Nurses’ Knowledge and Practices Regarding Safe Drinking Water and Waterborne Diseases: Clinical Risk Assessment, Infection-Control Education, Environmental Health Surveillance, Community-Based Prevention, and Hospital Nursing Interventions

Abstract

Safe drinking water is fundamental to health. Nurses occupy pivotal positions at the intersection of clinical care, infection prevention and control (IPC), environmental health surveillance, and community outreach; they are uniquely positioned to prevent, detect, and respond to waterborne disease. However, knowledge gaps and variability in practices among nursing staff compromise risk mitigation at individual, facility, and population levels. Nurses are essential actors across the continuum of water safety: prevention, surveillance, clinical management, outbreak response, and education. The complexity of waterborne disease prevention demands that nursing roles extend beyond bedside care to active participation in environmental surveillance, Water Safety Plan (WSP) implementation, and public health coordination. Nurses bring clinical insight into risk assessment (identifying vulnerable patient groups such as neonates, oncology and transplant patients, and those with indwelling devices), operational knowledge of point-of-use (POU) device workflows, and frontline experience with early clinical signals that often precede laboratory confirmation. Evidence from hospital-based programs demonstrates that integrated clinical–environmental approaches — for example, routine microbiologic monitoring coupled with targeted patient surveillance — reduce the incidence and duration of water-related healthcare-associated infections (HAIs) and outbreaks by enabling earlier corrective action and targeted prophylaxis.