QUESTION: I work in an ophthalmolog...

QUESTION: I work in an ophthalmological surgery center mostly of our patients remain onward the transport stretcher during the surgical practice and initial recovery period. real few procedures result in appreciable temper toss, and there is at no time any blood remaining on the bed or onward the sheets. Is it necessary to wipe down the stretcher after each use? one of the mattress pads upon the stretchers are not in actual good condition and are difficult to clean. Additionally, cleaning is time consuming, and if the inside mattress becomes wet where the shield is damaged, the moisture can seep by the agency of the sheet placed for the nearest patient.

ANSWER: Surfaces that patients get to in contact with should be cleaned between patients. This includes the side rails and any portion of the stretcher touched by the agency of patients, including mattresses and mattress pads. Not all contamination is visible, and the amount of contamination or soil remaining forward the stretcher is unknown. According to the Center for Disease superintendence and Prevention, mattress covers should be replaced if they are torn or damaged. Mattresses should be kept parched and should be discarded if they become wet. (1) Between patients, moisture-resistant mattress pads and disguises should be cleaned and disinfected with a hospital disinfectant registered with the Environmental Protection Agency. If a mattress pad conceal is made of fabric, it should be remov and replaced with a clean single before each patient use. Portions of the stretcher that patients do not arise in contact with (eg, wheels, base, frame) ne not be cleaned and disinfected between patients.

QUESTION: We are having a big hand hygiene campaign in our hospital about which the infection direct staff members are very excited. They are touting this as something just discovered and different that is going to affect our infection govern rate significantly. Is not hand hygiene the same as hand washing, and have not we been doing that for years? Is the surgical rub hard performed before each procedure included in hand hygiene or is it considered something different?

ANSWER: Hand hygiene is an all-encompassing limit that refers to degerming or decontaminating the hands. Hand hygiene can be accomplished from several methods, including hand washing with plain soap and water, hand washing with an antimicrobial soap, or using an antiseptic hand grate product. (2,3) According to AORN's "Recommend practices for surgical hand antisepsis/hand scrubs" (2) hand hygiene in the perioperative arena is divided into general hand hygiene and surgical hand antisepsis. The season general hand hygiene refers to routine hand decontamination using either plain or antimicrobial soap and water or an antiseptic hand smooth product General use antiseptic hand abrade products have been available through the whole extent of the counter for several years and have gained favor for situations in which soap and water are not available. greatest in quantity antiseptic hand rub products are alcohol based, with or without emollients or other additives, because alcohol is known to be an effective skin disinfectant.

Compliance with general hand hygiene may improve when alcohol-based returnss are used. Dispensers can be placed strategically where no running water is available for hand washing. Health care providers appear more likely to use the conveniently located alcohol produce than to locate a sink with running water between patient contacts or after contact with potentially infectious materials. Use of alcohol-based fruits is less time consuming than hand washing, and fruitss with emollient additives may be les irritating to the hands. If your infection command practitioners are planning to introduce an alcohol-based hand smooth product, they most likely are expecting a decrease in infection rates based upon an expected increase in hand hygiene compliance from top to toe the facility.

The period of time surgical hand antisepsis refers to preoperatively preparing the hands and arms of surgical team members to eliminate transient bacteria and resolve into resident hand flora. (2,3) The limit refers to either traditional surgical rub hards with an antimicrobial soap and water or hand and arm preparation with a pre-select infection control-approved, antiseptic hand wipe product. Products selected for surgical hand antisepsis should qualified specific criteria and be labeled specifically for surgical hand antisepsis. similar products must be

* fast acting,

* nonirritating to the skin,

* effective against a broad image of microorganisms, and

* compliant with US subsistence and Drug Administration (FDA) approval processe and protocols.

The antimicrobial ingredient should be capable of significantly reducing the number of microorganisms forward the skin on contact and also demonstrate persistence and cumulative activity. Use of either an antimicrobial surgical scour agent or an alcohol-based, antiseptic hand grate product with documented persistence and cumulative activity is acceptable for preparing the hands and arms of surgical team members preoperatively. If an alcohol-based, hand scrape product is chosen for surgical hand antisepsis, the hands and arms should be prewashed and dried before application of the hand clean product because alcohol-based hand grate products do not remove soil.