EBME Forums
Posted By: Mark.N DIRTY equipment - 19/04/02 10:35 PM
Can anyone see anything wrong with the following suggestion(to identify cleaned equipment)-

Mark the equipment with a water soluble ink.
All Trusts have a decontamination policy. This would be an easy way of identifying depts/wards that require additional training..simple.
Posted By: Huw Re: DIRTY equipment - 19/04/02 10:40 PM
Quote:
posted by Mark.N:
Mark the equipment with a water soluble ink.
This would be an easy way of identifying depts/wards that require additional training..simple.


I'm sure you aren't joking -- but you have to be joking....!

Is that actually printed somewhere?
Posted By: Mark.N Re: DIRTY equipment - 19/04/02 10:50 PM
My attempt at chosing my words..whats wrong with the idea?
Posted By: Huw Re: DIRTY equipment - 19/04/02 11:02 PM
Sorry - it just appeared (to me) that you were quoting a document.
My mistake.
Posted By: Mark.N Re: DIRTY equipment - 19/04/02 11:08 PM
It's the end of a week of 'Monday morning feelings', I just thought that any attempt to help our highly trained nursing staff to perform their duties to Trust Policy would benefit us all..I'm too helpful, I know.
Posted By: John Sandham Re: DIRTY equipment - 23/04/02 8:57 AM
Mark
I think (based on what i see here) that lack of nurses, and lack of time to train, and lack of trainers, all make the problem worse.

Hopefully, the money being spent by the labour party on the NHS will be properly spent to give the NHS the resources we need.
eek
Posted By: Roy Re: DIRTY equipment - 23/04/02 11:56 AM
Hmmm!

From where I'm sat we just seem to be getting back the money we lost somewhere between last financial year and this one !

Something to do with the PCTs I believe, but don't quote me on that. eek
Posted By: Mark.N Re: DIRTY equipment - 23/04/02 6:00 PM
Politics & religion, 2 topics guaranteed to get a response or two.

I'm not going to add any more about the possibilities of encountering the odd bit of equipment that might have a spot of grime on it.. mad

cheers
Posted By: Mark.N Re: DIRTY equipment - 02/10/02 5:50 AM
I need another wall to talk to mad

cheers
Posted By: John Sandham Re: DIRTY equipment - 02/10/02 6:42 AM
Mark
We've started raising internal incident reports when we find equipment has not been cleaned.
(Name and Shame) We back this up with digital photographs.

It seems to have reduced the problem significantly, but it has not gone away completely. rolleyes
Posted By: Joe Benzini Re: DIRTY equipment - 06/11/02 7:40 AM
When accepting equipment do you receive a decontamination certificate? Do you get one for every piece of kit you get for repair?
Posted By: Mark.N Re: DIRTY equipment - 06/11/02 1:56 PM
We had label designed, with an input from the ward staff, that should be attached to every piece of equipment that is sent to our dept'..hhmmm.
The layout and wording of this label was kept as simple as posssible..to prevent confusion..ahh.
Information that we require is; date/time, asset no., location, contact name/tel, fault description, accesserories and also nature of contamination/method of decontamination..simple. In fact, some may call the design 'idiot proof'.

What else can one do. Perhaps we should have used a bigger font for the words. We even had a 'how to complete this label' form printed and laminated for each ward/area.

All I can say is, it don't blo#dy work!!

cheers
Posted By: Dave H Re: DIRTY equipment - 06/11/02 3:41 PM
We have a very similar procedure to yours Mark.N containing the same information as well as a reference number and space for logging the work order number from the computerised system.

It also contains a tear off portion so we can report back to them and let it "tally up" with their records. laugh

These records are contained in a pad, one of which is supplied to every user, including P.C.T's and health centres we deal with. laugh

We also took that extra step you mentioned Mark and provided all wards/departments/clinics etc. etc. with a laminated "idiots guide" laugh laugh

Still we get equipment without the paperwork, no decontamination declaration, 5 pieces of kit on one sheet etc. mad

As John said with their place, we too raise incident forms and try and "shame" the likes of Ward Managers and Control of Infection teams.

