dev_fh_45 · Chuong 4

RWMP (Risk-based Water Management Program) — framework quản lý rủi ro nước cho cơ sở y tế?

Tóm tắt nhanh: CMS (Medicare/Medicaid) từ 2019 yêu cầu bệnh viện Mỹ có RWMP. WHO và IPAC Canada cũng khuyến nghị tương tự. RWMP: xác định water systems risk, control measures, testing, corrective action. Không có RWMP = liability khi xảy ra HAI.

Nội dung chi tiết cho đào tạo

**RWMP Core Components (ASHRAE 188 framework):**

| Component | Nội dung |

|---|---|

| 1. Water System Inventory | Mapping tất cả equipment có nguy cơ (cooling towers, hot water heaters, decorative fountains, ice machines) |

| 2. Risk Assessment | Xác định conditions tạo điều kiện cho Legionella và pathogen |

| 3. Control Measures | Chlorination, temperature, cleaning schedules |

| 4. Monitoring Procedures | Culture testing, ATP testing frequency |

| 5. Corrective Actions | Action triggers và response protocols |

| 6. Verification | Annual audit, 3rd party review |

| 7. Training | Staff và contractors aware of RWMP |

**High-risk equipment list:**

  • Cooling towers (Legionella source #1)
  • Hot water heaters < 60°C
  • Decorative fountains
  • Ice machines
  • Whirlpool baths / hydrotherapy
  • Water walls

**RWMP implementation steps:**

  • Form Water Management Team (engineer, infection control, facilities)
  • Describe water system (P&IDs, flow diagrams)
  • Identify hazard analysis for each component
  • Assign control measures và monitoring
  • Document and execute

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