Hand Hygiene Saves Lives, But Is It Realistic For All Nurses? - page 4

by TheCommuter Asst. Admin

18,038 Views | 47 Comments

As healthcare workers, we all know that proper hand hygiene saves lives because it greatly helps to prevent the spread of microbes that cause lethal diseases. Reputable entities such as the Centers for Disease Control and... Read More


  1. 1
    I'm a student so perhaps unqualified to respond. But... seriously? I know the logistics of an in and out complete sink wash may not work in some roles (myriad patients, unsanitary community health conditions), but what is the difficulty of carrying around a small bottle of hand sanitizer in one's pocket? And then doing the complete wash when necessary for patients with c diff, etc? I'm practically compulsive about using sanitizer at this point. They could do one of those reality shows about me because I find myself constantly pulling the bottle out and using it, even between between patients. Hey, I've got a low wbc count. So I figure if I'm concerned for my own safety, shouldn't I be equally or doubly concerned for the next patient who may even be more immune compromised? And what about my family? Don't want to bring anything home to them. They aren't all in the greatest of health. I strip at the door and launder as it is.

    I think in one country (Sweden maybe?) they don't even let you bring your scrubs home. The hospital launders your gear and you change AT work. And... they have lower infection rates.

    I have always either worked with the public (i.e. with people in compromised situations) or in food processing (commercial), so... I guess I've always been hypersensitive about the hand hygiene.
    BostonTerrierLoverRN likes this.
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    I'm sick to death of all the hand washing slogans. That is not the problem you wash your hands but there are germs everywhere in the hospitals. If the hospitals wanted to lower infections they would have dedicated equipment vitals, computer for every patient and cleaning would include using a UV radiation device that cleans a room between patients.

    We can wash our hands till their raw but if the cleaning of the hospital surfaces and equipment isn't meticulous it makes no difference! Cleaning is not what it used to be at least where I work! Cutbacks on housekeepers, rushing, cheaper products washing my hands isn't going to fix that or sharing equipment from room to room because the hospital is too cheap to provide dedicated equipment for each patient!
    monkeybug, nrsang97, and emmy27 like this.
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    If I'm playing mednurse for the day then hand sanitizer/wipes are the only way to perform hand hygiene between EVERY single pt.I
    have to put my meds away... clear my cart... locate a bathroom because the one closest to the dining hall (employee bath) is broken, etc....
    I don't have time for that.
    We have sanitizer dispensers installed...and 1/2 are usually empty because house-keeping is lazy about filling them.

    I have to pull meds as quickly as possible:
    - I usually have between 40-42 residents to administer meds to.
    - SEVERAL people (para schizo, manic) must have their medication added to their food or they won't take them and they'll start getting out of hand...before you know it, they're raging and we're having to send them out to bring them down. I have one little lady who just got back. They readjusted her meds. DC'd one and put her on a benzo (can't recall the name). It's working. She's calm. Talkative, even. Still very delusional but more...'normal'. You can almost see the REAL her peeking through sometimes. Almost.
    We need to keep her that way. She canNOT afford to be allowed to skip meds. I try my d*mndest to beat the food trays to her in order to keep that woman regulated. Etc....
    - I need to get the meds out 'on time'. I need to pass the meds at the times when the residents are most likely to congregate in one spot.

    I'd like to mention that I don't touch the meds. Since I cut corners on the hand hygiene...I try to, at least, not handle the pills with my hands.

