Water Temperature From Hot Water Outlets in a Major Public Hospital: How Hot is Our Water?

Abstract

Objectives: To measure the water temperature issuing from a representative sample of patient-accessible outlets around the Royal Adelaide Hospital. To initiate an audit cycle in the event of unacceptably high water temperatures to ensure their reduction.

Methods: Samples were taken of water issuing from hot taps, showers, and hand hygiene basins in patient areas throughout the hospital, encompassing newly renovated as well as old sections of the hospital. A 45 second "warming" period was followed by hot water collection into a polystyrene cup to 8 cm. The mean of 3 temperatures measured using an infrared thermometer was calculated.

Results: Several taps and patient showers were demonstrated to supply water at a temperature capable of causing scald injuries. Most problem outlets were found in the oldest section of the hospital, fewer in the wing of "intermediate" age and none in the most recently renovated emergency block. The data were tabulated and summarized before being passed on to RAH Engineering and Building Services, which initiated remedial action. Several thermostatic mixing valves were found to be faulty (and replaced) or poorly set (and re-set). After this adjustment, outlets previously supplying excessively hot water were re-tested and found to be safe, closing the audit loop.

Conclusion: Maintenance services infrequently conduct scheduled assessment of hot water outlet temperatures and rely on staff member complaints or concerns to focus their attention on problem areas. With recent evidence of the disastrous potential of hot water on a vulnerable population of hospital in-patients, hazard identification and reporting is everybody's responsibility.

Figure 1

Schematic of the Horne 15 (TMV H1502) TMV in use at the Royal Adelaide Hospital. TMV indicates themostatic mixing valve.

Figure 2

Site map of the Royal Adelaide Hospital indicating the positions of the assessed areas—“old” North Wing in white oval, “intermediate” East Wing in green oval, and newly renovated Emergency Block in red oval.