Is it disinfected?

[jigi]

Hi,

Im a nurse in Sydney, Australia and would like some opinions on an infection control matter.

I noticed that one of my colleagues has been using a plastic bucket/tub to wash patients leg wounds with. These tubs are being used amongst multiple patients.

The way in which she washes the tub is :

(1) Washes the tub with water and a product called 3M Avagard™ Antiseptic Hand and Body Wash with Chlorhexidine Gluconate 2%w/w. She then wipes it dry with a towel.

(2) Wipes the tub with Clinell Universal wipes which contain Benzalkoniumchloride, Didecyl dimethylammonium chloride and Polyhexamethylenebiguanide (PHMB).

The tubs are then allowed to dry and are stacked on top of each other.

From my understanding, as the tubs are in contact with non intact skin, a high level of disinfection is required either thermally or chemically which this cleaning procedure does not meet.

I am highly concerned as I believe there is a high risk of cross contamination. I will be discussing this with the NUM first thing in the morning.

Would love to hear everyones opinions on this matter.

[K+MgSO4, BSN]

Talk to your NUM and infection prevention. Clinell could be used if they were pt named buckets. You could get stainless steel buckets and run them through CSSD or line the bucket with a clean garbage bag... maybe double bag?? Then clean out the bucket with Clinell. ?.. I'm seeing this like a suction canister and liner.

[dishes, BSN, RN]

You are right to be concerned about cross contamination, the practice you described is cleaning not high level disinfecting. Agree with K+MgS04, plastic should not be used between patients, it is too porous and will harbour bacteria. There are several articles on the CDC website on contamination of plastic basins. Is it possible for the patients leg wounds to be cleaned in the shower instead with a basin?

[iluvivt, BSN, RN]

This is not sound practice. The IFUs for Chlorhexadine state it is only to be used on intact skin so the only thing you should look at is the second product you are using . I believe the best practice in this case is to use a sterile bowl or apply the cleaning agent or treatment onto 4 x4s or fluffs and then onto the patient's skin.They come individually packaged and are inexpensive. You can also use Kerlix fluffs and use the little basin that they come in. I used to do that all the time.

[xoemmylouox, ASN, RN]

I agree with the PP's - this does not sound like true sterilization has occurred which you need to prevent cross contamination.