FMC - taking pillows out of all units?

[anurseadvocate]

I am interested in knowing your opinions in regards to FMC taking pillows out of all unit. The reasons given in numerous facilities is 'infection control'. However, units are telling patients they can bring their own pillow from home....................WOW.. this is certainly an infection waiting to happen. Patients use pillows under their arms when staff are cannulating, use a pillow under their arm for comfort, or behind their back for comfort in the most uncomfortable chairs... Staff in units are stating that torn pillows harbor bacteria............well, HELLO.. if the pillow is torn then get rid of it.

Patients can bring, from home, their pillow. However, this is even a worse nightmare. When staff cannulate patients their PPE (plastic gown) often, if not always, touches the patient's pillow. Then the staff go to the next patient, touching their pillow with their gown, or hands (as we know many staff do not wash between patients). Hence, TRANSFER OF BACTERIA. We do NOT, repeat NOT know what bacteria patients are bringing from home.

Many of us believe this is not a practice, new policy to prevent the spread of infection but a cost-saving policy as a result of the new bundling...saving money on high numbers of disposable pillow cases used.

Patient comfort should come first. This has shocked many patients, as did the foot stools...But it is obvious that patients bringing their own pillows from home can be worse than present policy. If ALL staff were careful not to have their gowns touch the patient's pillow, then this would be a different story. Infection remains the number two cause of death among this vulnerable population and even with the surveys and results of surveys it is apparent that lack of correct infection control practices remains high on the list...

[traumaRUs, MSN, APRN]

This is nothing new. I work in 21 FMC and Davita units and for at the least the past 4 years (since I took this job), no blankets, sheets or pillows have been provided by any of the units.

I think its totally gross to reuse pillows and the techs don't allow the pts to rest their arms on their pillows, they must rest their arms on the chair with a blue pad between the pt and the chair.

[anurseadvocate]

So much for having the patient be comfortable. If the patient has a pillow, from the unit, with a plastic covering that is cleaned/disinfected between patients then has a disposable cover on it that is ok.. BUt, have any units recently removed pillows? IF it is cost related then patients should be told the honest reason versus infection control. Too bad they don't focus more on staff implementing correct infection control practices... just take a look at a survey.. ask to see a survey of the unit u work in... I would bet, more than not, there are deficiencies in IC

[rn,lmt]

I worked in a unit where many of the patients had bedbugs. These little critters love to make their homes in pillows, mattresses, and a million other places. In fact, some of the patients were so infested, they would "flick" them off of their clothes, shoes, coats, and blankets throughout their treatments. I don't think there is a good answer about the pillow question.

[anurseadvocate]

This is nothing new. I work in 21 FMC and Davita units and for at the least the past 4 years (since I took this job), no blankets, sheets or pillows have been provided by any of the units.

I think its totally gross to reuse pillows and the techs don't allow the pts to rest their arms on their pillows, they must rest their arms on the chair with a blue pad between the pt and the chair.

In all due respect again..... it might be gross .. and bringing pillows from home is bringing into the unit more infectious agents... using pillows that are disinfected after each use ,,, then w/ a cover is protection for patients. In all the 21 units you work in (FMC and Davita) have you read their survey findings? I am sure there were many other areas of infection control cited that probably need more attention.... you are probably aware that even with the new revised Conditions that infection control continues to be at the top of the list....

[traumaRUs, MSN, APRN]

I don't work for FMC or Davita, I'm one of the mid-levels who care for the pts medical/dialysis needs. The running of the HDU is the responsibilty of the dialysis company, not mine.

I have nothing to do with the rules one way or the other. I'm just commenting that this is what I see.

[madwife2002, BSN, RN]

I heard the reason that dialysis units were not providing sheets/blankets or pillowcases was the cost of having them laundered, and not infection control.

It will only get worse when medicare introduce the new way of charging for dialysis-a kinda one price fits all

[anurseadvocate]

Indeed, the bundling will and has, in my thinking, already started a wave through dialysis units. Some units do not supply certain items e.g. bandaids (per a patient I spoke with) yet another stopped using pillows (cost of disposable covers). I am guessing that there will be many changes down the road, including cutting staffing. Prior to the bundling, facilities charged for everything (separately billable items, etc e.g. medications, supplies).. now they will be getting a fixed rate with various allowances for certain situations/conditions (to make it simple)...However, as we all know, many facilities abused the use of Epogen thus resulting in studies e.g. the CHOIR, etc. and then the Congressional Hearings on Epogen. Epogen accounted for, if I can remember, approximately 20, or a bit higher, percent of their revenue -- a good chunk... many providers are now pushing home dialysis whereas before they did not..... perhaps thinking they will make money (profit driven, business world of dialysis - reality) There are many pros to this bundling but then again there are many cons which will affect staff as well as patients.

[maxinel]

Fresenius in my opinion, is a profit driven company and bottom line is how much they can save. I've worked for them off and on for the last 2 years, and I'm totally unimpressed. 'Ultra Care' is a joke.

[anurseadvocate]

Most of the providers are 'profit-driven' and profit is the bottom line for them and is the priority.. however, it is my belief that a company can, in fact, make a profit and still provide quality safe care. Indeed this move is, no doubt, to save money especially with the bundled rate coming. Providers are GETTING READY................many are now pushing home dialysis whereas before they did not.... it is my personal opinion that if providers were to be more transparent e.g. telling patients we are trying to save money in certain areas in order to be able to continue to provide quality safe care in light of the upcoming cuts in payment --- well, perhaps patients would not be so upset about such changes. And then one must ask why all of a sudden would a unit be removing a pillow and stating it is for infection control when that unit has had pillows for years and years... speaking of...................do they think people are stupid (smiling).. I think not...

[GeauxNursing]

we got rid of pillows years ago. (davita) the FMC I work for PRN has no pillows. Or footstools on the chairs anymore, can anyone explain that one?

If you say that pts cannot bring in their own pillows because we rub up on them accidentally, then can they not bring in their own bags? Their blankets and earphones, gloves, and other comfort items? I might rub up on those just as easily. The pts might as well come in and get naked before they get in the chairs, their clothes might be contaminated! Sorry, just being silly.

But seriously, I'm sure it was a combination of the two issues: cost and infection control. The pillows we got rid of were kind of yucky. Yes, they were disinfected every treatment, but they weren't in good shape.

[anurseadvocate]

Good point - The reason for removal of foot stools was because there were injuries and a death due to apparently tripping over the stool.