Newcastle Hospital NHS Foundation Trust Control of Infection Committee Water Coolers and Ice-Making Machines Policy Effective September 2006 Review September 2009 Due to concerns regarding the microbiological quality of water or ice from these which could pose a risk to patients, especially those whose immune system is compromised. The policy indicates :- Which areas are suitable for these machines and which type of machine should be purchased. The purposes of what ice should be used for i.e. ice packs and cooling specimens for blood samples collected for blood gases. It should not be used for consumption in immunocompromised patients whom would normally drink sterile water. Cleaning of the machines. It is the responsibility of the Ward Sister or Head of Department. The scoop should be washed daily in soap or detergent. The machine and trays should be cleaned at least once weekly with detergent and hot water. After cleaning the compartment should be disinfected with Hypochlorite Solution at 100ppm, rinsed with cold tap water and dried before returning it to use. That all requests for both machines should be discussed with Infection Control and the estates department. All machines should be assessed and fitted by The Estates Department in accordance with preventative measures against Legionella Infection. Page 1 of 5
Newcastle upon Tyne Hospitals NHS Trust Policy for the Use of Waters Coolers and Ice-making Machines Effective September 06 Review September 09 1. Introduction The microbiological quality of water or ice from a water cooler or ice-making machine may be of poor quality. It could therefore pose a risk to patients, particularly those whose immune systems are compromised. This policy indicates which areas and machines are most suitable for patients and staff. 2. Water Coolers 2.1 Types of water cooler Some water coolers in the Trust are of the stand-alone type utilising replaceable bottles of water obtained from a commercial supplier. The water quality from these machines may be poor and their running costs are high due to the need to replace the water bottles regularly. Adequate storage space is often a problem. They also have irregular or no routine maintenance, which lowers water quality. Consequently within the clinical area it is Trust policy that no new machines of this nature should be purchased, leased or installed, or new contracts entered into. Areas which already have these should replace the water cooler with a more suitable type as part of a regular maintenance programme, (see below). The infection control teams will advise areas where the highest priority should be given for replacement. The recommended type of water cooler is one which is plumbed-in and supplies water of mains quality. This type of machine should be maintained annually by the Estates Department or specialist contractor who should keep documentary evidence of maintenance. All new installations of water coolers should be machines of this type. Note: all plumbed-in water coolers (or ice-making machines) must be assessed and fitted by the Estates Department in accordance with preventative measures against Legionella infection. 2.2 Installation of water coolers Page 2 of 5
(i) Non-clinical areas These include all areas where patients are not managed, such as administration, SSD IT etc. In these areas a water cooler may be installed without reference to the Infection Control Team (ICT), provided of course that funds and suitable location are available. (ii) Clinical areas where only staff will consume water from the coolers As with non-clinical areas, a water cooler may be installed without reference to the ICT, but the machine must be marked prominently with a notice stating that it is for staff use only. The water cooler must be situated in a non-patient area such as an office or staff room. (iii) Clinical Areas where both staff and patients will consume water from the cooler All requests for water coolers intended for staff and patient use must be referred to the ICT for discussion before ordering. All staff may consume water from the cooler. Patients may also do so provided that the machine is a plumbed-in type and if patients would otherwise safely consume mains tap water. Patients must not consume water from the bottled water type of machine. Note: commercial bottled water may be of very low quality and must not be substituted for mains water or for sterile bottled water if that is required for immunocompromised patients. 2.3 Cleaning of water cooler machines It is the responsibility of the ward sister or head of department to ensure that the following is maintained; Always use single-use disposable cups, do not drink directly from the cooler, all water coolers should be specified with a cup filler and not a direct drinking nozzle or outlet The water cooler should be cleaned with detergent and hot water daily as well as being kept clean and dry at all times Always wash hands before use Note: Some freestanding machines have drip trays. These should be emptied regularly throughout the day, kept clean and dry at all times and washed daily with hot water and detergent. Page 3 of 5
4. Ice-making machines 4.1 Use of ice-making machines These machines are currently used to supply ice for the following purposes: Ice packs Cooling specimens such as blood samples collected for blood gases Ice obtained from ice-making machines has been shown to be of poor microbiological quality. Consequently ice from these machines must not be consumed and each machine must display a prominent notice stating not for human consumption. Where ice is required for consumption to cool drinks a plumbed-in water cooler is the preferred alternative. If ice itself is required, ice from the freezer compartment of a domestic refrigerator may be given to patients who would otherwise safely consume mains tap water. An alternative would be the use of ice cube bags from commercial suppliers, which are disposable after use. Ice from either of these sources must not be given to patients who would normally drink sterile water. 4.2 New request for ice-makers All new requests for ice-making machines must be discussed with the ICT before ordering. Since the only use of these machines will be to cool clinical samples or for the application of ice packs, it may not be necessary for an ice-maker to be installed on each ward. It may therefore be possible to redistribute ice-making machines between wards, thus avoiding the purchase of any new machines. 4.3 Cleaning of ice-making machines It is the responsibility of the ward sister or head of department to ensure that the ice compartment of a domestic refrigerator, and/or ice-making machine if present, are kept clean. It is recommended that the ice tray of a domestic refrigerator is washed a minimum of once weekly with hot water and detergent. For dedicated ice-making machines, ice must not be removed or handled with the hands of the user. A dedicated ice scoop should be provided for all machines so that this can be avoided. The scoop should be washed with detergent and hot water daily and dried thoroughly. The ice storage compartments of both domestic refrigerator and dedicated icemaking machines must be cleaned by the department staff a minimum of once weekly with detergent and hot water. Cleaning schedules need to be documented. Any ice and reservoir water in the machine must be discarded. Page 4 of 5
After cleaning the compartment should be disinfected with hypochlorite solution at 100 ppm, rinsed in cold tap water, and dried before returning it to use. Infection Control Committee September 2006 Review date: September 2009 Reviewer: Mrs. A. Reed Page 5 of 5