Using Same Equipement on all Patients?

scizzerin · Mar 4, 2007

Hi.

On my unit, we just recently adopted assigning BP cuffs to each patient, that follows them if they are transferred or thrown away when they are discharged. Before, it was a pain to clean the equiptment when exiting the room (the cuff & o2 sat) then have to wait for it to dry before going to the next pt. Yes I always alcohol my stethoscope, BUT...with that being said... I know others don't take the time, and I know I'm a germophobe (sp?) which is more why I do it rather than policy, although there is a policy. I wash down the entire cart (dynamap) when I work, stocking it with extra cuffs, hand sanitizer & telemetry stickies, but it seems no one else does. Yes, I am a bit OCD.... he he he...

Germs=me sick= no work= no rent

GingerSue · Mar 4, 2007

I remember one LTC facility that had available one forcep kept in solution to be used for all patients dressings - what do you think of that arrangement?

Agnus · Mar 4, 2007

The last few places I worked each pt had thier own BP cuff that followed them thoughout thier hospital stay and was discared on discharge. My current hospital uses the same one on every body. If A pt is in isolation for MRSA they keep the same coff and machine and it is all "disinfected" on discharge. I wonder if a study has been done on this.

Every place I have been we used disposable stethascopes for isolation pts. As fare asd Temps go some use temadot for isolation others just disinfect the thermometer.

allantiques4me · Mar 4, 2007

I remember one LTC facility that had available one forcep kept in solution to be used for all patients dressings - what do you think of that arrangement?

I remember working in a place like that many years ago!

Atl_John · Mar 4, 2007

I'm sitting here with the flu or something like the flu, and I can't help but wonder if I didn't get it from a patient or heaven forbid i gave it to any patients. But it got me thinking, they don't tell us at ALL to clean our stethoscopes before we put them on our patients and these are patients who just had CABG surgeries or valve replacements, and I'm puting my dirty stethoscope on these patients as are the other nurses. I don't know it just got me thinking about all of this, same with the BP cuffs. Just irks me a little, wish each patient had their own cuff. I actually had a nurse tell me one time when I was giving an insulin shot and had on gloves, why are you using gloves don't you know we are profit sharing. I about died with that comment, more worried about her profits than about safety. WOW !!!

LanaBanana · Mar 4, 2007

We don't disinfect our equipment except after use on a contact precautions patient. If a pt is VRE positive then they get their own equipment, MRSA and C-diffs just gets cleaned after use. We also use the temporal thermometers that are supposed to have an antimicrobial head on them that last something like 12 years. I had a dr question me this week on if I cleaned if after each patient. I explained the antimicrobial thing and then said that if a pt was on contact precautions or had any open sores on the area the thermometer is swiped then we clean appropriately. I also try to clean it after using it on someone with really greasy skin because I know I wouldn't want that grease on my forehead! But I have to admit that when I went to the urgent care center this week and they used one of those thermometers on me it made me think about who else it had been used on!

Kookubear · Mar 22, 2008

Hey heres a question, how many of you have a problem with using the same BP cuffs, SA O2 monitors, etc on all the patients that we know aren't MRSA , etc Positive. Sitting here I was just thinking, how many times have you gone from one of your patients to the other without disenfecting your stethoscope, or how many times have you taken a BP on patient A then went to patient B using the same BP cuff? Do any of you feel that we should be using individual BP cuffs for each patient, etc. Preaching clean your steh between each patient just like you would wash your hands between each. Your thoughts please.

It's not just the equipment. When rolling patients or taking vitals they frequently come into contact with your own clothing. Obviously you're supposed to be wearing a gown in contact-precautions, but even with regular patients, whatever they have could be on you and when yuo go to the next room...but I don't suppose it's practical to shower and change uniforms between rooms... :bugeyes: It also occured to me after my first time with a patient with MRSA; I was so careful to drop my uniform in the washer with bleach and jump in the shower right when I came home. It didn't occur to me til several days later that I wore my coat home over my uniform...sat in my car.... Now the chances of any virus surviving long without a host are slim but it does make you stop and think...

Journey_On, BSN, RN · May 16, 2008

If you do choose to clean your BP cuff, what kind of cleaning agent would you use to clean it? Would Clorox wipes or alcohol wipes be effective on that type of fabric?

