Whilst on a rural placement I was treating a stroke patient, who needed to go to the toilet mid way through a treatment session. I took the elderly lady to the toilet using a wheelchair and assisted her into the bathroom and transfer to the toilet seat. I helped her to pull her pants/nappy back up when she was finished and transferred her back into the wheelchair. We then wheeled a couple of metres to where the sinks were and I assisted her to wash her hands. Unfortunately her hands had been soiled but she hadn’t noticed.eeek! so a long hand wash was required.
After she had completed washing her hands with soap and warm water, I felt like she should scrub them again! But I couldn’t think of kind enough words or a good enough reason to tell her why to wash them once again. I wasn’t looking forward to having to touch her hands in the treatment. I got over it. However, I was thinking how unclean it could be sharing wheelchairs, the hand rests on the wheelchairs, the handrails in the toilet, the taps on the sink etc in hospitals and aged care facilities where patients may not be as ‘thorough’ with hygiene.
If a similar situation was to arise I would make sure the patients hands were thoroughly cleaned with hot water and soap. I would also wear gloves when assisting the patient in the toilet and wipe the wheelchair armrests with alcohol wipes if the wheelchair was to be used by other patients. This situation shows the need for continuing infection control and hygiene. It would be appropriate to kindly educate the patient on hand washing technique if you are with them whilst they are washing their hands, with emphasis on between fingers and nails that often get missed. In future I would also ensure alcohol wipes were readily available in my workplace.
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2 comments:
Infection control as we all know is a major issue, most importantly between patients but also just as importantly for us and other health care providers. One way I've found to manage is (it may seem a bit pedantic) to glove and gown whenever there is a the slightest chance of body fluid transfer. A way to ensure the patient doesn't feel bad about it is to explain it is for there safety as well so nothing is transfered to them.
I also had a similar incident where a patient wet the bed through a transfer and got his hands wet. I could not stop the t/f due to pt safety however it made me realise that everything a pt touches may become soiled. Think about your pen too!
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