Still we have to deal with incorrect paperwork, the excuse that "we're too busy and haven't got time to fill it in" is often stated. frown

We have got to a stage now where we are considering changing our system of fault reporting/decontamination sheets to try to improve the poorly adhered to guidelines.

May I add that we also supplement our decontamination process by providing to all users a seperate "External Decontamination Certificate" book for items leaving the Trust.
Posted By: Mark.N Re: DIRTY equipment - 06/11/02 6:32 PM
We have now been told not to accept anything that isn't visibly clean..quite right too.
Yes, we've been at fault for accepting kit that has been cleaned. We've played the 'nice cop, bad cop' routine with our 'colleagues'.
When we start to enforce this 'Trust Policy' we're going to be labelled as nit-pickers, job-worths etc..
It's going to be our fault when their equipment doesn't get repaired as quickly as they would like. The Equipment Library is going to grind to a halt - no equipment for loan, because it's all out on the wards dirty and awaiting collection.

Watch this space..

cheers
Posted By: Max Re: DIRTY equipment - 07/11/02 1:03 PM
The idea of getting staff to complete a piece of paper to state what is wrong with the item in question or to inform on how it was cleaned is a non starter and not worth the paper it is written on. Modern systems are meant to be paperless and thereby more efficient. It will only be through training and communication that clean equipments will be returned to the department with information relating to the fault. If you doubt the cleanliness of an equipment do not accept it. Through time, effort and perserverence staff will learn what is required before an equipment will be accepted into the department. smile
Posted By: Mark.N Re: DIRTY equipment - 07/11/02 2:02 PM
Max, you're quite right... rolleyes

cheers
Posted By: Dave H Re: DIRTY equipment - 07/11/02 2:32 PM
Just wondering Max what you do with equipment that has to go outside your Trust to other hospitals or O.E.M's.

Do they take your word for it that it is decontaminated and has not been in contact with a hazadous substance. eek

If they do, then please let me know because we have to ship equipment with a Declaration of Decontamination Certificate.

As to a paperless system, yes I think that would be ideal too, if your fault reporting and general administration is totally paperless, I take my hat off to you. cool

I too, like the marvels of the technological age but still feel safe knowing that I can refer too the "written word" when the systems crash. confused

As for staff doing what is required of them and showing due diligence through training, education and instruction etc I can only presume your nursing staff are of a higher calibre because the words "the lights are on but no-one is at home" comes to mind with our lot. eek

I'm sure now I'll be vilified by the hordes of the nursing profession that read these pages, alls I would say is don't tell me - tell your colleagues. mad
Posted By: JIM GAVIN Re: DIRTY equipment - 07/11/02 3:06 PM
I agree with Max.

Fellow MTO's, etc, please use the correct terminology.

To often I hear use of the word 'Decontamination', it is not.

It is a Certificate of Contamination Status.

They do not claim decontamination, as you are all implying.

They may not have been able to decontaminate the medical device, for what ever reason, therefore you should be informed of the risks, that's what it comes down to and what precautions to take.

If the medical device and/or accompanying certificate are vague in appearance, treat the device with caution and the certificate with contempt. Further, disregard what they tell you and adopt all the necessary precautions, always, as if all devices were contaminated.

That is the regime we operate in our department, gloves, masks, aprons, cleaning and disinfecting materials. We do the best we can to protect ourselves from false claims. I do not want my staff putting themselves, colleagues or family and friends at risks, we all have a duty of care here. If in doubt, incinerate it. Get infection control to take swabs, etc, etc.

Equipment from suppliers and returned to suppliers must be accompanied with the a Certificate of Contamination Status too. You should not be allowing medical devices into your Trust without such a certificate from suppliers, whether it be for trial, loan, evaluation, etc.

Likewise you should or end user, supplier the supplier with a certifcate on return to them of the medical device. Do you all, I doubt if many do, not impressive.

