Des travaux scientifiques ont été réalisés à l’hôpital Robert Ballanger au niveau des canalisations d’eau du service de stérilisation centrale. Il est apparu un manque de recommandations réglementaires, quant à la gestion du risque lié à l’eau en stérilisation, et un défaut de connaissance des activités des intervenants, hospitaliers et extérieurs, sur le réseau d’eau de l’établissement

Les contrôles physico-chimiques et microbiologiques font apparaître une hétérogénéité dans les résultats, due en partie à l’absence de contrôle de qualité, à la multiplicité des intervenants ou à la vétusté des réseaux.

Il semble indispensable de mettre en oeuvre une centralisation des résultats, de suivre les opérations de maintenance, de créer des indicateurs qualité et d’établir des référentiels internes, afin de mieux maîtriser la qualité de l’eau, utilisée notamment en stérilisation centrale qui fournit des dispositifs médicaux stériles.

Since 2000, the central sterilization departments have been part of pharmacy departments within hospitals – this is an optional activity which depends on the prefect authorities. The central sterilization department of the Robert Ballanger Hospital (RBH) in Aulnay-sous-Bois (north-east of Paris, France) set up actions, following a significant bacteriological contamination of the water supplying the steam generators of autoclaves. This situation brought out a lack of lawful recommendations on sterilization environmental control programs, on the risk management related to water and on a defect of knowledge of the activities of the various water actors involved with the hospital network. Consequently, an assessment was carried out in the sterilization department of public and private hospital structures in the Paris region. The results showed a great heterogeneity in the frequency and nature of physicochemical and microbiological controls carried out. Our survey underlines an important variation among pharmacists’ acknowledgment on water network in their establishment. It seems to be related to plumbing works realisation, bacteriological contamination experience and so on. The importance of a centralization of the water risk management is highlight.

All the hospital partners had a role to play, from the surgeon to the management of the health institution. Engineering departments and external subcontracting companies of maintenance were concerned too. Thus, a group related to water was put into place in RBH, in order to update the maps of the water network, as well as to follow the maintenance activities, to establish quality indicators and to make known and to apply the legislation. It seems better if each hospital is responsible for establishing its internal references, according to guidelines made by competent authorities, because of the plurality of equipments, structures and age, encountered among various establishments.