During renovations when plumbing fixtures at one end are being capped rather than removed, should the infection preventionist bring this concern to the water management team, and why?

• A. Yes, because lack of water flow can cause stagnation and spread of microorganisms
• B. No, because capped fixtures pose no risk
• C. Only if there is a leak
• D. It is not IP's concern

Answer: (A)

During renovations, water movement can be disrupted, and capping fixtures at one end creates long sections with very little or no flow. Stagnant water loses disinfectant residuals, encourages sediment buildup and biofilm formation, and provides a favorable environment for pathogens to persist. This increases the risk of waterborne infections when the system is re-energized or fixtures are used.

The infection preventionist should bring this concern to the water management team to ensure a plan is in place: assess for dead legs, implement flushing to clear stagnant water, maintain appropriate temperatures and disinfectant residuals, use temporary piping or bypasses to keep water moving, and consider sampling if indicated. This coordination helps prevent Legionella and other opportunistic pathogens from growing and being aerosolized during and after renovations.

The idea that there is no risk from capped fixtures or that it’s not IP’s concern misses the core goal of protecting patients and staff from waterborne infections, and waiting for a problem to appear can lead to outbreaks.