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CDC Legionella toolkit

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DEVELOPING A LEGIONELLA WATER MANAGEMENT PROGRAM 21 6 Make Sure the Program Is Running as Designed & Is Effective Verification: Are we doing what we said we would do? Your program team should establish procedures to confirm, both initially and on an ongoing basis, that the water management program is being implemented as designed. This step is called "verification." For example, if you said you would test the hot tub daily for chlorine and record and communicate those results, have you been doing that? If you found a problem, did you take the action included in your program? People should not verify the program activity for which they are responsible. For example, if one person is responsible for maintaining the hot tub and another is responsible for the cooling tower, they could verify each other's work, not their own. Healthcare Facilities Water management program teams that include infection control staff may also choose to use their facility's routine surveillance for healthcare- associated Legionnaires' disease to validate their program. To look for healthcare-associated cases, histories for all patients with diagnosed Legionnaires' disease should be reviewed for possible healthcare exposures and certain patients with healthcare- associated pneumonia (see gray box on page 13) should be tested for Legionnaires' disease. Validation: Is our program actually working? Now that you have a water management program, you need to be sure that it is effective. Your program team should establish procedures to confirm, both initially and on an ongoing basis, that the water management program effectively controls the hazardous conditions throughout the building water systems. This step is called "validation." Environmental testing for Legionella is useful to validate the effectiveness of control measures. The program team should determine if environmental testing for Legionella should be performed and, if so, how test results will be used to validate the program. Factors that might make testing for Legionella more important include: Having difficulty maintaining the building water systems within control limits Having a prior history of Legionnaires' disease associated with the building water systems Being a healthcare facility that provides inpatient services to people who are at increased risk for Legionnaires' disease (see Appendix A) If the program team decides to test for Legionella, then the testing protocol should be specified and documented in advance. You should also be familiar with and adhere to local and state regulations and accreditation standards for this testing. Reference: ASHRAE 188: Legionellosis: Risk Management for Building Water Systems June 26, 2015. ASHRAE: Atlanta. www.ashrae.org 6 6 6

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