Ms Kelly Ryan1, Ms Laura Murphy1, Ms Pauline Bass3, A/Prof Andrew Stewardson3, Mr Bradley Wilson1, Ms Anna Katsanevas1, Ms Tania Birthisel1, Prof Steve McGloughlin1,2
1Department of Intensive Care, The Alfred Hospital, Melbourne, Australia, 2Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia, 3Department of Infectious Disease, The Alfred Hospital and Monash University School of Translational Medicine, Melbourne, Australia
Biography:
An experienced critical care nurse with over 10 years in the Intensive Care Unit (ICU). I’m currently working as an Infection Prevention Clinical Nurse Consultant in ICU. I’m passionate about infection prevention and sustainability. I’m committed to improving patient outcomes through evidence-based practice, quality improvement, and sustainable healthcare initiatives.
Abstract:
Introduction
Emerging evidence links waterless care in Intensive Care Units (ICU) to fewer gram-negative infections when these organisms are detected in sinks. The Alfred ICU relies on a sink decontamination program to control the colonisation of its clinical hand basins. For an upcoming ICU redevelopment, waterless rooms are being considered. This pilot trial aims to assess workflow changes and gather invaluable bedside nursing feedback.
Method
For five days, six ICU cubicles had their sinks closed off and alternative water free products and bottled water provided. Staff received background information and the proposed waterless care workflows and were encouraged to complete an anonymous survey after each shift.
Results
From the 17 survey responses, 76% (n= 13) agreed waterless care is something they could adapt to. Staff reported leaving the room on average 4.5 times per 12 hour shift to wash their hands with soap and water and 3.5 times to empty fluid waste. Product concerns included patient experience, insufficient solution in wipes and shower caps, and difficulty cleaning heavily soiled areas, particularly dried blood. Key workflow concerns included lack of warmed water, the need to leave the room more frequently, and despite an existing sink hygiene program, many staff continue to rely on clinical sinks for fluid disposal.
Conclusion
Bedside nursing feedback on workflow changes is vital to support implementation and identify potential issues. Alongside product selection, the proximity of sinks and access to fluid waste disposal areas outside ICU rooms are critical considerations when designing sink-free ICU rooms.