smoddra

Our physical therapy department uses the moist heat packs that are placed in a cover and then applied to the patient. I recently came into this position and inherited this issue that has evidently been discussed before. Evidently the covers were not being washed and were used on several patients. This brought up issues and several things were looked into like obtaining more covers, how to clean the covers and disposable covers. Meanwhile they have been putting the heat pack in the cover and then covering it with a towel or pillowcase. This issue has been brought to me and the question is if it is okay to use the towel or pillowcase in between the covers and the patients. I have been unable to find any documentation related to this topic. The covers are damp since there is not time for drying in between uses. Because of this the towels or pillowcases become moist also. I need to give my input on the Infection Control standpoint to determine what the next steps are. If anyone has had any issues with this or has any info on the matter it would be greatly appreciated.

The director is asking about this I think mainly to justify only getting caths with urometer in the ICU. The thing is that even if this is done a majority of caths are placed prior to ICU admit.

Yes they have some experience on thr floor but only in a small hospital ICU. There has been no issue in infection related to this topic. I thought it would come down to a technique issue also.

I have had a department director approach me about a catheter question that I was not for sure of the answer to. Sometimes a foley cath is placed and then there are changes with the pt that require close output monitoring. The original bag for the catheters is being romoved and a bag with a urometer is put on. The question is "Is this safe practice since the closed system cathter is being opened to change the bag"? I have not really found anything that supports this topic. I thought that if it had to be done it was okay unless it was happening on every patient? Any feedback welcomed please.

Yes, this is one reason why we are now trying to figure out something different. The staff is trying to avoid going to the dirty utility area after every pt. Could they put a second sharps container in the room and use it for instruments if it is properly marked as instruments?

Our wound center uses instruments on almost every pt. They had been keeping the instruments in a bowl under the sinks in the room. I just recently took over as IC and have told them that we can not do that. Their question was how do they remove the instruments from the room where it was used to the dirty utility area since they would be carrying contaminated items in the halls. I had suggested some kind of box or bin that they could be placed in for transport. The staff asked if they could utilize a sharps container or something similar with the soaking solution in it until the end of the day and then remove them from the rooms for cleaning. Any information or thoughts on a solution for this problem?

The closed room has no sink which is the only thing they need a dirty for. Nothing clean would be kept in this area. Cleaning supplies in the cabinets and at end of the day the sink would be used for cleaning instruments. The area would not be used much if at all during the day and only for dirty things. My main concern was if it had to be in an enclosed room.

The current argument is that sterile field is broken when the hole is cut and then contamination is made when surgeon pulls hand back through. When director of surgery was asked scenario she said that as soon as drape was cut the field was broken and pt needed redraped. She could not provide any proof of this. OB director thought that it would be contaminated when he brought his hand back through because the drape would have been touched. I am the infection control nurse and thought it would be okay if a sleeve was worn and removed. We all three have different responses to this question so I was trying to figure out what was the correct procedure.

The scenario is a c-section is being performed and the baby needs to be disengaged. The surgeon cuts a hole in drape and reaches through to the lady parts and pushes baby up. He then pulls his hand back through the hole and removes top glove since he is double gloved. He then continues with the surgery. Was this a sterile procedure? Were any contaminations made?

I was asked by our wound care department about getting rid of their dirty utility room. They were using an exam room for it that they were needing as an exam room again. All they use their dirty utility for is prewashing instruments at the end of the day. They have a sink and cabinet area that was there med station but they were moving it to a closed room. Was wondering if this area could be used as their dirty area if it was labeled and not used for anything else. I haven't really found much info about it. I found an article about just having a marked off area in a lab and using it as dirty. Any input would be very appreciated.

Hello, I am not an operating room nurse and some of the sterile technique info i learned in school is a little fuzzy. My question contains a couple of components. 1. If a sterile drape is cut does that break the sterile field and need to be re-draped? 2. If it does not then if a double gloved surgeon reached through the hole to the elbow and then brought their arm back through the hole wouldn't that cause a contaminating break? 3. If those previous actions did not cause a break and the surgeon removed first glove layer and proceded with surgery wouldn't his arm be contaminated also? Has anyone ever seen this practice? Any input or opinions would be very appreciated.