Ask the care expert ... about water temperature in SNFs

Sherrie Dornberger, RNC, CDONA, FACDONA, executive director, NADONA
Sherrie Dornberger, RNC, CDONA, FACDONA, executive director, NADONA

The nursing and maintenance departments are feuding over the water temperature. What should it be in a skilled care unit?

According to F-323 PP and the federal guidelines, the water temps should stay below 120 degrees Fahrenheit. A burn would take five minutes at that temp; 100 degrees is listed as a safe water temperature.

In our building, all of the nursing supervisors had thermometers to check water temps as they would fluctuate during the day, depending the need for hot water in the kitchen, on-premises laundry, preventive work, etc.

We would issue notices to the maintenance department, with a copy to administration, if the temps went over a certain degree. We also kept water thermometers for the tubs, and our staff was trained to not rely on the temperature gauge built into the tubs. They were mandated to do a second check with another thermometer — and NOT the thermometer used on the residents! 

A burn is extremely painful and is easy to prevent. A burned resident also would require a call to the Department of Health, and most likely would result in a fine (deficiency for actual harm). A loss of certification or the employee's license is possible. 

Perhaps a short in-service with maintenance on what burns look like, and how hot 120 degrees really is, would help. Explain we are dealing with frail residents who may have illnesses that make them susceptible to a burn.

Help all departments realize they are an important spoke in the wheel in providing a safe and secure environment. The job of adjusting water temps may be taken for granted on a daily basis, but try to make everyone understand QA checks and safety inspections are part of resident care. Everyone should be working toward the same goal.