Ask Your Question!
We receive a lot of infection prevention and control questions from home care and hospice staff and managers…. If you have a question that you would like answered, just fill out the form below and your answers will appear on our "Ask Mary" page. Only your first name, city and state will be made public.
Question: We consider laptops dirty. Some staff designate one pouch of their bag as dirty to hold their laptop. I do not like this; I tell them to carry the laptop inside a separate bag all together, and maintain the nursing bag as clean only. Do you have any references or insight into this specific issue?
Submitted by: Cindy Adams RN MSN, VNA of SW Indiana, Evansville, IN
I was out on a home visit this week with a nurse and she too had a bag and the laptop was carried inside the nursing bag in a separate component which is acceptable as long as the equipment is managed in an appropriate manner…. The laptop would be similar to the vital sign equipment that is also stored inside the nursing bag and taken out for use during the home visit. If your organization’s policies require that vital sign equipment be cleaned after use before being placed back into the bag, then the nurses could manage the laptop in the same manner. A laptop is a non-critical piece of equipment that will never have direct contact with the patient, only their environment. The most important infection prevention strategy for staff is to perform hand hygiene after having contact with the keyboard, and before having direct contact with the patient (as that’s where the transfer of organisms from the keyboard to the patient would occur). Even after the laptop is put inside the primary bag or a separate bag (if that is your final choice), the laptop will still have organisms on its surfaces. The laptop could (but does not have to be) managed with a barrier and/or cleaned after use, and then be put back into the primary nursing bag. The bottom line is that a separate bag for the laptop is not required
Question: I believe you had mentioned in the past that not all clinicians need to be fit tested. We could just fit test some from each team or branch and they would be the dedicated staff to see patients that require an N-95 mask. Is this correct & if so do we determine how many staff we want fit tested?
Submitted by: Julie Neuman RN, BSN, Employee Health Nurse, Visiting Nurse Health System, Atlanta, GA
Yes, that is correct. You can just fit test some staff from each team or branch and they would be the dedicated staff to see patients that require Airborne Precautions, and the use of an N-95 respirator. There is no formula as to the number of staff that have to be fit tested...that would be a number that is determined by management. If additional staff need to be fit tested, that could be performed on a just-in-basis before being assigned care to that patient. For the staff that are fit tested, make sure that they are fit tested on an annual basis.
Question: How often should I clean my equipment that I take into the home and use to take the patient’s vital signs?
Submitted by: Barbara, Tampa FL
The Center for Disease Control and Prevention’s Guideline for Disinfection and Sterilization in Healthcare Facilities (Rutala, et al, 2008) suggests that at a minimum, noncritical patient-care devices (e.g., blood pressure cuff, stethoscope, etc.) be disinfected when visibly soiled and on a regular basis. Each home care and hospice organization is expected to define in policy what is considered “a regular basis”. “A regular basis” may be defined as: after each use on a patient and prior to replacing the used items back in the nursing bag; daily, before the first visit or after the last home visit; or weekly.
However, noncritical, reusable vital sign equipment must be cleaned and disinfected before being placed back into the nursing bag and/or used on another patient if:
- The noncritical item is visibly soiled;
- The patient is on Contact Precautions; or
- The patient is known to be infected or colonized with a multidrug-resistant organism, such as MRSA or Clostridium difficile (McGoldrick, 2014, Home Care Infection Prevention and Control Program).
Question: Is it required that I place a barrier under my nursing bag that I bring into my patient’s home?
Submitted by: Patricia, Worcester, MA
No, unless it is required by organizational policy. Even if it is your organization’s policy to not routinely use a barrier, a surface barrier can always be used at the staff member’s discretion. A surface barrier should always be used if a rolling bag is transferred from the floor to another surface in the home. Also, if a nursing bag is not taken into a home (for any reason) and items are temporarily removed from the nursing bag, these removed from the bag should be placed on a barrier in the home.