Water quality has been a popular subject in the news recently. I thought it would be a topic worth mentioning in this week's issue because of how it can affect the Decontam Department. Water quality is critical with many areas of uses. During surgical instrument reprocessing, it's important to test the water quality because it is key to the performance of chemical cleaning agents. In particular, hard water binds up detergent molecules, preventing them from breaking down the contaminants. Further, these molecules are often a source of staining and pitting of surgical instruments. Enzymes used in enzymatic detergent are highly influenced by the pH level of water. An improper pH level can lead to the partial or complete inactivation of the enzymes relied upon to breakdown the soil on instruments. Total alkalinity measures the amount of alkaline buffers in water. These alkaline substances buffer the water against sudden changes in pH. Total alkalinity is the key to maintaining water balance. Be sure your department has regular testing in place to ensure you are cleaning instruments with optimal water quality.