The views expressed (some of which just seem to be having a go for the sake of it) apparently confirm that generally my views and opinions are particularly unpopular - it seems that I'm really out of touch with what is really going on out there. Hmmm.
This aside; from the comments made concerning contaminated equipment, in this thread, there are probably others who take this even more seriously than I do - to their credit. I do think it's really important for EBME managers to take reasonable precautions to ensure the health and safety of EBME staff and others. After all it is their statutory duty. I am not citicising John Sandham, Mark. E, Louis L or Dave.H in this respect - they are trying to meet (meeting or possibly exceeding) their obligations, no doubt. I do wonder though, at which point where EBMEs lose control of this process and should not realistically be expected to "police" the use (and abuse) of equipment and cannot possibly ensure its decontamination status (for example, outside the EBME, in clinical areas). A few questions:
Do you carry out planned-maintnenance on-site, in clinical and ward areas?
When you come into contact with equpment in these areas, how do you ensure
that equipment has been decontaminated or that it is clean and that you can work on it? If it appears
to be contaminated, how do you deal with this in the clinical area? For example, if you think
it's dirty do you immediately ask a member of staff to clean it - will they? Do you then insist
on a certificate to ensure it is clean, there and then? Do you do this for everything, down to a SpO2 probe or a PC used in a clinical area? Do you walk away and ignore
Does your hospital have a scheme or policy of ensuring that all equipment is cleaned between patients?
Should always be the case - then why does equipment come down to EBME dirty? Who does this cleaning? Who monitors it? Who enforces the policy? Should there be a certificate to ensure this or can we rely on the word of the clinical staff to ensure that equipment is not only clean for other staff but patients as well (or vice-versa)? Is the trust and cooperation always there?
My view is that it is vital for EBME department managers to ensure that EBME staff are not exposed to contaminated or even dirty equipment and I'm certain a lot of departments do this very well as stuff comes into the department - I'm not knocking that, since this issue is important. It is also my view that it is for managers in clinical areas to ensure that their staff ensure the safety of others.......yes, that the clinical areas ensure the cleanliness of their equipment (or clean-up after themselves as someone put it).
Ged Swinton's comments were very good, I think. Unfortunately, unless the equipment belongs in a high-care area where the staff are quite highly motivated (usually), well trained and experienced then, in my own experience, the equipment doesn't necessarily even get a wipe-down before being put on the next patient or being delivered to EBME for repair. Equipment on wards that "does the rounds" is usually kept in a poorer state than stuff in a high-care environment. We have all had instances of "sticky" and blood-stained equipment haven't we? To his credit; Ged is interested enough to give some input and sees the problem is relevent to him - input from nursing staff is to be encouraged - hence my initial comments about our (yes, me included) patronising attitudes to other groups of NHS staff, aimed at Dave H. We should encourage, rather than discourage, other groups like porters, nurses, etc, etc to contribute on the site. When I say qualifications, Dave, I don't just mean academic ones - I mean academic, courses, training and experience - which is ultimately what qualifies
anybody to do their job effectively.
The idea of EBMEs managing the equipment within some kind of equipment store or library is a really good one, I think, particularly if it means that dedicated staff can be employed to clean, decontaminate or sterilize equipment before it is reused or repaired. This would also allow EBMEs to pick up on damage, functional-problems and assist in scheduling for maintenance and more effectively manage cleaning, decontamination and sterilization of equipment, perhaps. John Sandham's department and others are probably more developed than other departments in this respect. Sadly, other trusts do not give their EBMEs as free a reign to be proactive, as John puts it.......
Unfortunately, when there is no central equipment store and EBME staff are "out there" in clinical areas, I am wondering how vulnerable they are to picking up infections off equipment and how far the paper-authority (i.e. certificates of decontamination status) applies in practice. There are also the associated problems of cross-infection to be considered when equipment moves around a hospital in an uncontrolled fashion.
Yes Floyd, I do think this is important and perhaps I do need to chill out - you're welcome to that opinion (what was the point of your posting again, other than to try humiliating me?). At least Dave H. and Mercury man are quite funny with it. :p
I have worked for managers in the past who have not taken this seriously and when the issue of decontamination has been raised have shrugged it off. Wait until you have picked up a nasty skin infection or respiratory problem and you're not sure how it came about or just get an inkling that you have been exposed to something nasty at work and you will take your own welfare a bit more seriously, maybe. Maybe not. In the meantime, your manager is hopefully doing this for you.
It is a fact that I have also worked off-site in hospitals where the clinical staff have not informed engineers working in certain areas that the areas have been rife with MRSA, S&D, etc. they've not even insisted on handwashing. It is a fact that I have observed sandwich-eating in anaesthetics rooms and in the theatre itself, between cases - possibly a consequence of the sandwich and coke-dispensers that we see in "dirty-areas" of theatres; we have all seen the theatre staff on the trawl to the canteen in their blues and greens haven't we? Sometimes with white-coats and some times without......it does happen. Training will not sort out this problem, in my opinion.
Does anybody share the same views or have similar experiences? Am I that far out of touch with what actually goes on in your hospital?
Poor facilities for adequate cleaning, no backup, no globally enforced
on-site policy for decontamination of equipment, etc, etc. No coordinated control, across the board. It all gets very messy (if you pardon the pun). It is a fact that I, myself, have contracted respiratory problems which, after subsequent swabbing, have been confirmed to be MRSA related. Two weeks of applying a topical antibiotic every 4 hours up my nose was not particularly fun. In the same hospital, it is a fact, I was exposed to body-fluids from used plastic-ware, which was inappropriately packaged and not labelled, piled in a stores to be delivered to another hospital for sterilization, on top of faulty equipment - stored on the floor, incidentally. Although as far as the Trust H&S manager was concerned in the it wasn't an incident, if you get my drift......
The bags had been placed on top of equipment for repair and the contents had leaked onto the equipment. The hospital also had cockroach infestation at this time, as well. Don't tell me I take things too seriously, please. I have returned equipment to clinical areas whereupon I have watched the nurse who has received it subsequently use it to wedge-open a fire door so that a trolley could be wheeled out of a store. It is a fact that I've seen £5000 multiparameter monitors left ouside in the rain because the R&D stores was closed for lunch and the Nursing assistant that delivered the equipment didn't know what to do about it.
The problem is not about EBMEs and the efforts of those working there to do their job. It is about people "out there" not taking equipment issues seriously and being less-interested if a problem is not patient-centered, I think. If infection isn't a problem in hospitals then why are infection control nurses coming out of the woodwork? Should this issue be an EBME problem or should it be tackled by the experts? Where are the experts?
The point of this rambling (not paperwork-centered, standard-bashing or spouting requirements but based on experiences and I hope relevent) monologue is that attitudes to equipment usage and its decontamination need to change. I will make my apologies now if this posting offends (or bores) anyone