Like John S. we on-line complete a Clinical Risk Form for incidents of gross negligence, such as incorrect or false, etc., completed Certificates of Contamination Status.

If my staff accept anything less than correct I am personally liable for putting them at risk and rightly so too, again I have a duty of care. If there is a problem chaps sort it at the right level, don't just moan about it.

What is it?

Be proactive not reactive.

Remember, it is NOT a Decontamination Certificate, so do not use the phrase, it does not exist.
Posted By: Dave H Re: DIRTY equipment - 07/11/02 4:12 PM
Jim

What do you agree with Max on, that staff should be correctly vigilant in their cleaning of equipment or that we shouldn't require any "hard copy". confused

You are, of course, absolutely right it is a Declaration of Contamination, however, it doesn't help me when I have a stack of "Certificate of Decontamination Status" books already printed up and in use.

I could always adopt the approach of Billy "Liar" when dealing with the "Shadrack and Duxbury" calendars but I don't think the drainage system will take it. confused confused

The issue is not wether they declare it's contamination status or state it has been decontaminated it's that the bug**rs just don't do it.

I applaud the fact that your guys are well "suited-up" but do you do this at the point of collection or is the poor old porter left to cart it to your place and "suffer the consequences" later.

We require the status of all equipment being brought onto our sites to have their "contamination" status confirmed wether for loan/trial or demo.

We are treated with utter devastation by some reps who say " we've never had to do this before"
and yes sometimes it does slow the process up but I feel happier knowing we've done things the proper way.
I'm well use to consultants jumping up and down anyway. rolleyes

We provide "Certificates" for items that leave this department wether for Transfer or going to another O.E.M.
All users have the same "Certificate" book and should, according to Trust policy, do the same when they let stuff off their ward/department.

We raise incidents on non-conformity to Trust policy but unfortunately this is done on that dredded paper stuff, I think your electronic format is a better idea and I'll raise it with our IT dept.

Just be interested to know what you get incinerated, leads?, pumps?, etc if contaminated.
You've had a few staff through your doors since I've known you Jim, I always thought you trained them up and they moved on to "pastures new", didn't realise you had them "torched" if their swabs came back positive. frown
Posted By: Bob Perkins Re: DIRTY equipment - 08/11/02 12:32 PM
Is anybody running a decontamination certification procedure that works in practice? If so I would be interested in your experienced comments, and copies of policies and procedures etc (Please).
Posted By: Mark.N Re: DIRTY equipment - 08/11/02 11:16 PM
As per Bob, please frown

cheers
Posted By: Huw E Re: DIRTY equipment - 10/11/02 12:42 AM
It seems that (some)nurses arent even aware of the concept of cross contamination, I think that any equipment that is 'suspect' the equipment should be left on the wards until its cleaned and let the ward managers know.
Posted By: Mark.N Re: DIRTY equipment - 11/11/02 7:32 AM
Huw.E
Alot of the nursing staff don't seem to see unclean equipment as a health problem. If they did, they'd do something about it. Mind you, they ought to know. Perhaps it's us. We're not highly trained nursing 'professionals'.

cheers
Posted By: KM Re: DIRTY equipment - 11/11/02 9:40 AM
Has anyone else noticed that the cleaning of
equipment tends to be an nhs issue.
Nurses brought in from far off shores to work
in the nhs do tend to look after the equipment better, in my opinion.
Maybe its beacause our home grown crop are used to having everything done for them.
confused
Posted By: Dave H Re: DIRTY equipment - 11/11/02 10:58 AM
Spot on with that one Karl laugh , maybe if football is the "English disease" then the lack of care in cleaning equipment is a "British disease" eek

I'd go even furhter to say that in my dabbles with the Private Sector..excuse me whilst I spit.. that their "housekeeping" is of a lot higher standard. The equipment was definitely in a better condition and was always presented in a clean condition. wink

