Healthcare and water safety – what makes a good hospital water cooler?
Hygiene-centred innovation is here to stay
The Coronavirus pandemic elevated the importance of hygiene and user safety for the water industry. Faced with an instantly changed landscape, Borg & Overström met the challenge head on. The introduction of footswitch and touchless operation reduced footfall around dispensers and eliminated the risk of cross contamination.
We took this even further by infusing product touch panels with antimicrobial coating which kills bacteria when idle. On the rare occasion where extra maintenance and cleaning is needed, the use of PVD coating makes the process even easier.
Naturally, few places have seen greater pandemic impact than healthcare facilities, who continue to operate under stringent measures for the protection of staff and patients. Nobody wants to see the NHS under stress, and those who can help ease this burden should. Where we come in is in helping prevent HCAIs or healthcare associated infections.
Seeking a solution requires understanding the problem. First, let’s quantify some of the data.
How many patients pick up infections in hospitals?
In January of 2020, the British Medical Journal published the study “Modelling the annual NHS costs and outcomes attributable to healthcare-associated infections in England” headed by Dr Julian F. Guest. This massive undertaking calculated an accurate budgetary costing of HCAIs. It covered the periods 2016 to 2017.
Given the massive and lasting systemic changes induced by the pandemic, we are still awaiting a comprehensive follow-up to account for how Covid surges raised these numbers and subsequent mitigation efforts quelled them again. One thing remains clear, however: too many patients are facing unacceptable levels of risk. Even the pre-Covid numbers paint a disturbing picture.
The study found there were 653 000 HCAIs per 13.8 million inpatients at general and teaching hospitals in England alone, with 22 800 dying as a result of infection. That is 4.7% – a disturbingly high figure.
When the authors expanded their research’s framework to include all NHS hospitals in England (including specialist facilities), they found 834 000 documented HCAIs had cost the NHS £2.7 billion, with 28500 patient deaths.
General hospital ward cost-per-bed comes in at £97 per bed, per day. On average, each infection accounts for 8.5 hospital bed days, meaning there are 7.1 million combined days of hospital bed occupation days born from these infections, and they account for 21% of all hospital bed occupation.
Elevated patient infection has a knock-on effect to staff, who are exposed to the risks. The report then found this has led to a combined 79 000 days of staff absenteeism. NHS hospitals have subsequently seen a 55% rise in cost to bring in absentee cover workers, and it’s costing even more to do this than to hire new staff.
The cost of dehydration – patient comorbidity
Dehydration is bad news for anyone admitted to hospital. It is both a predictor of HCAIs and a symptom of them.
Once again, we can draw from a wealth of medical research on the subject. In May 2018, doctors Rebecca Shells and Nicola Morell-Scott published Prevention of dehydration in hospital patients and made their case plainly, linking dehydration to “increased risk of mortality in patients who are acutely unwell” and saying that it “increases the risk of further illness.”
Naturally, this rises with elderly and immunocompromised patients. But it isn’t just patients who need to raise their water intake for the good of all.
The cost of dehydration – staff engagement
We have previously covered how dehydration devastates staff productivity – causing dimmed focus, higher stress, even replicating the symptoms of alcohol consumption. Every employer wants high engagement and morale assured for their workforce, and every employee wants a healthy professional life surrounded by like-minded professionals.
In a healthcare setting, these qualities will literally mean the difference between life and death. The Royal College of Nursing has an official burnout prevention resource called Rest, Rehydrate, Refuel which urges the importance of hydration for personal wellbeing and job performance. This goes for every healthcare professional.
Staff dehydration has long afflicted NHS staff performance and wellbeing. A 2016 study found an alarming 45% of clinical staff were dehydrated by the end of their shift. The onset of thirst is often a sign that it’s too late to escape previously undetected negative effects, and hydration must be consistently preventative rather than reactive.
It certainly doesn’t come down to the habits and choices of medical staff. A more recent 2019 report published by the Medical Protection Society revealed staff to be overworked to the extent that they felt unable to even hydrate, with 40% feeling unable to take time to eat or drink.
Speaking about this in the British Medical Journal, Dr David Oliver gave an impassioned defence of NHS staff, condemning managerial cultures which discourage visible consumption of food and water, many of which believe the debunked myth that it leads to hospitals being marked down during review.
The full article, titled Staff hydration matters more than keeping up appearances, begins and ends with an urgent reminder of how important hydration is for staff and that they must never be discouraged from it by anyone.
“Clearly, there is concern that if clinical staff were seen swigging from a water bottle, sipping from a teacup, or grabbing a snack in public ward areas—let alone enjoying some uplifting personal chitchat as they worked flat out—it would seem “unprofessional.” Well, I’ve got news. It isn’t…Let us do everything we can to ensure clinical staff stay hydrated at work. It’s more important than keeping up appearances.”
Solutions for hospitals – what is to be done?
In their aforementioned study, Shells and Morrell-Scott don’t just lay out the impact of dehydration on patient health, but point to the solutions:
“The use of bedside water devices allows patients to drink freely without assistance. Access to these can reduce a patient’s length of stay in hospital and minimise the risk of developing a urinary tract infection.”
The least a hospital can do is ensure consistent, quality hydration for their patients. Cutting corners won’t do anyone any good in this case, and existing dispensers are not up to the task. Cheap, communal reservoir machines have a higher chance of bacterial infection, and the patients relying on them have a lower chance of enjoying regular hydration.
Though extreme cases like the tragic death of Milly Main are thankfully rare, more can be done everywhere to provide patients and staff with clean, safe, high quality filtered water in an accessible manner that doesn’t result in excessive footfall and crowding. What would such dispensers need?
Borg & Overström’s line of dispensers have the answers healthcare seeks. Easy to install, maintain and use whether countertop, floor standing or tap system.
Thorough sanitisation through high-quality dispensers
Reservoir systems come with many faults, but the worst is that their contents are constantly in contact with oxygen. No amount of UV filtration will fix such a system. The UV bulb often sits in the middle of a five-litre tank of water, but it cannot sterilise all of the water within. Bacterial cells shield each other – a dead or stunned bacterium will defend a live one. This system is not as effective as having in-line UV.
As the old expression goes, “prevention is the best cure” – and in this case, it appears that preventing patient and staff dehydration can join UV-treated water, antimicrobial coating, hands-free dispensing and frequent handwashing in protecting everyone in healthcare.