Removing sinks from ICU rooms reduces bacterial colonization, study finds

Implementing "water-free" patient care and removing sinks from intensive care unit patient rooms can reduce the number of ICU patients colonized with gram-negative bacteria, according to a study published in the journal Antimicrobial Resistance & Infection Control.

The presence of multidrug-resistant gram-negative bacilli in tap water is a growing concern for hospitals as these bacteria can colonize in the plumbing system and cause outbreaks among immunocompromised patients. Multidrug-resistant gram-negative bacteria include Salmonella, Pseudomonas, Shigella, Yersinia and the Enterobacteriaceae family.

To determine whether eliminating the use of tap water during patient care activities and removing sinks from ICU patient rooms could reduce bacterial colonization among patients, researchers monitored colonization rates in ICU patients for a year. The research team continued to monitor bacterial colonization in ICU patients after the removal of sinks and the implementation of a water-free care intervention — meaning every time an activity would normally use tap water, a water-free alternative was used instead. The pre-intervention and post-intervention periods both involved more than 1,400 patients who were admitted to the ICU for at least 48 hours.

The overall colonization rate of gram-negative bacteria among ICU patients dropped from 26.3 positive microbiological test results per 1,000 ICU admission days to 21.6 positive tests per 1,000 admission days.

"In view of our results we should reconsider the necessity of sinks and other 'wet' areas in the patient rooms," wrote the study's authors. "Under time constraints, healthcare workers' compliance with infection prevention and control measures is often reduced, specifically in the case of hand hygiene, infection prevention protocols and waste management protocols. Reconstructing the hospital infrastructure in a way that behavior of healthcare workers is more directed towards good clinical practice is a step in the direction of sustainable infection control."

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