Center shares lessons from water damage

Sprinkler head damaged during cleaning

Managers at surgery centers have learned that, similar to a Code Blue, you must react quickly when you have a water leak to prevention serious damage, including mold.

At Powder River Surgery Center in Gillette, WY, a staff member was performing terminal cleaning at about 5 p.m. on a Wednesday earlier this year and accidentally hit a sprinkler head. It immediately began spewing water, says Michelle Kioschos, RN, CNOR, executive director of the center.

The employee ran out of the room, closed the door, and yelled for help. An employee sprinted to the main sprinkler room to turn off the water, which took a couple of minutes. "There's a lot of water that comes out of a sprinkler head," Kioschos says.

Members of the staff grabbed blankets, sheets, patient gowns, mops, and whatever else they could find to stop the flow, Kioschos says. The water started seeping through the walls, and the staff members worked quickly to stop it from flowing throughout the center. They then started to clean up the water. "The water was contained and damaged was minimal due to the quick response of staff," she says.

A staff person ran to call the fire department. The firefighters ensured water still was flowing to the rest of the two-level building.

The center called a national disaster recovery company. "They were there in 10 minutes," Kioschos says. The recovery staff cleaned up the excess water and placed blower hoses in the walls just in case any moisture had reached those areas. The air blowing continued for two days. Every couple of hours they performed a humidity check and a mold check. Their visit was followed by an independent construction company that verified the continuity of the walls. "There was no water damage, because the response time was so quick," Kioschos says.

The center cancelled surgical procedures for two days (Thursday and Friday), then staff members worked through the weekend cleaning up to ensure there was no potential for infection or contamination. As a precaution, the staff threw out all sterile supplies in the room with the water leak, even the ones in a closed cabinet, but the equipment was saved, Kioschos says.

The center performed cultures immediately after the incident in the rooms and cabinets. The entire center was terminally cleaned twice. The walls were scraped and repainted. All floors were buffed and waxed. "We wanted to make sure there was no residual water anywhere at any point," Kioschos says. "It might sound like I went to the extreme, but in this environment, I don't think you can ever go to the extreme."

She shares these lessons:

• Consider water damage to be a potential risk. "I've been administrator for eight years, and one of the things I learned is that not all potential risks are not what we think they are," Kioschos says. "Knowing we terminally clean rooms every day, I had no idea that [water damage] was a potential risk."

• Know where your emergency shutoff valve is located. "That reduces significantly the water damage," Kioschos says.

All utility shut-off valves should be marked clearly, including which one is "open" and which one is "close," sources advice. Also, list the locations of those shut-off valves in a fire and disaster manual, and use a floor plan to mark where they are, they advise. Some valves, especially sectional valves, might be above the ceiling tiles, they note.

• Work with your local firefighters to ensure they are familiar with the layout of your building. While the fire marshal regularly checks out the Powder River facility's sprinkler system, the firefighters and volunteers with that department aren't familiar with the building, even though they are located only a block away, Kioschos says. Also, the building superintendent isn't always on site, she points out.

"If you're at a facility open 24 hours, there's always someone around," Kioschos says. "We're an ASC; we close at 5. What if this happens after 5, and security lets them in? Do they know where to go?"

To address this issue, firefighters have been doing walk-throughs to become familiar with the building, Kioschos says. (For another water damage incident, see story, below.)

Rare earthquake causes water leak

In April 2008, the Midwest experienced a small earthquake. When staff arrived the next morning at Kendall Pointe Surgery Center in Oswego, IL, they discovered a small cold water feed supply line to a sink had broken. About 2 inches of water had poured into the PACU area.

"Like a Code Blue, you respond without really thinking about it," says Angie Burns, administrator. "We saw the water, we got towels and piled them around the leak until we could get a plumber to it." The plumber was called immediately to stop the water flow, and then the staff turned to cleaning up.

Mark Mayo, executive director, ASC Association of Illinois, said, "Cleanup was not as simple as mopping." As the situation created a start to a mold condition, cleanup required fungicide, air drying, and removal and replacement of a lower portion of drywall and insulation between some walls, as water had seeped up drywall, Mayo says. None of the damage reached the ORs.

When the water leak was discovered, Burns immediately went home and retrieved a shop vac to vacuum up the water. She also called a national firm that brought additional shop vacs to vacate the water. That company also used massive fans to dry the center. The center managers contacted the insurance company to report the damage. This step should be taken immediately, because the insurance company will provide instructions and start a claim, Burns says.

The managers contacted another company to handle the water remediation and mold remediation.

The center was closed for only one day (Friday). The vendors worked over the weekend, including nights, so the center could reopen Monday.