Healthcare Plumbing And Piping:
Coming Clean On Sink Specifications
Society is increasingly becoming aware of all of the ways people contaminate their hands, but even still, many people do not wash when they know they should. For example, the American Society for Microbiology says that only two out of three people wash their hands after using a restroom, although 95 percent of people claim they do.
Personal health aside, these types of hygiene lapses are much more serious than a simple turn-off in healthcare settings. In fact, clean hands are the single most important factor in preventing the spread of dangerous germs and antibiotic resistance.
According to the Centers for Disease Control and Prevention (CDC), nearly 2 million patients in the United States get an infection in hospitals, and about 90,000 of these patients die as a result of their infection each year. These are frightening statistics and proof that plumbing professionals should be proactive in selecting the proper hand-washing equipment that will improve hygiene and help prevent the spread of germs and infections in healthcare settings.
Healthcare Hygiene And Faucets Go Hand-In-HandExperts agree that scrubbing hands with soap and using running water for a total wash time of at least 20 seconds does an effective job of removing bacteria. Installing easy-to-use electronic faucets in public and employee restrooms can boost hand-washing rates. As opposed to manually operated models, electronic faucets activate automatically for sanitary, touch-free operation, which eliminates human contact with germ-ridden fixtures.
Electronic faucets offer the added bonus in high-use settings of cutting down on the wear and tear of faucet components and reducing water waste resulting from users who “forget” to turn off the water when done.
Drying hands completely is also key to good hygiene, and like electronic faucets, sensor-operated hand dryers encourage use while doing away with buttons where bacteria can collect.
Another product category to consider is automatic soap-dispensing systems, which can be combined with electronic faucets. Ideal for all healthcare and institutional settings, sensor-operated soap-dispensing systems deliver a pre-measured amount of soap on demand and most models employ LEDs to indicate when soap cartridges need changing — ensuring hand-washing soap is always available.
One more source of germs and bacteria to consider in healthcare settings is the bedpan. A study conducted by the Veterans’ Affairs Medical Center in Durham, N.C., demonstrated links between bedpan cleaning and reuse, and environment contamination. The study examined a contaminated bedpan that was cleaned using a hand-held sprayer in an open hopper sink (the method currently used by nursing staff).
Study administrators applied oil-based Glo-germ and performed a black light test to identify where remaining contamination was present. Alarmingly, the black light showed contamination on the hopper sink, walls, floor and spraywand, as well as the caregiver’s gloves, clothing and shoes — although they appeared clean to the naked eye.
An alternative option to conventional handling is using a Flushometer bedpan washer that can eliminate unsanitary hose sprays and the additional housekeeping that hoses require, as well as reducing the potential of patients slipping.
Improving Hygiene In HealthcareOne might expect healthcare professionals to follow more rigorous hygiene standards than the general public. But countless cases have emerged in recent years of patients who have either become seriously ill — or have even died — as a result of coming in contact with infectious diseases or contaminants that have been spread due to healthcare practitioners’ lax hygiene procedures.
A recent expose on unhealthy hospitals conducted by the Chicago Tribune found that nearly half of Illinois’ 305 hospitals have been cited for potentially life-threatening breakdowns of infection-control standards since 1995 — and this is happening nationwide.
The article series linked numerous cases of illnesses and deaths to preventable hygiene problems such as unclean hands. In one Detroit hospital, for example, doctors and nurses moved about the pediatric intensive-care unit without washing hands. Infections killed four babies in the same row of bassinets.
While the public has been relatively sheltered from the horror stories concerning these illnesses and deaths at a number of prominent hospitals across the country, hospitals and other healthcare facilities are nevertheless feeling pressure to take more proactive infection-control measures.
Even though doctors and nurses know better than most people about how to stop the spread of germs, hospitals are finding that they have to hammer home to them the message about one of the most fundamental, yet effective ways to reduce infection rates: proper hand-washing.
According to the CDC, hand washing has been shown to terminate outbreaks in healthcare facilities, to minimize transmission of antimicrobial-resistant organisms and to reduce overall infection rates. In reaction to highly publicized cases of patients that have been sickened by unsanitary hospital environments or improper patient-handling procedures — or perhaps out of fear that they will be yet another defendant in a series of negligence lawsuits — healthcare facilities are paying greater attention to the issue.
Hospitals that may have laid off infection-control professionals due to tight operating budgets are beginning to realize that these positions are too important to the health of their patients — not to mention their bottom line — to be considered unnecessary baggage. Other hospitals are undergoing facility-wide campaigns, educating healthcare workers about the importance of washing their hands.
Hospital management can set rules for where, when and how healthcare workers should wash their hands and hang up all the educational posters it wants to make employees think twice before engaging in unsanitary practices that put patients at risk. But rules and educational campaigns mean little unless they are backed by hand-washing equipment that enables workers to conveniently and efficiently comply with these measures. Hygiene experts, including the CDC, strongly suggest specifying equipment that employees will most readily adopt for everyday use.
Electronic faucets are a practical and suitable choice for healthcare facilities for many of the same reasons that they work well in other settings with large populations. Moreover, some models deploy timers that signal to users when they have completed the recommended hand-washing protocol. For surgeons or other healthcare professionals who should wash up to their elbows before attending to patients, the infrared sensors in some scrub sinks and hand-washing stations have built-in enhanced detection zones that detect over a wider zone than that normally deployed in standard electronic faucets to ensure proper washing continues above the wrist.
Hygiene doesn’t necessarily stop once the user is done: Some hand-washing stations are now optionally programmed for an extended delivery period of water after users have removed their hands from the detection zone. Providing 20 seconds of rinse time for the sink area helps cleanse the sink, which is a time-saver, as well as a hygienic bonus, for subsequent users.
The importance of individuals’ infection-control measures notwithstanding, sink design is also integral to stopping the spread of infection. Below-deck electronics, for example, help protect units from invasive contaminants.
Other sink design features — such as stainless-steel construction that enables sinks to be completely washed down, seamless welds that minimize surface areas where bacteria collects, sloping bottom surfaces and raised outer rims that reduce splashing and dripping, and knee-actuated soap dispensers — also go a long way toward enabling healthcare facilities to maintain high standards of cleanliness.
The Importance Of Accessibility And DesignWhen installing sinks and other hand-washing equipment, placement is also critical. CDC studies indicate that the frequency of hand washing is affected by the accessibility of hand-hygiene facilities. In certain healthcare facilities, only one sink is available in rooms with several patients, or sinks are located far away from the door of the room, which may discourage hand washing by personnel leaving the room.
It may be tempting to have as few sinks as possible to keep costs down, but the CDC recommends that healthcare facility specifiers put expenditures for hand-hygiene products into perspective: Estimated hospital costs resulting from four or five healthcare-associated infections of average severity — or just one case of high severity — can exceed annual hand-hygiene budgets.
What’s troubling to hear is that the higher the demand for hand hygiene, the lower the adherence to recommended washing procedures — and the high-demand areas are oftentimes the wards caring for the sickest patients. Studies on the issue have found the lowest adherence rate (36 percent) to be in intensive-care units where healthcare workers should wash their hands about 20 times per patient-hour.
In separate studies on hand-hygiene adherence, the CDC found that in 1997, the last year for which it has figures, healthcare workers washed their hands for an average of only 4.7 to 5.3 seconds. In total, only about one-third of all healthcare workers washes for an adequate amount of time.
The CDC concludes that easy access to hand-hygiene supplies, including sinks, is essential for optimal adherence to hand-hygiene recommendations. Thus, accessibility, as well as hand-washing equipment design, are critical considerations for healthcare facilities.