A multicentric survey and single-centre observational study of usage behaviour of sinks in intensive care: training is needed to minimize risk.

Introduction: Sinks have been introduced near patients to improve hand hygiene as part of infection prevention and control measures. However, sinks are a known reservoir for gram-negative bacterial pathogens in particular and their removal to prevent bacterial infections in intensive care patients is currently recommended by several international guidelines.

Methods: Healthcare workers (HCWs) in 15 intensive care units (ICUs) in Germany were given the opportunity to complete an anonymous survey on the use of sinks between August 2022 and January 2023. Observations were then made in three participating ICUs to determine the frequency and reason for contact with the sink.

Results: 258 questionnaires were returned (nurses 87%). 90% found it useful to very useful to have a sink in the patient room, and 56% reported using it daily for hand hygiene. We observed 33 contacts between nurses and sinks over 17 h. In 20/33 (60%) cases, the sink was used for waste disposal. In 3/33 (10%) it was used for hand washing.

Discussion: Sinks are still used for daily care in intensive care units. Educational Interventions in existing buildings to minimise risk through "sink hygiene" (i.e. separation of sinks for water disposal and uptake) can make an important contribution to infection prevention.