The plumbing system is a critical aspect of the working of a hospital. While the plumbing system itself should be simple in design and reliable, it is even more important to plan the operational efficiency of the various parts of the plumbing system to ensure that they function properly for years to come.
A healthcare system can be very demanding and the plumbing system should be designed in a way to meet the various demands and challenges presented by the hospital. The plumbing systems must meet the technical specifications particular to every hospital and also the various standards, codes, etc. that will enable the staff of the hospital to maintain the components of the hospital plumbing system easily.
The plumbing systems of hospitals are unique and comprise equipment which that have distinct maintenance requirements and for the hospital to function efficiently, it is important to understand its plumbing system and its working. We will be discussing the various components that comprise a hospital plumbing system in this article.
Hospital Plumbing System
Central Sterile Systems
The central sterile system requires a large water supply for the hospital’s surgical tools and the plumbing system must be designed to accommodate the varying requirements of the central sterile system. Usually, satellite decontamination rooms are located near the operating theatre (OT), so that the surgical equipment is cleaned, sterilised and returned to the OT quickly, instead of transferring the surgical instruments and equipment back and forth to a central sterile system that is located in some other part of the hospital.
The drainage dump load also goes into the central sterile system and since the equipment takes in the water and eliminates it very fast, the drainage system must be sufficiently large to manage the high flow or it should have a holding tank that holds the outflow and allow slow drainage. The central sterile system must also be equipped with water softeners and backflow preventers.
In a hospital, many important areas such as the OTs, nurse stations, procedure rooms, gastrointestinal areas, etc. are equipped with sterilisers that are installed for washing and rinsing probes at temperatures of around 71oC-82oC. The steriliser system must ensure that the water delivered to these sterilisers must be at the minimum level of temperature and the water must be maintained at the particular temperature for the entire duration of the sterilisation cycle.
The sterilisation system must be equipped with valves for mixing, controlling the temperature and to prevent backflow. The backflow equipment must be maintained and tested once in a year to ensure that it is working properly.
Purified water is an essential component of pathology, lab testing, etc. in the hospital. The plumbing system for laboratory use should be designed in such a way that the water connections, as well as the system for water purification, do not allow the backflow of the water and is removed in such a manner that there is no human contact once the water leaves the lab.
Depending on the function, hospital laboratories need different kinds of water. Most require RO (reverse osmosis) water, but some functions may need deionized water and so the manner in which the water is processed for lab use becomes critical.
There are many decisions that hospitals must make such as, can the system function using filtered municipal water or do you need several filters to produce highly filtered water? Do you need a third-party vendor to manage and maintain the system or can the upkeep be managed by the hospital employees?
Th hospital staff, however, is usually responsible for the water, chemicals and wastes that leave the laboratory and the acid-neutralising systems and point-of-use are utilised. Laboratory wastes contain diseases and chemicals, which can spread and to check this, monitoring points are required that are connected to the BAS or the building automation system and if there is any malfunction that occurs with any of the components of the waste management system, the facilities management team must be informed immediately.
Pathology Laboratory Systems
Pathology labs are different from regular labs, as they use chemicals which produce a lot of foam. So, to prevent this foam, the plumbing system must be equipped with drain covers and anti-foaming systems. Pathology labs use unique chemicals and due to the foam, the water requirements for pathology labs is different, which also requires different filtration systems.
The pathology laboratory waste system also needs to be connected to the BAS and in the case of a system failure, the BAS must alert the facilities staff. Sometimes, a 3rd party vendor may be hired by the hospital to maintain and repair the specialised pathology lab waste system equipment.
The dialysis systems in the hospital can be set up in two ways, either using an RO system or water filtration carts. These systems deliver tap water or purified water to the dialysis equipment.
The RO system provides filtered water to the dialysis machine directly. The RO system comprises a charcoal filter, water softener and some means of reducing chlorine in the water. RO systems are quite commonly used; however, they are more expensive, require an investment and also need regular monitoring and maintenance.
Whereas, in the case of portable water filtration units, you only require a regular tap water connection. Usually, water carts are rented and sometimes even maintained by a third-party vendor. In the case of the water carts, the hospital must consider the expense of hiring these units in their annual budget.
Emergency Plumbing Systems
Hospitals usually have 3 kinds of emergency plumbing systems i.e. eye/face washes, eye washes and emergency showers depending on the particular hazards in each area. These washes and showers must be tested every week to ensure that they are working properly. There are also specific regulations for how these systems must function such as flow rate, the temperature of the water, spray patterns, types of devices, etc.
Domestic Hot Water Systems
This system shares the water supply with the general domestic water system of the hospital and the generation and maintenance of the system affect the hot water availability and the temperature control of the water.
The common ways of producing hot water in hospitals are steam and gas generation and if this is not possible, electrical energy is used to produce the hot water, which is a more expensive process. These days, several hospitals are using renewable energy sources such as solar energy, but this depends on the location of the hospital and climate of the place.
The faucets and fixtures for delivery of hot water are also regulated by code with strict limitations. There are devices to control the water temperature, master mixers, digital re-circulation valves, etc.
The patient care modules are usually used in intensive care units of hospitals, which require a toilet and these modules combine 2-3 plumbing fixtures into a single cabinet which fits into a compact space. These modules must be made of durable materials, must be easy to clean and maintain.
Surgeon scrub sinks, usually located outside the OT are deep basins used by the surgeons to scrub up to their elbows before entering or when exiting the OT. These scrub sinks should work along with the infection control protocol of the hospital, which requires the medical staff to wash their hands without first turning on the water. These sinks are usually knee, foot or infrared sensor activated. The scrub sinks must be maintained regularly for proper functioning.
Today, in the dynamic world of healthcare, reliable, easy-to-maintain and efficient plumbing systems are of the greatest priority that can enable the efficient functioning of the hospital without any shutdowns, which can be quite expensive and hamper the hospital’s productivity and efficiency, and potentially put its patients at risk.
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