meal trays + MRSA, C. Dif, or VRE

[psalm51]

despite the mutation, virulence, difficulty and EXPENSE in treating these "Superbugs", REGULAR meal trays are taken into patient's rooms and, when removed, are placed on the tray carrier with all the other trays. there is no distinction or separate method or procedure for transporting them back to the kitchen! (I know they will be disinfected in the wash -- but think of what can happen between point A (pt room) and point B (dishwasher)

common sense is NOT COMMON anymore!

we USE to give isolation patients DISPOSABLE trays and tableware. then i guess we got so cocky that we thought we could kill any germ that came along -- so we did away with disposables. now, old bugs have mutated and new ones are arriving.

does anyone have a link or know of a resource that supports the use of disposable meal trays for patients in contact isolation???

i can't believe that the CDC hasn't changed its position on this.

please help! i'm trying to get this changed at our hospital.

thank you!

[SuesquatchRN, BSN, RN]

My infection control nurse thought long and hard about this and determined that since the kitchen staff wears gloves they're afe. And the truth is, that's correct. It's contact, not airborne or droplet.

[EmmaG, RN]

My infection control nurse thought long and hard about this and determined that since the kitchen staff wears gloves they're afe. And the truth is, that's correct. It's contact, not airborne or droplet.

Yes, they wear gloves. The dietary staff who pick up trays go from room to room, wearing the same gloves, room to room, and they never wash their hands before or after touching those trays--- and other surfaces in patient rooms (i.e. they will move water pitchers and cups, dentures, and other personal items off the tray or out of the way).

I've seen it handled differently in different hospitals. Some were very strict, with disposable trays and floor staff being responsible for delivering and disposing of trays. Other places have been rather lax, going as far as to bring trays from isolation rooms out into common areas like the kitchen or stacked on counters.

Considering the contamination of most surfaces in an isolation room and how long these bugs can survive, it just makes good sense to restrict the number of staff going in and out.

[GrumpyRN63, ADN, RN]

I'm with you psalm51, in fact that was my position word for word when we had a visit from the head of dietary, his speil was about changes in tray distribution and roles blah, blah, I was likewhat ever happened to disposable trays? trays don't always go straight to the cart they sit out on the counter b/c the dietary people wont go in the isolation rooms,and they and the people that handle them touch a lot of stuff from A to B, like the cart is in or kitchen and we have to open the doorto get in he looked at me like no one had ever heard this hmmmm, oh and they get regular trays in ALL isolation rooms,TB,Chickenpox, FLU you name it contact, droplet,the works.........

[jackson145]

I never understood why the water pitcher could not be removed from a TB patient's room to be re-filled but it was OK to take meal trays in & out and leave them sitting on the rack for (possibly) hours.

Also, like with C-dif, we cover our front with the gown but a lot of us (not me-short hair) have their hair hanging down near the patient and touching front of gown. Doesn't that defeat efforts?

[EmmaG, RN]

Now that Medicare is refusing reimbursement of conditions related to poor infection control, I wonder if these folks are going to be changing their tune?

[mcknis]

I'm with you psalm51, in fact that was my position word for word when we had a visit from the head of dietary, his speil was about changes in tray distribution and roles blah, blah, I was likewhat ever happened to disposable trays? trays don't always go straight to the cart they sit out on the counter b/c the dietary people wont go in the isolation rooms,and they and the people that handle them touch a lot of stuff from A to B, like the cart is in or kitchen and we have to open the doorto get in he looked at me like no one had ever heard this hmmmm, oh and they get regular trays in ALL isolation rooms,TB,Chickenpox, FLU you name it contact, droplet,the works.........

Grumpy...thats how it is in my facility as well. I think it is stupid, but the big guys up stairs look at their wallets more than they look at our pts! Argh!!!

[barefootlady, ADN, RN]

It would be interesting to do a real study on the floor, isolation vs. regular, all precautions strictly observed, and see what happened. Of course, it would require a committment of staff and that is always difficult in the hectic world of todays healthcare.

[anonymurse]

Grumpy...thats how it is in my facility as well. I think it is stupid, but the big guys up stairs look at their wallets more than they look at our pts! Argh!!!

Not quite true. They also consider public image fashion. Heard a rumor they're going to do away with smoking areas on the property. I've seen patients out in the freezing cold under the smoking shelters with their pumps. Now they're supposed to stand in the sleet for their nicofix? I heard Medicaid wasn't going to pay for hospital-acquired pneumonia. If so, TPTB aren't even looking after the bottom line.

[SuesquatchRN, BSN, RN]

Yes, they wear gloves. The dietary staff who pick up trays go from room to room, wearing the same gloves, room to room, and they never wash their hands before or after touching those trays--- and other surfaces in patient rooms (i.e. they will move water pitchers and cups, dentures, and other personal items off the tray or out of the way).

We didn't permit kitchen staff in or out of those rooms. We did the trays ourselves.

[EmmaG, RN]

We didn't permit kitchen staff in or out of those rooms. We did the trays ourselves.

Probably the grossest thing I've seen is where dietary staff picked up used trays while delivering new trays; they would take the new tray in and pick up the old, then place the used ones on the same cart loaded with the new. That is just disgusting, isolation or no.

[SuesquatchRN, BSN, RN]

Probably the grossest thing I've seen is where dietary staff picked up used trays while delivering new trays; they would take the new tray in and pick up the old, then place the used ones on the same cart loaded with the new. That is just disgusting, isolation or no.

Yeah, that's foul. Although s another cart where do you put the used ones?

When I was in LTC trying to hold a meal was always annoying - a "kitchen" the size of a broom closet and a nurses' station filled with old people at the desk. NO room!

Germy things, we humans.