I was told that it would be a good idea to buy a BP cuff to practice, but I am a germophobe too and would want to clean mine in between people that I practice on.

nightmare, RN · May 16, 2008

This is something I think I will bring up with our manager! We have one sphyg.which we use on everybody!Thinking about it as a lot of MRSA patients test positive under the oxters and the cuff is very close to there we are probably spreading it to everyone.However i know I will just get a roll of the eyes and a shrug but I can but try!

Morettia2, BSN, RN · May 17, 2008

I work on an Interventional Cardiology/CCU step down unit, and every pt. has individial disposable BP cuffs, that hook up to the bedside monitor and tele packs. Each and every pt. admitted get's a brand new cuff from the supply pyxis.Each pt. also has a mounted Phillips TELEMON monitor at every bedside that can be taken down and transported with the pt. if the pt. needs to leave the floor and is remounted when the pt. returns, and is wiped down with germacide wipes.

For the isolation pt, we have disposable Stehoscopes(which I call dollar store scopes b/c you manually put them together and half the time they don't work or just fall apart), each isolation pt. gets a digital themoter(I also call the dollar store bargain b/c half of them don't work) that stays at the bedside so when doing vitals you don't have to bring in the vitals machine, we use the disposable blue plastic gowns( I call them trashbag gowns b/c you feel like you are wearing a Da** trashbag but you are covered) and my hosp uses 3 types of disposable masks but most of us use the N95 that looks like a duck bill.

So when you gear up you look like a duck wearing a trashbag using a neon blue scope that falls apart, "Hi,I am am Angie, I am going to be your nurse" as you breathe like Darth Vader through the mask, and the pt. can't understand a word you are saying b/c you voice is muffeled by the mask, and sound like the teacher from Charlie Brown Cartoons(wahhwahhwhhhaaa)and sweat like beast under the trashbag gown no matter how well your Secret/Degree clinical Protection deodorant works, and the 1 bottle of baby powder you poured down your back and pants.

No wonder the isolation pt's on my floor have poor morale, their nurse looks like a 1950's SCIFI comic strip.

Also each isolation pt. gets a bright yellow isolation cart outside the room stocked with all the supplies so you don't contaminate the supply PYXIS.

But during a CODE BLUE, for an isolation pt. the gown usually lasts all of 5 min., b/c you are sticking to everything, the mask comes flying off b/c you can't understand anything anyone is saying, even when yelling, it's sounds like (rahhrrraeeerrr).

We just had one isolation pt. code at 6:30am, right before shift change, a few weeks ago, pt. stopped breathing and pulseless v-tach, and the contact gear lasted 5 min. and everyone in the room ripped off the gowns and masks at the same time and things were able to get accomplished, granted I took bath in germacide wipes after and came right home and felt like scrubbing my skin with Ajax b/c the pt. was C-DIFF +, MRSA(blood,urine,nares,and BKA wound), ESBL(urine) , What I call the the trifecta, but with the absence of VRE and all the other demon contact strains.

But I always wonder how well was the code cart scrubbed down, was the CPR board disenfected properly, and what about all the un-used supplies in the code cart that were manhandeled by all of us, and the 2 most Important things, was the O2 tank changed to a new tank after the code, and was the defibrillator wiped down properly along with the leads?

We have RRT's and codes often, we are a critical care floor and I always think when I run the code cart over and start the process of placing things on a pt and drawing blood, ect.. how well is all of the equip. cleaned? I give ER nurses and MD's and staff alot, I mean ALOT of respect b/c they don't know what they are dealing with and gear up with 10x's the amount of gear we use.

The only thing that is uncontaminated is CODE MED tray, it is sealed, untill I rip it open and place my gloved double triple gloved contaminated hands all over the meds but then we take the opened contaminated CODE MED tray to the pharmacy after a code so they can give us a brand new sealed one..

But I think no matter what there is always going to be some cross-contamination with equiptment use and I TRY my BEST for that not to happen, and I am VERY conscious of this, hand washing(my hands are raw), and I wipe everything down with gremacide wipes every few hours, my 100 badges I have hanging off my uniform, my stethoscope(littman has anti-microbial bacterial tubing, at least that what the box said when I bought it 3 years ago), the pt's bedside charts, and even my shoes(gotta love dansko's), and I even got to the point of wiping around my neck where my scope sitts with ETOH wipes..

I became an RN for a reason, but as an added bonus I also became alot more conscious and aware of grems in my own personal surroundings, which can be a good and bad thing, espically when you have a few days off from work..can you say CLEAN HOUSE!!

student456 · May 21, 2008

I use Virox sanitizing wipes to clean BP cuff and other equipment...