Nurses are busier than ever, but so are the bacteria and viruses with which we battle. They are more resistant and getting more so everyday. How many of us have at least one isolated patient on our modules when we work? The hand sanitizing foam is ubiquitous at all institutions, but are we using it properly? Do we put our patients at risk by going from room to room without foaming or washing every time?
I spent my last shift paying particular attention to how often I used hand foam. I found out something interesting. It feels odd to use it as often as we should. My hands got slimy. It was not realistic to use it the way the administration intends. Instead, I ended up washing my hands with soap and water about every third visit to a room. This added some time to my routine, but made me feel much cleaner.
The foam, as most know, is to be used anytime you leave a patient room, unless your hands are “soiled”, in which case you should use soap and water. The other exception is for cases of c. difficile infection. This also requires soap and water, as it is a spore, and is not killed by the foam. The foam is also to be used at other times, but the focus is on patient contact.
Think about how you use your hands when you enter a patient’s room. Do you touch the beeping IV button? Do you touch the button to silence the call bell? Do you set your papers down on the table? Do you use your pen after you have touched the patient, before you wash? Do you clean your stethoscope between patients? Do you only use the foam after you take off gloves and not when you have done something you don‘t think of as “unclean“? All of these are pitfalls into spreading disease, increasing length of stay, and endangering your patients.
Some hospitals currently track the amount of foam used, but this data does not give information about when the foam is being used, only how much of it. Another way hospitals survey their staff is to assign staff members to observe, record, and report about their co-workers. The best of these programs focus on the positive, rewarding those who are consistently in compliance by recognition and compensation ranging from prizes to tying it to pay increases. Virginia Commonwealth University is starting a sensor program to track foam usage by health care workers. The sensor notes the presence of ethyl alcohol, blinking green or red, depending on the finding. (1) This opens up an arena of tracking not before used, and shows the importance of getting into the habit of fitting this step into your routine now.