What this points to.. maybe slacking standards in the good old NHS, big organisation no need to bother with the small attention to details..after all where are they going to go if they don't like it. eek
Posted By: KM Re: DIRTY equipment - 11/11/02 11:16 AM
Are there any nurses out there who could enlighten us oink engineering types, as to why they dont see dirty equipment as an issue for the main carer of patients to be bothered about. rolleyes
Obviously the senior "management" grade nurses spout on about it all the time, but its really the shop floor level bods that need to be taking pride in their working space. confused
Or should we, the oinks, be reporting dirty equipment via clinical risk groups etc as a routine. laugh laugh
Then at least when somthing goes wrong we can say told ye so. wink
Posted By: Louis Lyniswern III Re: DIRTY equipment - 11/11/02 2:17 PM
Dave, The little intemperance's are normally far too busy with their lipstick and Velcro to bother cleaning equipment.
laugh
Posted By: Jill Cloherty Re: DIRTY equipment - 11/11/02 4:02 PM
Hello the real world !
If you bother to look at nurse training now, you will find that students are taught at degree level about lots of medical issues, unfortunately basic things like equipment care, communication and co-operation with other departments are overlooked or under emphasised.
Nursing staff are sent out qualified with little hospital experience and unrealistic ideas of the job they are expected to do by the NHS.
I have often been told “cleaning equipment is not my job” by junior and senior nursing staff.
The HCA is now expected to do all the menial nursing tasks. Gone are the days of the dedicated and practical SEN's and wards with more than two trained staff on duty at once.
Perhaps the answer might lie in some input into the Health Care Assistants training and the NVQ schemes.
It would be more a fruitful avenue of investigation than the blame culture and buck passing I can read here, then the endless paper treadmill may serve the use for which it was designed.
Rather than fire fighting we train HCA's to clean equipment so they don't break it, investment of time can pay off in the long run.
Posted By: Mark.E Re: DIRTY equipment - 11/11/02 7:50 PM
Here here, I could not agree more with this "Gal." give her a lollipop.
Posted By: Dave H Re: DIRTY equipment - 11/11/02 11:03 PM
Ever onward, ever upward.

Maybe we'll get to the day when the "degree" level nurses are superceeded by the "masters" level and eventually the "doctorate" level at entry point.

Hopefully then all those other nasty little duties like looking after patients will have been passed on to the "masters" level entry HCA's who can pass on instructions to the "degree" level Ward Clerks who can finally get the right level of person to clean the equipment effectively, namely the domestics.

They can always lob the syringe drivers in their mop buckets and wheel them down to Biomed hence solving the decontamination and transport issues in one bold sweep.

Oops, forgot, no-one will be in the department; by that stage we'll be at "Professorship" level and will be holding seminars in the Post Grad centre for the 2nd year Portering degree students on the subject "Forces and motions involved in Oxy cylinder handling" confused
Posted By: KM Re: DIRTY equipment - 12/11/02 12:41 PM
AAH THE ART OF BUCK PASSING.
LONG LIVE PERSONAL OPINION.
rolleyes
Posted By: Anonymous Re: DIRTY equipment - 12/11/02 1:13 PM
??????????????
Posted By: Louis Lyniswern III Re: DIRTY equipment - 12/11/02 1:14 PM
Now that one has got off ones soapbox, Jill, my female co-functional, may Louis remind you that it is not “Book Passing” if you where to take your broken toaster back to the shop where you bought it would empty the crumb tray first or just take it back? would you clean it even if you where sending someone else on your behalf?
Jill my fellow hombre, surely it is common courtesy to hand the goods back in a clean and safe condition is it not. This should be foremost the responsibility of the user. There are probably many “delegated helpers” as your self inserted into the equation, but the buck has to end with the USER. My friend, it is that simple.

Louis shocked
Posted By: John Sandham Re: DIRTY equipment - 12/11/02 4:44 PM
Jill
I think that using properly trained cleaners is a good way to free up valuable nursing time, especially if it gets the job done.

Is anyone using equipment cleaners?

We still ask the user to get the equipment cleaned after each patient.
We don't mind if the nurse cleans it or whether someone else cleans it, but they do clean it.

