Nurse, clean up aisle 5 (rant)

[cleback]

Just a had to get this off my chest....

My organization recently implemented a policy that before every medpass, procedure, etc., the nurse is to perform environmental cleaning of surfaces (computers, bedside railing, scanners, tabletops). They say, this is to reduce transmission of infection... which infections they're concerned about, we're not told. All of our trackable infections are at or below expected numbers.

While I agree that a clean environment is necessary for safe patient care, I do not agree that it should be a nursing task. I don't think the powers that be realize that 2 minutes of cleaning before each medpass and activity really adds up over a shift. I calculated 30 minutes out of an 8 hr shift just for meds....I can't help but think that devalues actual nursing tasks that we could be doing instead.

I suppose I'm just really disappointed in my organization, though I know it could be worse. How do you guys handle being tasked non-skilled, non-nursing duties?

[JKL33]

Just smile and look enthusiastic and tell them what a great idea that is. Then go on about your business, prioritizing appropriately.

Someone worked very hard on this initiative, you know.

Whatever you do don't let one soul hear you complain - and tell all your friends to shut their traps, too. Any complaining and you all will find yourselves having

Cleaning and Readiness for Administration of Pharmaceuticals "time outs" and clicking CRAP time-out boxes faster than I can say "told you so!"

Hang in there, cleback!

[klone, MSN, RN]

I'd respond the same way I do to all these types of requests, which is that keeping the room and surfaces clean is already on my overall list of things to do, and per my job description I will continue to prioritize all of these tasks appropriately, so if a full room clean happens to be at the top of prioritization list at any given time then it will get done, otherwise it won't.

That sounds quite reasonable.

[amoLucia]

What all do you have to do the cleanups? I would imagine that when there seems to be an astronomical sky-high rise in the purchase need for SaniWipes

then the purchase orders will go up. With that comes increased budget needs.

Maybe the initiative will burn itself out r/t to supply & demand costs.

[cleback]

Regardless of where I am floated, I take the time to wipe whichever computer I will use that shift. I wipe my stethoscope after each patient assessment. It is important to me to ensure that good quality nursing included infection control. I believe nurses are an important part of in prevention of potential infection(s). Perhaps your facilities infection control team has come up with some new policies based on current literature that they want to implement? I understand your frustration with it taking up time though. I am not sure what the issue really is? Is it just a time thing? Is it the depth or degree of cleaning?

I agree with keeping your personal equipment clean between used, particularly the equipment coming in direct contact with patients. That seems common sense to me.

They implemented it after a TJC surveyor at a similar facility asked a nurse how she knew the table was clean after putting a med on it.

After the facility implemented it, they had a drop in transmission/infections, which is good...But like I also mentioned, we're at or below all indicators. We've said "no thanks" to other less pain-in-the-butt, evidence-supported measures (such as daily chlorohexidene baths for those with central lines) because our rates are so low to begin with, it wouldn't be cost effective.

Also, cleaner environment, less transmission still doesn't make the case why it's a nursing responsibility. All it tells me is that EVS is a vital part of the team. And maybe that nursing can learn to speak to their process ("I know this counter is clean because EVS cleans it once a day and I visually inspect it gross soil before use").

I just am not sold on how my wiping down the computer for the 3rd or 4th time that day before giving a prn a Norco or colace is going to have any impact on infections risk (the computer stays in the patient room btw).

I too like Muno's suggestion.

[pixierose, BSN, RN]

I just am not sold on how my wiping down the computer for the 3rd or 4th time that day before giving a prn a Norco or colace is going to have any impact on infections risk (the computer stays in the patient room btw).

I too like Muno's suggestion.

Yeah, that does seem a little excessive ... even to this germaphobe.

[Crush]

Thanks for the clarification. So they want you guys to clean the equipment each time you use it?(not being snarky or anything with the question) I would find that tedious. I understand once at start of shift or if you have noticed something funky. I dunno, I would just go with the flow I guess. Once they have to pay for the extra sani-wipes, paying for any overtime r/t it, etc. then they may revisit policies. Perhaps if others at your facility are having similar concerns, you can all get together can come up with a solution that works for all parties involved. It does sound a bit over the top. And yes, Muno's suggestion is reasonable.

[Orion81RN]

The issue I have is the time it eats up to do before every med given or procedure done. I get the need for clean surfaces... I do...but is it really a good use of nursing time to do routine cleaning? Like I mentioned in my op, if I calculate doing it before every med pass, that's about 30 min of just cleaning.

When I think of 1 med pass, I think of all my patients. If I have, say, 30 patients, I'd wipe down the med cart once before the med pass, and once after giving the 30 pt's their meds. Not between every patient.

[Have Nurse, ADN, RN]

We have a meeting and designate it to Housekeeping, where it belongs. We wash our hands before doing our med pass. We don't, nor are we taught, to do additional duties regarding prevention of infection outside of nursing tasks, (ie: linen changes, dressing changes, grabbing a disinfectant wipe on occasion when appropriate to clean a glucometer or other medical equipment you need to use at the time..etc.) Time to educated the "powers that be".

It can be done respectfully. Sometimes they just don't realize, as you say, how this affects a med pass. Your Nursing Admin should be backing you on this.

[SpankedInPittsburgh, DNP, RN]

Just smile and look enthusiastic and tell them what a great idea that is. Then go on about your business, prioritizing appropriately.

Someone worked very hard on this initiative, you know.

Whatever you do don't let one soul hear you complain - and tell all your friends to shut their

traps, too. Any complaining and you all will find yourselves having

Cleaning and Readiness for Administration of Pharmaceuticals "time outs" and clicking CRAP time-out boxes faster than I can say "told you so!"

Hang in there, cleback!

Yep at the ER I work at the bosses and the super-geniuses who do studies always seem to come up with something extra for busy ER Nurses to do. At one point they were putting up chore lists which were routinely shredded. Usually when they come up with an initiative which involves me prioritizing something besides patient care my normal response is "yeah I'll get right on that" which of course translates into "drop dead there is no way I'm ever doing that and go back to your office before you mess something up."

[MikeyT-c-IV]

Every time I go place a PICC I need to use the bedside table. More often than not, the table is a complete disaster and needs a good cleaning anyway. I'm happy to do my part.

[Leader25, ASN, BSN, RN]

I usually started my shift by wiping down my whole areas and those close by(I called it my housekeeping duties) but that is my own germ freak choice,(i could not stand the dirt left behind by other shifts)It took longer than a few minutes,and slowed me down but I was happier.

To be told you have do the non nursing task is another straw on this tired camels back.Will this be on your yearly evaluation?Is it on Joint commission's check list?

[MissourigalRN]

NURSES ARE GENERALLY THE MOST RESPONSIBLE. This is why we get stuck doing these piddly tasks that have nothing to do with nursing. In our facility the nurses are expected to mop up messes, clean humidifiers and oxygen filters, clean cpap/bipap machines, clear dining room tables and wash them, fix TVs and internet problems, assist with meals, take out trash. People just dont realize that we have to do all these things and pass medications multiple times a day, do treatments, obtain vitals, do assessments, call doctors/pharmacy, update families, and be sane. There is never enough time in the day for us.