Contact precautions and nowhere to wash my hands?

[november17]

Our hospital policy states you must have gloves and gown prior to entering a patient's room that is in contact precautions. Fair enough. They also state that we must wash our hands using soap and water after removing our gloves. Again, completely reasonable, I'm in agreement with that.

The rooms at the hospital I work at are pretty small. The sink is inside the room, next to the patient's bed. It is a shared sink, patients use them to wash their hands too. To get to the sinks you have to walk into the room. The next nearest handwashing station is at the nurse's station.

To wash my hands with soap and water, I have to enter the patient's room after degloving and degowning, which I'm not supposed to do (per policy and if I was seen doing it I'd get dinged by the infection control nurse). Otherwise, I have to go to the nurse's station and handle the sink handles there and hope I don't touch anything accidentally on my way. Not to mention, if I'm touching the sink handle at the nurse's station I'm contaminating it.

So, my question is, in your opinion, what is best practice in this situation?

[S.Gettes]

Well since the sinks have sensors to turn on when needed and the door is open then this means there is no need once you have done your duties for the patient for you to touch anything. I would simply go in with gloves and gown as per requirements and then remove said items upon leaving room ensuring not to touch anything along the way or anyone and wash hands at nearest wash station that does not require you to enter the room of another patient. If nurses station basin is not sensored then you may need to request another nurse to turn taps on for you so that you may wash your hands without contaminating the tap. This is something that should be looked at though as i do see your dilemma.

[kanzi monkey]

Well since the sinks have sensors to turn on when needed and the door is open then this means there is no need once you have done your duties for the patient for you to touch anything. I would simply go in with gloves and gown as per requirements and then remove said items upon leaving room ensuring not to touch anything along the way or anyone and wash hands at nearest wash station that does not require you to enter the room of another patient. If nurses station basin is not sensored then you may need to request another nurse to turn taps on for you so that you may wash your hands without contaminating the tap. This is something that should be looked at though as i do see your dilemma.

No sensors or foot controls on our sinks. It is not realistic to expect that someone will be available to turn on the tap--frequently the nurses station is empty and everyone is in a room. I think the issue addressed in the OP is that following "policies" is sometimes impossible, and infection control is often managed on the fly using impromptu creativity and critical thinking skills. We all know the REASON we have infection control, but the "policies" in place to ensure IC are just not always realistic. When considered more as "guidelines", we can do our best to meet the written expectation, while recognizing that the real expectation is not that "gowns and gloves are removed, hands washed before leaving room, etc, etc", but that "infection will not be spread from one pt environment to another". The issue is that some people will maybe see a person that is not strictly adhering to the policy and report them as not complying with the rules--even though that person might be actively aware of IC, and improvising a method for maintaining it when the environment demands an alternative.

[Scarlette Wings]

sounds like an excellent opportunity to make some improvements in the design of your facility and in patient care. there is nothing that can really take the place of hand washing with soap and water. even the gels and foams with the alcohol that many hospitals use are not as thorough. approach your infection control person with a request for more hand hygiene stations and sinks for hand washing. making the request may be all the ammunition she or he needs for approaching administration.