Sink design to blame for outbreak

One patient, one room, one bed, one sink goes the infection control rhyme. That was until a Pseudomonas aeruginosa outbreak between December 2004 and March 2006 at Toronto General Hospital killed 12 transplant patients.

The issue: tall, high pressure ‘gooseneck’ sinks drove water straight into the drain hole of the sink without getting water into the basin.

The problem: sludge in the bottom of the sink containing Pseudomonas aeruginosa was splashed out of the drain when the high pressure water hit it and transported around the room when people washed their hands.

The solution: Who knows best on this one? The doctor? The Infection Control Practitioner? The epidemiologist? The engineer?

The answer is likely all of the above.

First things first

Design is important and needs to be first. Before cost, before space, before time, before everything else, things need to be designed and evaluated. Things seem to get designed these days to fill a space, or fit along a wall, or to be this tall by this wide, and once the right ratio of tall-ness to wide-ness is achieved, the evaluation is over.

Design is how it works, not how it looks.