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.
Specializes in Dialysis, Nephrology & Cosmetic Surgery.
I worked in one NHS hospital from 1992 - 1999 and we would have a trolley just outside the siderooms where the infectious patients where, on the top, was a bowl filled with a mild sodium hypochloite solution (bleach). The nurses would remove the trays from the patient and pass the crockery and cutlery through the bleach solution before the hostess would put it with the others to be returned to the kitchens. I don't know if they still do that but I was surprised when I returned to the NHS and a different hospital that the trays were all collected in together to be returned to the kitchen.
Does anyone know if this is used anywhere else? I'm wondering if there is some evidence to suggest that rinsing items in a bleach solution was ineffective?
I think disposable plates and cutlery are ok but I know i don't like eating with them so I'm sure our patients won't.
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.
Both hospitals where I live and the big one north of us have zero tolerance no smoking policies. Staff and patients may not smoke anywhere on property and it's quite a walk to the perimeter of the hospital. Also, if staff leaves, say at noon, and comes back smelling like smoke, they are sent home. Also, no perfumes or smells of any kind (they never cite people for BO strangely enough). We had one patient complain that a perfume caused her migraine and that was that. No longer allowed! We hired extra security to troop around at night and make sure night shifters don't sneak out for a puff.
My floor doesn't have a dietary staff to pass out or pickup trays - it's up to the nursing staff to pass them. However, we do put our "contaminated" trays from contact rooms back on the same cart with other trays. This has always bothered me because I'll see family members perusing the tray carts looking for condiments or unopened side items. THey don't know which trays are from contact rooms and which aren't. Now, there are other problems that come in when people start taking items off of other trays, but that's a big one.
where i work we are to take plastic plates,etc. in the rooms and dispose all trash in that room, and at the end of day take the trash out and place in red bags...and we have to wear gloves(of course)gown, and mask depending where that patient has mrsa.... it is a scarry thing.but if you think about it.. 50% of us have mrsa. the main thing i think you should do always is wash your hands good.
At the hospital I work in, we have dietary staff leave the trays of patients on precautions at the nurses desk. It is the nursing staff responsibility to bring the tray to the patient's room. As far as removing the trays, we keep white trash bags in the isolation carts. The nursing staff then covers the tray, wears gloves and puts it in the dirty tray closet.
However, we do put our "contaminated" trays from contact rooms back on the same cart with other trays. This has always bothered me because I'll see family members perusing the tray carts looking for condiments or unopened side items.
We didn't permit kitchen staff in or out of those rooms. We did the trays ourselves.
Everyplace I have worked did not allowed kitchen staff into rooms with isolation trays. The tray is left on the cart for nursing staff to deliver to the room. Then it is up to the nursing staff to take the tray out of the room and put it back on the cart. In the past 10 years I have worked at three different hospitals and they all did it this way.
The cart is a metal cart that has closed doors..There is very little or no contact between outside would and the cart except on it's way in and out of the room. I am assuming the trays were taken off the cart in the kitchen by staff that is wearing gloves but I don't know that.
we have open carts, no gloves, and occasionally staff or visitors helping themselves to "extra" items on used trays; and no one has any idea where the tray has been : (
it's been out of control for sometime -- and now, given the media attention to community acquired superbugs, it just seems that the CDC or hospitals would tighten up on isolation techniques. (i could just see one of the news shows doing an expose' on isolation technique in our hospital OMG!)
but then, i come from the old days of double bagging, disposable dishes, and end-of-shift isolation "clean up".
again, THANK YOU to everyone. At the very least, GLOVES and HANDWASHING at our end will provide some control.
We have disposable trays, tableware for all pts that are anything but standard/universal precautions. We just began the procedure where dietary brings the meal tray cart on our floor to those that are contact, airborne, droplet precautions and it is the nurses/aides jobs to disseminate the trays into the pts rooms accordingly.
We have the same problems where I work. Only here the dietary people won't enter the rooms to pick up the trays, so nursing has to remove them. The problem is, by the time we can get a chance to remove the tray, dietary has already made the pickup. So we have to carry the tray to our pantry and find a place to put it. Usually just on a counter or window sill, as 50% of the time, dietary doesn't leave behind a rack like they are susposed to. So the tray just sits out there, when anyone can touch it. Full of MRSA, C-diff, whatever. We have brought out concerns to our useless infection control nurse but she just brushes our concerns aside!
WOW! Forward to April 2008. I am a nursing student graduating next month. I have brought up this concern to my instructors. We can't take anything out of the rooms or anything in the rooms but food trays move freely in and out without concern. I wonder when this will change.
OMG!)
Virgo_RN, BSN, RN
3,543 Posts
I've wondered the same thing.