Water outlets that are used infrequently or not at all may present a transmission risk from stagnant water and have the ability to contaminate the wider water system. Consideration should be given to removal of the outlet where there is no longer a clinical need for it. See SHTM 04-01 Parts A & B for further information.
Clinical sinks including wash hand basins – safe practice points
Below is an educational animation which focuses on clinical wash hand basins (CWHBs), their intended purpose, water associated infection risks, and what we all can do together to reduce this risk. The animation is supported by a poster for use beside CWHBs to locally promote good practice for health and care staff as well as the general public who may visit those settings.
Animation: Good practice for clinical wash hand basins
Poster: Good practice for clinical wash hand basins
- All clinical sinks and CWHBs should conform to SHTM 64.
- There should be enough space in the sink to allow the required activity to be performed without touching the basin sides, fixtures, or fittings (for example, taps), including whilst point of use (POU) filters are installed.
- When filling equipment such as patient wash bowls these items should not touch the taps, POU filter, basin sides or drain outlet.
- Water flowing from the tap should not be able to flow directly into the drain as this can cause splashing.
- Hand hygiene product dispensers should be placed so that the contents cannot leak or spill into/onto water outlets.
- Clinical wash hand basins should only be used for the purpose of performing hand hygiene.
- Clinical wash hand basins should not be used for disposal of any foodstuffs, drinks, bodily fluids, clinical or medicinal waste.
- Do not wash or place medical or patient care equipment in clinical wash hand basins, patient sinks, showers or baths.
- Equipment should not be stored on or near to the sink.
- Personal items (for example toothpaste, cosmetics) should not be stored on the sink.
Showers
- Shower heads and hoses should be allowed to drain after use so that water is not retained in a loop in the hose
- The shower hose should not be long enough to allow the shower head to touch the shower drain or floor.
- Showers should be included in the flushing programme.
Staff should report any problems or concerns regarding the safety, maintenance, usage, and cleanliness of water outlets to the appropriate service for example estates and facilities department/ancillary staff.
Surface contamination from spraying or splashing during water outlet use
Water flowing from taps during use should not create any splashing onto surrounding surfaces or equipment.
- Drug preparation, aseptic or other clinical procedures should not be carried out in close proximity to sinks, water outlets or within surrounding areas where splashing may occur.
- Splash zones may occur up to 2 metres from the water outlet, however risks should still be considered in areas where splash or spray exceeds this distance to manage these risks locally.
- Other factors to consider include the environmental layout, location of equipment (fixed and moveable), placement of patients, whether patients are high risk, and the activities to be undertaken.
- If there is splashing of surrounding areas and relocation or reconfiguration of the water outlet is not possible, physical barriers such as impermeable, wipeable screens capable of withstanding cleaning agents can be considered.
Flushing
Flushing of taps should be undertaken at all outlets (See SHTM 04-01 Part B) including little used outlets and outlets within low occupancy areas.
All departments should identify a responsible person to ensure that flushing of all outlets are being performed in their areas as specified, in practice this may be the Senior Charge Nurse, Clinical Lead or domestic manager.
- In high-risk settings, all outlets should be flushed at least daily for one minute.
- In all other settings, all outlets should be flushed twice weekly as a minimum for at least three minutes in occupied buildings and should be based on local risk assessment, taking into account the local water pressure, temperature and flow rate.
- For any outlet currently fitted with a POU filter, the filter should not be removed in order undertake flushing.
- Outlet flushing should not cause splashing/spraying beyond the outlet. If flushing creates splashing or spraying onto adjacent surfaces, the area should be cleaned/disinfected (as per NIPCM Chapter 1) to reduce the risk of contamination and slippages and falls.
- Records should be maintained to demonstrate that flushing has been undertaken and for the appropriate duration.
- Using a pre-existing daily schedule to incorporate flushing, for example the local domestic cleaning schedule, can increase compliance.
- All staff involved with flushing responsibilities should be appropriately trained.