Medical facilities
In medical facilities such as hospitals, doctors’ surgeries or nursing homes, the quality and safety of drinking water is particularly important to minimise the risk of infections, illnesses or complications.
The use of drinking water in medical facilities covers various aspects, such as the supply of clean and sufficient water for hygiene, cleaning, sterilisation, cooling or the nutrition of patients and staff.
Responsibility for ensuring the safe and appropriate use of drinking water in medical facilities lies with the operators, authorities and healthcare providers.
Our standard analysis of drinking water in medical facilities includes the following parameters:
In addition to drinking water, the process water in water-bearing systems, such as haemodialysis systems, dental and ENT treatment units, is also a critical factor. Here, the risk of contamination with pathogens such as Pseudomonas aeruginosa and Legionella is very high. The formation of biofilm is promoted to an enormous extent by temperatures >25°C in particular.
A corresponding flushing plan must be included in the hygiene plan of every practice. Regular, annual checks of the drinking water and processed water must be carried out.
Dental treatment units
Treatment centres are medical devices and are therefore subject to the Medical Devices Act and the regulations based on it. When used correctly, the devices must not jeopardise the safety or health of patients or users.
Responsibility for hygiene requirements for water in dental treatment units lies with the Commission for Hospital Hygiene and Infection Prevention at the Robert Koch Institute (KRINKO), as it is responsible for scientific recommendations for the protection of patients in accordance with the Infection Protection Act.
To this end, the commission issued the recommendation “Infection Prevention in Dentistry – Hygiene Requirements in 2006”. The requirements comprise the following parameters, which also include the treatment of highly immunocompromised patients:
Haemodialysis system
Hygiene is crucial when using haemodialysis systems to prevent infections and other complications.
The permeate or osmotic water is a component of the dialysis water that is prepared for a patient’s haemodialysis. It is demineralised water without additives. The starting product for the permeate is water that complies with the Drinking Water Ordinance and undergoes various successive treatment stages. The quality of the permeate is crucial for the efficiency of dialysis and patient safety.
The drinking water is analysed for the following parameters before treatment:
Regarding the quality and control requirements of permeate and dialysate fluid, the requirements of the European Pharmacopoeia and ISO standard 23500-2011 (3) must be followed. These standards define the control of many chemical contaminants and microbiological quality.
Additional tests are required when recommissioning the liquid-carrying components of the supply system and after technical measures. The maximum value of colony-forming units (CFU) of 100/ml must not be exceeded. In addition, no coliform bacteria or Pseudomonas aeruginosa must be detectable in 100ml.
| Microbiological parameters | Guideline and limit values (Dialysis Guideline 2022/ MiQ 22, 2018/ Supplement to the dialysis standard, 2006/ ISO 23500) |
|---|---|
|
Total colony numbers |
100 CFU/ml (action level: 50 CFU/ml) |
|
Pseudomonas aeruginosa |
0 CFU/ 100 ml |
|
Coliform germs |
0 CFU/ 100 ml |
|
Gram-negative rods |
≤ 10 CFU/ ml
|
|
Bacterial endotoxins |
< 0.25 IU/ ml (action level: < 0.125 IU/ ml) |
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