Now we can't change a trash bag until patient leaves the room....is this getting crazy??

[MereSanity]

OK I need some input here. So I was always taught not to wipe down tables or spray instruments while the patient is in the room (seems like common sense), but now my hospital has decided that we can't break down the back table, change the trash (if we do we must leave the bag open so as to not spread contaminants (which I always made sure not to push down on the bag anyway), or tidy up because it might spread germs. I like to keep my room clean (no I don't go overboard but I can't leave trash all over the floor either)! And turn overs should really suck now too. After a less than exhaustive search I have not been able to find any supporting documentation regarding this "new and improved practice". I was wondering if someone could provide some literature or guidelines regarding this practice or at least let me know who else is doing this? Thanks in advance.

[WhoDatWhoDare, BSN, RN]

What you're doing now is how I've always been taught to do... sorry to give you the bad news

One correction is we do change out the trash bags if they're full, but leave them in the room.

[FurBabyMom, MSN, RN]

I think that this is an issue that is largely "handled" at the facility or health care system level through policies and procedure guidance.

We're allowed to change the trash - it cannot leave the room before the patient which makes pretty clear sense...especially with the number of incorrect counts where the disappearing object has been in the linen or trash bags. We have a fair number of cases which will exceed 12 hours with regularity. Two trash bags is not it for an all day case. And I tidy as I go...the floor shouldn't be a disaster in any circumstances.

Interestingly enough, we've been told we're allowed to spray our instrument trays while the patient is in the room but after incision closure. So if I have 12 trays and 8 are case specific, I can get those completely ready to go (breaking in the process) and leaving the others available if needed emergently.

We're not supposed to break our tables down until the patient is extubated and anesthesia is "happy" with their airway and breathing. I often clean up and stack 10 of my 12 trays or whatever with those being ready to put on the case cart or in containers then in the cart. I do leave a set of instruments which could, in a pinch, be used for a trach, open, unstrung and available. I've been in situations that progressed to emergent re-intubation and or traching.