Most wards are quite good at signing our form, but sometimes fail to read it. We do get equipment back with a cleaned notice attached, which has not even seen a damp cloth. If this happens we speak to the staff and point out the error. It is usually the night staffs fault (according to the day staff) but they do then clean the equipment.
Posted By: Anonymous Re: DIRTY equipment - 12/11/02 6:30 PM
Louis and John,

I think you might be trying to teach Grandma to suck eggs (no offence Gill) you know - and Mark E's lollipop comment really takes the biscuit (no pun intended!). With Gill's valuable input I watched a busy, regional NICU develop into one of the best around, with respect to equipment usage, equipment training, clinical-support, clinical data management and maintenance.

She does also take the time to train those more intellectually-challenged like myself, which is unusual in departments where everybody is watching their backs and paranoid about others job-roles, qualifications, grades and knowledge. By the way, I think hers is the sort of approach that those who aim to be "Proactive, not reactive" and others who give "formal" training to users (hah, hah) should be aiming for.

Finally, Dave H. what does it matter if everyone you work with is well qualified? Why bother about other's qualifications at all as long as they meet the minimum criteria? Paranoia maybe? Concerned about slipping further down the food-chain into the primordial-sludge, perhaps?
Posted By: John Sandham Re: DIRTY equipment - 13/11/02 8:35 AM
Richard,
From the tone of your posting I think you have mis-interpreted the posting. confused
I was being sincere when I said equipment cleaners could free up valuable nursing time.
At our Trust I regularly see too few nurses trying to care for too many patients, and I have the uptmost respect for the work they do, and vice-versa. You could speak to any nurse in our Trust and they would agree.

I agree with Jill. smile

We are trying to find funding for cleaners who will only clean equipment. The tissue viability nurse has take the lead in this initiative, as it seems to be the ripple mattresses that are the main item we have problems with.

I can't speak for Mark.E , but I read his comments as complimentary, and I didn't take it as being sarcastic at all.

Sometimes written text loses the 'tone' and can be read to mean different things, which is why I tend to use the instant graemlins, to give more tone/meaning to the text. cool
Posted By: Dave H Re: DIRTY equipment - 13/11/02 9:50 AM
Firstly may I endorse what John has said, I didn't take his comments as flippant and neither did I interpret Mark.E's comment as sarcastic.

I think Jill's comments were valuable and she obviously is dedicated and "proactive" in her approach, from what I can interpret, from her postings. wink

Now on to you Richard mad

Firstly I can't "interpret" from your profile who you are.
I post details so as to give other readers an idea as to who I am and what my background is.

Your status gives the impression of a caller to a daytime chat show i.e. "Richard from Essex"
It is your right but if you want to fire some bullets why not take off your Zorro mask. confused

Do I have a problem with people being well qualified?

Absolutely not, What I have a problem with is people "chasing" qualifications for qualifications sake, wether that be in nursing or engineering, a view point my erstwhile colleague Mr Mundy has eluded to in the past.

A minimum criteria of qualifications?

Again no, an adequate level of qualifications, or training for that matter. Does having a degree make for a better nurse? My experience of nurses doesn't show that. What it does,I think, is start the ball rolling to "fast tracking" people out of the profession they originally joined to become one of the hordes of professional managers.

Paranoia?

Most definitely. I've always been paranoid, as I always subscribe to most conspiracy theories too, but working in the NHS for so long gives you that too.
Is my paranoia due to the cleanliness of equipment or the state of nursing attainment, I think not dear Richard, am I being sarcastic..your darn tootin' laugh

"Slipping down the food chain into the primordial-sludge"
Such articulation! Do you mean am I worried I'm being left behind and resigned to the scrapheap?
I have no fear of this, either as an individual or as a profession.

I believe the work we are doing is of uttmost importance and greatly valued.

All comments to do with cleaning/contamination is meant as a topic for debate to improve standards.

Blame culture does exist as does "passing the buck".

