Thermostatic Mixing Valves or TMVs are used extensively in hospitals, healthcare environments, care homes and other social care settings where they are used to successfully control the scalding risks associated with very hot water, typically water at temperatures in excess of 44OC.
However, whilst TMVs help to protect patients, staff and visitors from scalding they bring with them a number of other issues including an increased risk of Legionella and Pseudemonas accumulation and proliferation; together with additional facilities and engineering costs, higher equipment and installation charges; and on-going TMV servicing, inspections, repairs and maintenance obligations.
Hospitals & Hot Water Scalding… Who is at Risk?
We are all aware of the risks associated with very hot water, especially in hospitals, healthcare and social care environments.
Hot water can easily scald someone if the risks of exposure to such high temperatures are not managed in the proper manner.
This is especially true where large areas of the body are exposed to high temperatures, and where there is the potential for whole-body immersion.
Under such circumstances scalds can be very serious and have in the past led to fatalities.
Bathing and showering are recognised as high risk activities and suitable precautions need to be taken to safely control the water temperatures where such activities take place.
Additionally, there are certain groups of people that are more vulnerable and where the risk of being scalded could be heightened.
For example, both children and the elderly can be at higher risk of being scalded.
Other people may not be well enough to be safe around sources of hot water; they may not be able to react quickly enough to a situation where hot water is present.
Vulnerable groups of people include:
The Importance of Scalding Risk Assessments in Hospitals & Healthcare Settings
Whenever healthcare or social care is provided to people, it is important to ensure hot water and hot surfaces associated scalding risk assessments are completed well ahead of time.
These risk assessments help ensure the likely dangers are spotted beforehand and can be dealt with to reduce the risks associated with hot water and hot surfaces.
Assessing the Risk of Scalding from Hot Water in Hospitals
The law says that you should ensure that there are systems in place for reducing the risk of scalding and that the risk is adequately controlled, so far as is reasonably practicable.
This means that you must assess the potential for scalding risks… however it is important to recognise that this should be done in the context of the vulnerability of those being cared for.
The scalding risk assessment should be carried out in the context of the vulnerability of those being cared for.
A scalding risk assessment of the hospital or healthcare premises should be carried out to identify what controls are necessary and how such control systems will be managed and maintained in to the future.
What are the Potential Risks?
Consideration must also be given to potential impairments other individuals may have in a hospital or healthcare environment.
For example, while fit and healthy individuals may be able to get in and out of a bath or shower without assistance, this may not be true of a very young or elderly person.
Thus, some individuals should not be left alone while bathing or showering.
In addition, some people may not be able to test the temperature of the water accurately or safely before using it.
As we age, our skin gets thinner and more fragile.
If the temperature of the water goes above 44 OC, this can potentially lead to injury by scalding… and this could be severe.
The risk would be much higher for an elderly person than for someone of a much younger age.
Thus supervision and engineered water temperature controls may be required in these circumstances.
Concerns with Mental Health & Patient Wellbeing
It is not merely physical issues that can lead to increased risks with scalding either.
Mental impairments can also lead to potential danger, and these should also be assessed as part of a scalding risk assessment.
In some cases, people may not realise there is a danger, and in these situations the individual should never be in a position to be able to run hot water on their own.
Control Measures for Hospital Hot Water Systems
Any water outlets that may be accessible to vulnerable people and where there is the potential for whole-body immersion (bathing and showers) should be carefully protected to ensure the water temperature is controlled and never exceeds 44°C.
Under these circumstances typical engineering controls include:
TMVs and temperature restricted water heaters may also be used at water outlets where people are especially vulnerable, this could include wash-hand basins where people have skin sensitivity issues.
TMVs & Scalding Risks – Getting the Balance Right
As is clear, proper management and assessment of risks associated with scalding water is paramount.
If proper solutions and ways of working are in place to begin with, the chances of someone being scalded are much reduced.
However, it is important to remember that the risks of scalding from hot water in health and social care environments need to be properly managed… but that should be done in context of the vulnerability of those being cared for.
World Class Water Management, Legionella & Pseudomonas Risk Management Solutions
Water Treatment Services are a leading independent UK water management company offering expert Legionella and Pseudomonas risk management solutions including professional water treatment and water hygiene services, water sampling, laboratory analysis, TMV servicing, and full engineering support services to ensure the risks associated with patient scalding, Legionnaires’ disease and other waterborne pathogens are managed to meet the compliance standards set by the Health & Safety Executive and Department of Health.
With offices in London serving the South and South East England, Manchester (North West), Birmingham (Midlands), Bristol (South East England and Wales), Leeds (North and North East) and Glasgow (Scotland), supported by regional teams of specially trained engineers, site service specialists and technical experts we can offer legionella risk management and ACOP L8 compliance solutions across the whole of the UK.
Contact us today to learn how our water management solutions can ensure your risks are managed effectively and the health and safety compliance standards set in this important area are achieved… contact us →
More information about managing the risks from hot water scalding and the use of TMVs and other temperature controls in healthcare environments here… HSE →
More information about TMVs… here →