If you’re concerned with managing the risk of Legionella in a Healthcare Facility or Hospital, creating and maintaining your Water Management Plan and its accompanying Emergency Contingency section is your main focus. 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.
The Emergency contingency section is driven by one class of serious situation; the presence of aerosolized legionella. That situation will be discovered either through patient presentation or through a water sample test that shows unacceptably high levels of Legionella. 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.
Hospital and 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 patient 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 and that costs staff time as well as the cost to procure.
An alternative to turning off the water once Legionella has been discovered in a specific area is to use Point of Use filters. 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 areas including Oncology, Neo-Natal, and Intensive care. Should a patient present, or samples indicate an unacceptably high level elsewhere within the facility, these high-risk populations 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.
References:
CDC, EPA, and American Water Works Association – Emergency Water Supply guide for Hospitals and Healthcare Facilities
General Legionella risk reduction information – www.aquamedix.net/resources/
