Congiu, Margherita (2011) Controllo del rischio clinico waterborne: modello di applicazione della metodologia Water Safety Plan in un’Azienda Ospedaliera. Doctoral Thesis.
The aim of this work is to apply the Water Safety Plan – the effective methodology for waterborne risk management in waterworks (WHO) – to hospital settings, such as those in the AOU of Sassari. WSP was applied to an hospital within the AOU, to control the waterborne risk from Legionella and Pseudomonas. The Control Plan was draft, team inspections, meetings, water samples were performed (Legionella, Ps.aeruginosa, CRAL, T) and organizational/operative information were taken. The following steps were the hazard analysis of criticalities and the identification of the priority control measures. L. pneumophila (L.pn.) 1 was isolated in the water from and returning to the hot water tank/boiler and from 53,3% of the hot water samples of the plumbing system. Random samples in the cold water system revealed L.pn. 7 and L.spp in unused taps. Pseudomonas was never found. CRAL was always lower than the optimal value. It has been performed an organizational criticalities analysis. After the hazard analysis, the identified priority control measures were focused on CRAL, verification of performed controls, T of hot water, cleaning and sanification of hot water tank/boilers and system, pipes with little or no flow, coordination among persons in charge of, support to health care personnel participation. WSP proves to be an essential instrument for waterborne risk management, allowing to understand criticalities, to perform hazard analysis, to identify priority control measures.
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