Legionellae Control in Health Care Facilities
A Guide for Minimizing Risk

Highlights of Contents

Establishing an Action Plan

• Evaluating your facility: six test questions to ask

• Lawsuit data: verdict and settlement amounts, how to determine the strength of a plaintiff's case

• Deciding how much money to spend to reduce your risk

• Communication

• When to disinfect systems

Preventive Measures for Plumbing systems

• New equipment purchases

• Recommendations for pipes, fixtures, and tanks

• Regulating water temperatures, mixing valves

• What not to do: procedures that are a waste of time and money

Preventive measures for cooling towers

• Operating and maintenance recommendations

• Avoiding conditions conducive to legionellae

• Drift control

• Checklist of preventive measures

• Disinfection

Preventive measures for other equipment

• HVAC humidifiers, ductwork, and drip pans

• Decorative fountains

Water sampling

• Deciding whether or not to sample routinely

• Collecting samples yourself vs hiring a consultant

• What equipment to sample

• Five high-priority locations

• Number of samples to collect each screening

• Frequency of screenings

• What other hospitals do (summary table)

• Comparing methods

• Using an in-house versus an outside laboratory

• Screening prospective laboratories:  14 questions

• Methods and prices of three experienced labs

• How to test the proficiency of a laboratory

• Supplies to buy for sampling

• Annual cost of routine sampling

How to Collect Environmental Samples

• Scheduling each screening

• Checklist to review two weeks before sampling

• Collecting samples and recording data

• Checklist for shipping samples to the laboratory

• Interpreting results

Disinfecting domestic water systems

• Comparison of heat shock, chlorine, UV, ozone, copper-silver: advantages, disadvantages, costs

• Getting advice from other hospitals: 11 questions to ask

• Screening manufacturers of disinfection units:  four questions to ask

• How to avoid overspending: practical points to consider before taking action

Responding to an Outbreak

• Key aspects of an investigation

• Getting outside help: paid versus free help

• Screening and selecting consultants

Source directory

• Hospital contacts willing to give advice by telephone

• Consultants and manufacturers

• Laboratories worldwide that specialize in Legionella

• Government agencies

• Attorneys experienced in Legionnaires' cases

• Professional societies

References, Bibliography, Handout, Logs, Index