The Importance of the Central Sterile Supply Department in Infection Prevention and Control

aerobic bacteria (a water-quality indicator) from the same samples inoculated immediately after the samples were removed from the building water system; Legionella culture results correlated well with results from spread plate analyses and were available far sooner (at least 80% reduction in time required to deliver results) compared with spread plate analyses of shipped water samples. Data on comparison of methods, accuracy, precision, specificity, and sensitivity have been previously published and are cited in our article. Our WMP was effective because it (1) united the expertise of infection control, facilities operations, facilities engineering, and industrial hygiene personnel, who all have key responsibilities in providing safe potable water at our facilities; (2) resulted in systematic risk characterization of areas in the facility so that we could focus on the highest patient risk; (3) resulted in development of one consistent plan that all stakeholders could understand and follow; (4) clarified and improved the management of resources necessary to implement the plan; (5) established a process to independently confirm and document implementation of the plan (verification); (6) provided a systematic basis to decide what to test for, where to test, and how much testing was necessary to assess hazard control (validation); and (7) provided a process to make scientifically defensible decisions about how to manage our building water systems. Several compelling facts led us to select and to now advocate the HACCP framework for building water system management: (1) the Legionella Outbreak Response Team from the Centers for Disease Control and Prevention has since year 2000 advised facility managers involved in outbreaks of Legionnaires’ disease to develop WMPs based on HACCP principles for their facilities; (2) the World Health Organization proposed HACCP for water system management then extensively and formally recommended use of these principles as the basis for water safety plans; and (3) in response to widespread, successful use of HACCP-based water management programs for the prevention of disease and injury associated with building water systems, NSF International has developed an educational and training certificate program that is now available nationwide. The reader is referred to our article for citations of peer-reviewed journal articles and other references that document effective application of HACCP principles to building water system management.