June 24, 2010 | | Comments 4
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Watch your fish tanks for waterborne illnesses

If you’ve ever seen Finding Nemo, you’ll know that fish tanks can get right nasty very quickly if they are not well-cared for.

That said, there’s not a ton of specific guidance on this regard; even the CDC Guidelines for Environmental Infection Control in Health-Care Facilities uses no stronger dictate than “avoid” when it comes to fish tanks:

I. Controlling the Spread of Waterborne Microorganisms

  1. Practice hand hygiene to prevent the hand transfer of waterborne pathogens, and use barrier precautions (e.g., gloves) as defined by other guidelines (36,142–146). Category IA
  2. Eliminate contaminated water or fluid environmental reservoirs (e.g., in equipment or solutions) wherever possible (142,147). Category IB
  3. Clean and disinfect sinks and wash basins on a regular basis by using an EPA-registered product as set by facility policies. Category II
  4. Evaluate for possible environmental sources (e.g., potable water) of specimen contamination when waterborne microorganisms (e.g., NTM) of unlikely clinical importance are isolated from clinical cultures (e.g., specimens collected aseptically from sterile sites or, if postprocedural, colonization after use of tap water in patient care) (148–151). Category IB
  5. Avoid placing decorative fountains and fish tanks in patient-care areas; ensure disinfection and fountain maintenance if decorative fountains are used in public areas of the health-care facility (152). Category IB

When all is said and done, this clearly becomes the territory of the mighty risk assessment process. The location of the tanks, how immunocompromised your patients might be, etc. are all important considerations. And I suspect that it would be worthwhile figuring out exactly what would make a fish tank in a patient-care area “unavoidable.”

For instance, recognizing the calming effect of little fishies swimming around, you might not be able to have them in a pediatric oncology area; but going a bit further, if you can environmentally separate the fish tank from the area, the risks might at that point be outweighed by the benefits. It also wouldn’t be a bad idea to involve some physicians in the assessment process — your epidemiologist or even an oncologist would be a very authoritative “voice” to have in the discussion, particularly if you find yourself defending your position with those regulatory types.

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Steve MacArthur About the Author: Steve MacArthur is a safety consultant with The Greeley Company in Danvers, Mass. He brings more than 30 years of healthcare management and consulting experience to his work with hospitals, physician offices, and ambulatory care facilities across the country. He is the author of HCPro's Hospital Safety Director's Handbook and is contributing editor for Briefings on Hospital Safety. Contact Steve at stevemacsafetyspace@gmail.com.

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  1. My activity director will hang me!

  2. Another risk to consider is that salt water tanks can pose electrical safety and fire risks if there is any possibility of water splashing or dripping on electrical connections.

  3. Since most of the issues with waterborne illnesses deal with aerosolization of the water, A covered fish tank that is properly cleaned and maintained should really pose little risk.

  4. I am wondering if anyone has an existing policy for fish tanks that they would be willing to share? This would be for a healthcare setting in a non patient care area (private office).
    Thank you.

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