Keeping it Clean

Patient hygiene has never been more important and you don’t have to work in a hospital for a long time to know how easily it can go wrong. But how good are the washing and bathing facilities in NHS hospitals and how can you make yours better?

Nigel Crook is from Gainsborough Specialist Bathing, the UK’s leading manufacturer and retailer of assisted bathing solutions. He says, “As specialists in the manufacture and installation of assisted bathing solutions in a number of hospitals across the UK, we do see that standards and facilities do vary from one Trust to another.  That’s not to say that what is being provided is generally of poor standard, more a question of whether the facilities meet the requirements of patients in the variety of different specialist wards each hospital has.” Says Crook, there’s a balance between managing budgets, providing the right level of features required for moving and handling patients, as well as factoring in infection control considerations: “What we are finding is that in the main, hospitals are bulk purchasing one type of bath for each site without taking into consideration the individual needs of each department.  For example, providing both a bath and a shower, rather than one or the other, means patients have choice, their dignity and independence can be respected.”

Crook says it’s not necessarily a case of essential products and facilities but more a matter of assessing the needs of the patient, the needs of a particular ward and then providing the appropriate bathing options. He says, “It goes without saying that there must be equipment that aids patient transfer if required; there are adequate grab rails, space for wheelchair access and rails close to the shower or bath for towels so the patient can get in and out safely, with or without carer assistance.  What is needed really depends on the patient, the ward and the conditions being cared for.”

Gainsborough Specialist Bathing provides a wide range of patient aids, including hoisting equipment, bathing chairs, stretchers and assisted transfer chairs.  Says Crook, “Comfort is a key factor in the design of all our products, from the physical unit (whether a bath or a shower) to the elements and equipment required for transferring the patient.”

Features and aids should also allow for a degree of independence, if suitable, for patients to bathe themselves whether supervised or independently. Says Crook, “It’s about promoting comfort in accessing the bath for example and taking into consideration independence, dignity and the care of patients’ emotional needs – making bathing a comfortable and dignified experience.”

One essential thing is obviously good hygiene. Says Tony Rheinberg from Armitage Shanks, “The best way to prevent healthcare-acquired infection is to eliminate the infectious agent or deny it a reservoir in which to grow.” To this end, the company’s Contour 21 sanitaryware is designed to be very easy to clean and avoid reservoirs where bacteria can grow. Rheinberg adds, “The Contour 21 basin has completely concealed fittings and has no overflow or tap holes to avoid potential contamination.” In addition, “Our WCs are rimless, so all areas are visible when cleaning. The very shape of the WC denies the bugs the dark damp places they need to grow.”

Elsewhere, Bushboard Washroom Systems provides RPM (ready plumbed module) units at various healthcare institutions including the Clinical Education Centre (CEC) at the University Hospital of North Staffordshire in Stoke on Trent.

Bushboard’s RPM units are HTM 64 and HTM 68 compliant and combine a dedicated range of  healthcare sanitaryware and brassware, fitted to panels and pre-assembled onto a specially designed pre-built rigid aluminium frame.

Boxes are manufactured exclusively from solid grade laminate, which is impervious to water and impact resistant, making it ideal for a busy healthcare environment. Its satin-anodised extrusions help protect vulnerable corners and deliver a flush overall finish to units, which minimises dirt traps where bacteria can multiply.

Water management company Cistermiser uses the latest WRAS-approved infrared technology to reduce cross-contamination and infection.

Infrared sensors control the Cistermiser Easyflush Wave and Easyflush Walkaway valves. These allow touch-free flushing and WC filling with no direct contact from the user. The Easyflush Wave simply requires the user to trigger a flush by passing a hand in front of the sensor, while the Easyflush Walkaway operates automatically when the user leaves the cubicle. In addition, use of the valves support healthcare facilities’ environmental targets by ensuring water is not wasted.

Cistermiser’s Direct Flush urinal valve supports a high level of hygiene by triggering a flush after every use. The urinal valve operates with just 0.5 litres of water.

It is not only in the flushing of WCs and urinals that bacteria can be transferred, the very act of hand washing presents a risk too. Traditional taps and percussion, or ‘push taps’, require the user to touch a potentially germ-infested part of the washroom, whilst also risking water wastage.

Cistermiser’s Novatap and Novaspout are touch-free deck and panel-mounted taps, so there is no need for the user to touch a tap in the act of hand washing, helping to fulfil the requirements of BREEAM HEA 12. Novatap and Novaspout rely on infrared technology, so that when the user’s hand is passed across the sensor the valve is opened. The valve is then closed again, two seconds after the user’s hands are removed, thus limiting the volume of water and reducing water wastage. Cistermiser’s Novatap and Novaspout both deliver water at 3.5l/min laminar flow, minimising the risk of Legionella that could otherwise be caused by aerated, turbulent flow. A periodic rinse function ensures that there is no risk of standing water where bacteria could breed either.

Thanks to the unrivalled water control that Cistermiser’s products provide, healthcare facilities can gain additional credits under BREEAM HEA12. Because infrared sensor control means there is no need for users to touch any of the washroom fittings there is a minimised risk of microbial cross-contamination.

“Healthcare associated infections are estimated to cost the NHS some £1,000 million every year,” says Geoffrey Gestetner, Managing Director of Cistermiser. “Not only this, but it is also vital that any measure supports an organisation’s environmental responsibilities too. Water wastage is a key issue and therefore systems that enable proper washroom control can help to ensure that unnecessary water waste is avoided.”

Gary Perry is Technical Director at Altecnic, one of the UK’s leading manufacturers and distributors of quality plumbing equipment. He says: “The correct and safe storage and distribution of hot water is a high priority for healthcare facilities. Water must be stored at or above 60°C to prevent legionella bacteria, yet it must be delivered to numerous outlets at between 35-46°C to prevent scalding or even serious burns.” To achieve both of these safety requirements, he says, “it is essential that fully accredited Thermostatic Mixing Valves (TMVs) are installed at every hot water outlet.”

TMVs regulate the water temperature from the storage tank and allow it to be set to a safe distribution temperature at the point of source, for example hot water in maternity units water temperature should be set no higher than 38°C to prevent serious burns, whereas visitor washroom basins can be set higher at 41°C to ensure hygiene. Altecnic was the first company to manufacture thermostatic mixing valves to meet UK building regulations for public buildings such as hospitals and care homes, and helped to establish the industry-recognised TMV3 accreditation scheme. Its range of failsafe Thermostatic Mixing Valves are specifically designed and manufactured to meet the requirements of the latest National Health Service model engineering specification D08 and BS 7942:2000.

In large public buildings such as hospitals and care homes, maintaining water distribution at a constant pressure can be difficult to achieve. By installing a device such as Altecnic’s patented Calflow Plus water regulator at every water outlet, water can be distributed at the correct volume - preventing loss of pressure during peak usage times. Calflow Plus is WRA approved and accredited with the Waterwise marque and incorporates a filtration mesh that helps prevent debris entering and damaging valves. It can aid even distribution in a multi-outlet new build and is available in a wide range of flow regulators capable of delivering between 2-18 litres per minute and operating up to an inlet pressure of 16 bar. Installing simple to fit water regulating devices such as Calflow Plus makes operational, economic and enviromental sense.

Not only do they control water distribution, preventing wastage, the Calflow Plus is easy to maintain and will prolong the lifespan of valves within taps and showers.