    Other than that - if I'm just a regular nurse for the day? Yes - I wash hands between each and every pt. Its not like I'm doing in-depth assessments on all 40+ pt's. Pass a few meds. A treatment here. Some woundcare there. A little suctioning as needed.
    The time crunch comes with the paperwork/charting, mostly.
    I hate charting.
    BrandonLPN likes this.
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    Yay! We got tablet and keyboard covers today!!! We just might catch up with the 20th century soon!
    Firestarter_RN likes this.
  5. 3
    Quote from brandy1017
    I'm sick to death of all the hand washing slogans. That is not the problem you wash your hands but there are germs everywhere in the hospitals.
    Our hospital fixed that. Now the nurses have to clean all the high-touch areas. Because well, housekeeping cleaning the high-touch areas would be crazy...
  6. 0
    Quote from TheCommuter
    As healthcare workers, we all know that proper hand hygiene saves lives because it greatly helps to prevent the spread of microbes that cause lethal diseases. Reputable entities such as the Centers for Disease Control and Prevention, the World Health Organization, and numerous other health-promoting groups all extol the benefits of good hand hygiene. Is proper hand hygiene achievable in all healthcare settings? I know that the knee-jerk reaction to this question from many people would be a resounding ďYes!Ē However, I suspect that the vast majority of those who believe it is possible to maintain proper hand hygiene in all types of locales have never worked outside the acute care hospital. Proper hand hygiene is very much doable when a nurse is caring for five to seven patients on a medical/surgical floor, has alcohol foam pumps in every room, and abundant sinks throughout the hospital. But what about the nurses who work in long term care, home health, private duty, or community health settings? I worked in long term care (a.k.a. nursing homes) for more than six years. During the night shift at one particular facility, I routinely cared for 68 residents with the help of three nursing assistants. The infection control staff at most healthcare facilities recommend that workers perform hand hygiene before entering every single patient room and upon leaving each room. Letís assume that I entered each residentís room twice during the course of a routine shift. This would amount to four occurrences of hand hygiene per resident. Four hand-washings or alcohol gel rubs multiplied by 68 residents would equal 272 instances of hand hygiene. In case youíre wondering, this was not feasible during the course of one 8-hour shift due to time constraints combined with the skinned, painful hands that would have resulted. Nurses who work in home health and private duty also face some of the same challenges, even if they only provide care to one patient at a time. Some patients cannot or will not keep hand soap and paper towels inside their homes. In these cases, it is up to the home health nurse to supply his or her own soap, towels, and hand sanitizer to maintain proper hand hygiene. Once in a blue moon the home health nurse may encounter a patient in a rural area who has no running water. On occasion they might be assigned to a patient whose dwelling has no hot or warm water due to the natural gas or electricity having been disconnected. In these instances the nurse would need to use alcohol gel rub, hope for the best, and wait until they leave the house to perform a complete hand-washing at a venue with a public restroom such as a gas station or restaurant. Achieving proper hand hygiene for nurses who work outside the traditional acute care hospital is a complex challenge with no simple solutions. However, healthcare workers who work in other settings can do the best they can with limited resources. Increased staffing and thorough education on infection control practices are helpful in long term care settings such as nursing homes and assisted living facilities. Home health companies and private duty agencies may consider providing detailed infection control education and supply employees with kits that include anti-microbial soap, paper towels, and alcohol-based gel rub or foam. Hand hygiene prevents illness, injury, and death. With appropriate education, adequate staffing, and abundant supplies, proper hand hygiene can become a reality in all types of healthcare settings. Hand washing protects us and our patients. Letís step up to the challenge.
    I have to say I work for a wonderful Homecare agency. They provide us with liquid hand soap, alcohol based hand sanitizer, hand lotion and paper towels. When we run out we just go to the office and get more. I work in an urban area and some places you don't even want to stand in let alone find somewhere to wash your hands. It really is tough out there and more agencies need to do what mine does.
  7. 3
    Quote from wooh
    Our hospital fixed that. Now the nurses have to clean all the high-touch areas. Because well, housekeeping cleaning the high-touch areas would be crazy...
    Almost crazy as housekeeping having to clean a poopy mess in a pt bathroom. I mean, everyone knows poop automatically equals nurse!

    But don't worry..... as long as the nurse cleans up all the visible pooh, housekeeping will come in behind and bleach everything.
    nrsang97, RNfaster, and wooh like this.
  8. 1
    Quote from brandy1017
    ...We can wash our hands till their raw...
    Maybe that contributes to yet another potential problem. Think of the skin as not just a multiple layer membrane that keeps body parts where they belong (i.e., inside), but also keep infection out. Wash you hands too often and (the cold climate folks will see this more often) there are numerous "ports" through which infection can enter the body or be carried to others. Alcohol draws moisture from surfaces, so dry skin is going to happen. Use a moisturizing lotion and you can eliminate some of the dryness, but is that also creating a moist medium in which to "grow" various infections?

    The answer is likely somewhere in between, and includes universal precautions.
    Firestarter_RN likes this.
  9. 0
    My diligence in adequate hand hygiene is due to my love of myself. I hate germs, so naturally I abhor other people's germs. I know we can't prevent everything, but I like to think I can prevent as much as I can by doing a simple thing like washing/sanitizing my hands as often as necessary and then some. We have to step up people. This is one reason to be selfish and not look bad. Perform hand hygeine to protect yourself. You will in turn protect others. It is that simple!
  10. 0
    Quote from MedChica
    If I'm playing mednurse for the day then hand sanitizer/wipes are the only way to perform hand hygiene between EVERY single pt.I
    have to put my meds away... clear my cart... locate a bathroom because the one closest to the dining hall (employee bath) is broken, etc....
    I don't have time for that.
    We have sanitizer dispensers installed...and 1/2 are usually empty because house-keeping is lazy about filling them.

    I have to pull meds as quickly as possible:
    - I usually have between 40-42 residents to administer meds to.
    - SEVERAL people (para schizo, manic) must have their medication added to their food or they won't take them and they'll start getting out of hand...before you know it, they're raging and we're having to send them out to bring them down. I have one little lady who just got back. They readjusted her meds. DC'd one and put her on a benzo (can't recall the name). It's working. She's calm. Talkative, even. Still very delusional but more...'normal'. You can almost see the REAL her peeking through sometimes. Almost.
    We need to keep her that way. She canNOT afford to be allowed to skip meds. I try my d*mndest to beat the food trays to her in order to keep that woman regulated. Etc....
    - I need to get the meds out 'on time'. I need to pass the meds at the times when the residents are most likely to congregate in one spot.

    I'd like to mention that I don't touch the meds. Since I cut corners on the hand hygiene...I try to, at least, not handle the pills with my hands.

    Other than that - if I'm just a regular nurse for the day? Yes - I wash hands between each and every pt. Its not like I'm doing in-depth assessments on all 40+ pt's. Pass a few meds. A treatment here. Some woundcare there. A little suctioning as needed.
    The time crunch comes with the paperwork/charting, mostly.
    I hate charting.
    I hear your gripe, but I don't see the problem. Hand sanitizer came about because of situations where hand washing was not feasible. If the hand sanitizer is always out, then get a hold of housekeeping... better yet get them to give you your own and stash it somewhere. I look at it this way: if it were my mother....


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