Sick sink syndrome: A cautionary tale on the impact of sustainability and climate resilience measures in a newly constructed hospital.
Louise Aiton1, Richard BartoloMaureen Canning Marion Kainer Candice DouglassAnie EdwardHannah Marsden Rachel McInnesMonique Sammut Adrian Tramontana1Western Health, Melbourne, VIC, Australia
Background
October 2022, Infection Prevention (IP) were notified of biofilm in Newborn Services (NBS) precinct. IP identified 484 sinks affected and polymer bottle traps fitted throughout the 4-year-old facility. Remedial action was undertaken including replacement of traps, removal of fixed grate strainers, steam cleaning, and chemical disinfection. Concurrently a neonate developed a Serratia marcescens bacteraemia.
Actions
Sink auditing by IP identified widespread biofilm issues. Linked sinks were swabbed, neonatal point prevalence screening was done. Sink steam cleaning, chemical disinfection trial and environmental auditing were completed. One-way removable grate strainers, replacement of polymer traps with brass equivalent and laminar flow fittings were installed. External engineering consultation included development of a computational fluid dynamic (CFD) model, review of water flows, hygiene flushes and tap fittings noting WELS rating 6.
Results
3 neonates tested positive for Serratia marcescens with 2 sinks confirmed from genotyping. 50% of sinks had evidence of biofilm present in facility. Steam treatment proved effective but suppressive only. Water practices review identified opportunities for improvement with broad awareness campaign. CFD informed engineering controls with water flows. Noncompliance of fixtures with AS/NZS 3500 was identified.
Conclusion
Actions to reduce the impact of climate change with requirement for new builds to achieve ≥5-star NABERS energy rating and guidelines to install water efficiency fixtures creates risks to patient safety and challenges for IP teams. Biofilm issues related to sustainability are challenging to risk mitigate and require effective long-term remedial solutions. IP are a critical part of early consultation to balance risks from sustainability.
Biography
A registered nurse for 30 years, Louise has experience in ICU and has previously held NUM and AHA roles. With extensive experience as an Infection Prevention Consultant over 11 years in both the private and public sectors, she commenced at Western Health in mid 2021 operationalizing the Contact Tracing during peak periods. With a strong focus and expertise in education, facility construction, risk mitigation activities, ASNZ:4178, Standard 3 implementation and project management, she took on the IP Lead for the biofilm risk mitigation project for 6 months for Western Health in 2023 in a multidisciplinary collaboration with key stakeholders.