceptable levels of Legionella are discovered, what’s the cost, what’s the scope, and what’s the time to address the problem? What are the alternatives to restore the supply of water to affected areas?
Bottled water can be stored on-site, Water tanks or jugs can be used but this water must be distributed. Implementing those solutions takes time, staff hours, and disrupts the normal residential lifestyle. Chemical treatments can be used but they take time to work.
During that time your residents will be forced to use alternate water sources for eating, drinking, and bathing.
Point-of-Use Filters can an effective alternative to bottled water or tanks. They are the fastest way to restore water to specific affected areas. No bottled water is needed, and no other water storage need be brought in. No need to unsettle elderly patients or to move very ill patients. Secondary chemical treatments will also work but take time and will hit a much larger area of your facility.
Point of User filters can be used on an on-going basis in high-risk patients/residents. Should a resident present, or samples indicate a high level elsewhere within the facility, these high-risk groups will have another layer of protection.
Finally, the EWSP is a plan to prevent against loss of function when things go wrong. Consider the Water Management Plan’s Emergency Contingency section as a special case within it.
General Legionella risk reduction information – www.aquamedix.net/resources/
