Quick question for my fellow CNAs...

If they need to be cleaned up, they need to be cleaned up. How is this an infection control issue? If you're using proper hand hygiene it should not be an issue. But leaving a patient in soiled linens/diapers for the duration of a meal can cause skin irritation and breakdown, especially when incontinence is an ongoing issue. We clean them up as needed at my hospital. I'm surprised to hear it's different in other facilities. Can't imagine leaving my patients sitting in it any longer than necessary.

The LTC facility I used to work @ had a similar policy like that in place too. But I would never let any of my residents sit in their soiled linens or clothes. If your resident is wet you have to change them simple as that. It's better to just change them then be accused of not taking care of your residents.

We do. Kind of. We check them a 1/2 hour before meal times and afterwards. We have to offer people the toilet prior to meals. We are too busy at meal times to stop and change people so we try to eliminate the need to. Of course, if somone does need changing during dinner, then we do it.

If they need to be cleaned up, they need to be cleaned up. How is this an infection control issue? If you're using proper hand hygiene it should not be an issue. But leaving a patient in soiled linens/diapers for the duration of a meal can cause skin irritation and breakdown, especially when incontinence is an ongoing issue. We clean them up as needed at my hospital. I'm surprised to hear it's different in other facilities. Can't imagine leaving my patients sitting in it any longer than necessary.

I'm not talking about leaving residents in soiled briefs during meal times. We do rounds before meals and after meals and change briefs then. I'm speaking of the trouble residents who know when meal time is, ring the light off the hook for you all day, but suddenly NEEDS to be changed the second you bring the trays on the hall.

Strange that you would be taught that... Maybe you forgot. I'm in a CNA class right now and although carts are not available, during meal time you HAVE to clean up vomit or incontinence immediately. You bag it as normal and hang it on the back of the toilet, then shut the door.

Would you like to eat your meal sitting on bm or urine? I don't think so.

The facility I work at does things a little different during meal time we have 2 CNAs that stay out of the dining room to catch lights and anything like that, so if we have someone who needs to be cleaned up we have a PCA go find either one of them and they will clean them no matter whose patient they are. It's a good set up bc meals move alot faster and no one is feeding and cleaning at the same time.

The way it's been handled here (at my current employer and my clinical site) is that the buckets are off the floor during mealtimes. If a pt. needs toileting (in this instance, bedbound & incontinent (e.g. wearing briefs)) or requires bathing/linen change/etc. then it can be done, but we bag the contaminated items & put them on top of the wastebasket or in the restroom. Technically, there is some concern with infection control, but since the bagged items don't ever leave the pt's room (at least until the buckets are back on the floor) it tends to be limited to the immediate area (pt. & whatever roomies they have, plus restroom). Also, we get 'em a fresh tray.

It's not an ideal solution, but far better than letting them sit in their bodily wastes until a more appropriate time, no?

----- Dave