Richard Norman, Managing Director of Indepth Hygiene Services Limited, the UK's leading company for specialist cleaning of ventilation systems talks about the importance of ensuring they are thoroughly cleaned.
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There has never been a previous time when those responsible for the maintenance of ventilation systems had more reason to ensure they are maintained in a clean and safe condition. On a fundamental level the National Health Service is charged with the responsibility in its own constitution to ensure "patients are treated by an organisation that provides its services in a clean and safe environment". The very air that patients, staff and visitors breathe must be safe and unpolluted. Since the essential functions of a ventilation (air conditioning) system is to circulate clean safe air it is indisputable that those with a particular responsibility for maintaining ventilation systems should ensure that all possible steps are taken to do just that.
Dr Ghasson Shabha, of Birmingham City University has published extensively his findings on the link between uncleaned ventilation systems and the spread of HCAI. He firmly maintains that temperature and humidity conditions typically found in ventilation ducting provide excellent opportunities for bugs to thrive. Dust and debris on internal surfaces of the ducting invariably contains human hair and skin flakes - ideal nutrients for the growth of micro-organisms such as MRSA and C. difficile. In fact there has been evidence in recent hospital surveys of the presence of MRSA micro-organisms in ventilation systems. As a result of remedial ductwork cleaning it has been shown that these micro-organisms can be eliminated.
The Healthcare Technical Memorandum stipulates maximum recommended bacterial contents of 10 cfu/sample for sterile areas and up to 50 cfu/sample for general areas. These levels will not be achievable without regular cleaning so in today's world of limited financial resources there simply has to be a compromise, but that compromise is not to take no action. There's too much evidence to show that to ignore the state of the air conditioning system puts all hospital occupants at risk.
Without even committing to expenditure it must be part of the estate or facilities manager's responsibility to fulfil the duty of care to have the system professionally audited and a detailed report provided, including results of tests on contamination levels. He will then have an accurate assessment of risks in the system and will have the typical management task of balancing competing priorities for financial resources. Not to put himself in a position to know how serious the problem is is to fall short of meeting his responsibilities. Indepth will carry out a detailed system survey and provide the report with a recommended action plan quite free of charge
However, it is not only air conditioning systems which warrant special attention to meet the overriding obligation of providing a clean and safe environment. Grease extract ventilation systems, invariably linked to the catering facilities, are a potential source of danger to hospital patients, staff and visitors. As grease particles from the cooking operation cool and settle on the internal ducting surfaces they present a fire hazardous risk requiring only a spark or flash flame from the cooking operation to ignite, with results which have been very well illustrated by recent fires in public restaurants.
The Fire Safety Order (The Regulatory Reform [Fire Safety] Order 2005) places responsibility for protecting building occupants from the dangers of fire firmly on those responsible for managing premises - and this applies to hospitals as much as to any other occupied premises.
At a recent seminar, a Fire Authority spokesman stated "these installations are probably the highest fire risk in buildings where there are catering facilities". There is therefore both a 'duty of care' and a legal requirement to have in place a cleaning regime which will ensure that potentially flammable grease deposits which accumulate in the ducting are fully removed.
As with air conditioning systems, uncleaned grease extract systems will use more energy. The more grease deposits are allowed to accumulate in the ducting the harder the fan has to work to maintain extract efficiency. The harder the fan has to work the more energy it consumes. So the legal requirement to clean ventilation systems to eliminate risks carries the additional benefit of reducing system energy costs.
In order to provide the Facilities or Estates Manager with a reliable standard by which to assess the effectiveness of a ventilation cleaning programme, the Heating and Ventilating Contractors' Association have produced a "Guide to Good Practice" Internal Cleanliness of Ventilation Systems TR19. It is accepted as the industry standard of excellence to which ventilation systems should be cleaned. All Indepth Hygiene ventilation ductwork cleaning is carried out in accordance with this standard so that responsible managers can be confident their ventilation systems will fully perform their essential function of providing safe and hygienic conditions in healthcare premises.
To arrange for a ventilation system assessment of risk survey to be carried out free of charge call Indepth Hygiene Services on 020 8661 7888 or email firstname.lastname@example.org.
0870 199 4044