Question on Washcloth and bathing

[ngazza]

My question is:

People at my facility are using wash clothes to wash patients with visible BM on the buttucks. Then at times also throwing them in the dirty laundry basket of said hamper. The hamper is washed for the resident with no disinfection (they just use laundry detergent).

Is this a healthcode violation?

Or a OSHA violation?

I am a CNA and I have told me administrator and DON. They just blow it off. I have asked for wipes as they are reembused by medicare and mediaid. No wipes have I seen purchased for the facility!

I cannot find physical proof anywhere in written form from any agency.

I absolutely refuse to do it and find it gross besides being a unhealthy to the patient.

Some of the caregivers find nothing wrong with it!

[TheCommuter, BSN, RN]

Using soapy washcloths to perform incontinent care is perfectly legal.

As long as the washcloths are being laundered, I see no problem with this practice. 30 minutes of high heat in a clothes dryer is enough to kill virtually any microbes, even the ones that exist in fecal matter.

[boggle, ASN, RN]

I'm glad to hear you thinking about infection control here as well as keeping nasty smells out of the resident's hamper. I think I hear you identifying 2 main concerns here (in addition to coworkers doing their own thing)........the condition/ cleanliness of the hamper, and the concern that the washcloths will be contaminted for further use along with any laundry it touches in the hamper? Does your facility have any written policy on handling laundry? There is likely a policy, just not know or being followed by the caregivers. The infection control nurse needs to hear your questions and concerns, ang take action to educate the caregivers and enforce the policy (before the facility gets cited by inspectors). Facilities I've known line the hampers with a plastic bag. Laundry is removed from the room in the bag, and a new bag is placed in the hamper. The facility's linen and washcloths were put in separate hampers. Facility's linen got the heavy duty bleach/ disinfectant treatment in the laundry. That kills everything.....the linens are safe to use again. The resident's own clothing was washed as regular clothing would be, but also had the hot water and hot dryers. Clothing soiled with feces would be put in its own plastic bag and washed separately in the laundry dept. Best wishes to you.

[KelRN215, BSN, RN]

I don't see the issue here. If a patient vomits, you clean them with washcloths and throw them in the laundry, no? If your child at home has an explosion of poop, you wash their clothes, no?

[Compassion_x]

Just a question, if you refuse to use the soapy washcloths, do you just use toilet paper? Because I find that the worst option usually (especially for incontinent BMs), because I would end up using half the roll instead of two washcloths and a hand towel.

[lovinlife11]

Funny, if one of my kids "exploded" when they were younger I tossed the clothes. Wasteful? Maybe. I just couldn't handle the thoughts of all the contamination.

[rita359]

So, I have a question. What do you think people throughout history did before wipes were invented sometime later than my children were born? They used rags or washclothes and washed them. Same for hospitals. Reused wash clothes all the time. Don't really see a problem with it.

[LilRedRN1973]

When I worked in the ICU, we always used washcloths to clean stool. And most of our patients were vented (i.e. not able to ambulate to the bathroom/portable toilet) so we were always cleaning up BM. We would get a tub of soapy water and get to work. At the smaller hospital I worked at, they had these packages you would put in the microwave to warm up and use those but honestly, they sucked. Wet, soapy washcloths worked MUCH better :-)

[nurseprnRN, BSN, RN]

I'm old enough to remember before there were disposables OR baby wipes OR disposable diapers of any size for anyone. Of course there have been advances in lots of things since then, back when Florence was a probie, but you know, feces haven't changed much. The practices you describe are not unhealthy and not in violation of anything.

Use the washcloths, wear gloves, and send the dirty linens to the laundry rather than leaving it in the room or hallway to smell up the joint. Institutional laundries have specifications for hot water, detergents, dryers, and all for a good reason, and I think you should go ask them about it. Linens do not need to be "disinfected" to the point of sterility. They are disinfected by normal laundering. Remember,your own panties have the same fecal germs on them when you put them in the laundry at home (or use a laundromat...where other people's panties have been), and you don't get all spazzed about that. I trust you don't throw away your underwear if it has a little smear on it.

Think about it. What's your evidence of harm? Note, your thinking it's gross is not evidence. Perhaps this kind of work isn't for you.

And -- it's "buttocks."

[Fngrpntsnotasin]

Nothing wrong with using a soapy washcloth. It is more comfortable for the person being cleansed, and normal washing and drying takes care of your concerns about it being gross.

[mstearns09]

We use disposable wipes at my facility. However, if I have a resident who has had a BM in the shower, I clean them with a warm, soapy washcloth. Any laundry which is soiled with potentially contaminated bodily fluids is bagged and sent out with our linens (we don't have the necessary plumbing to properly disinfect contaminated clothing and linen per our state's regulations).

I would think using a bed bath basin filled with warm soapy water and a washcloth would be easier than going through half a package of wet wipes like I do with some residents.

[neuron]

A couple of soapy wash cloths should be fine (as others stated), using WARM water.