Hopefully through communication we can improve this. On a local level we are geared up to do this with dialogue between ourselves, nursing staff, clinical staff, management, infection control and lots of other interested groups.

However nationally it's a bit more difficult to do, which is why this forum is a good place to "air" thoughts and viewpoints.

People and places do different aspects of healthcare provision in vastly diverse ways.

I for one, read this forum, and take the good and bad points out of all postings.
Some I will think of as good ideas and progress them here, others I won't and will store in the memory banks.

I don't profess to have all the answers, I am opinionated as you may have guessed. I'm also big enough to accept criticsm when deserved.
Don't think it is here, but I may be wrong. rolleyes
Posted By: Anonymous Re: DIRTY equipment - 13/11/02 11:03 AM
Actually, John, Louis and Mark E. The way I read your postings it seems that you assumed Jill was a Nursey-type. Graemlins or not, that's the way it came across to me and it will have to others.

With this almost patronising attitude, I know Jill's entitled to be a mit miffed. I think I would be - but hey, why worry be happy!

Dave. H. there was no need to bring nurses or other engineers qualifications into it - nothing to do with anyone else, in my opinion, unless you're in a position to decide for someone else (i.e. you're a Chief Technician).

As for being a Zorro; Richard is my real name, my email is there and if you or anyone else wants a private discussion you're welcome.

It shouldn't really worry you what my qualifications are or where I work but it's in a large General Hospital. I am a fully-qualified engineer with over 14 years in the NHS and a spell working for a private company, whose name escapes me! Mark E. will fill you in if you want to know anything else.

No doubt you'd prefer to have a bunch of idiots, who count on their fingers, working for you so you can keep hold of them once you've got 'em, Eh? Of course, you could be of the "I've got no interest in that so nobody else should have opportunities", way of thinking, perhaps? But maybe I've misinterpreted your posting above.
Posted By: Dave H Re: DIRTY equipment - 13/11/02 12:55 PM
Richard

I think you have mis-interpreted my previous posting.

I brought up about qualifications because in Jill's last posting she stated "students are taught at degree level" when referring to nurse training.
I assumed by this that this meant that these trained nurses are not taught about equipment care
but lesser trained nurses are eek

I never assumed Jill was a "Nursey-type" I assumed she was a Clinical Technologist as her profile states!
I can't therefore see what gives you the right to assume that this is what John,Louis or Mark.E assumed.
Or indeed what gives you a right to say that that would be the case with others.

Indeed if Jill is "miffed" over the presumption that you have said was "patronising" then I'm sure she can respond.

Do you take yourself as the "Alastair Campbell" to Jill's "Tony Blair". rolleyes

As for patronising, isn't the "kettle calling the pot black" true here. frown

As for my interest in your qualifications, I think you have mis-interpreted, I have no interest in your academic or vocational background.
My slant on qualifications was the "appropriate level for the job" pitch, as mentioned in other subjects previously.

As to your assumption that we employ "a bunch of idiots who have difficulty in counting" I am deeply disturbed that you think to question their integrity or skill in this way.

My colleagues are well qualified, to degree level in some cases for the record, I am not.
They are well experienced and trained and choose to work here because they probably enjoy it and consider themselves to be doing a worthwhile job.

I don't employ them, the Trust does.
I have no fears of them moving on, they will take that decision if and when it suits them.
I would take every effort to help them if this was their desired course of career development.

Several of the staff are also doing extra qualifications from technical to business management courses.
This is actively encouraged and procedures are put in place to benefit them during their period of study.

These are personal choices and I applaud them in their desire to acheive greater success, wherever this may take them.

They are however all sufficiently qualified to fulfill the posts they hold and my argument is that these "extra" qualifications will and should benefit them in their chosen career future progression, not in their current situation to which their structure is already formalised and planned.

I don't "keep hold" of staff, they stay for their own reasons, it has never been my way of thinking of keeping people down.

Indeed if you knew me you would know that nothing could be further from the truth.

I have worked in places where these regimes take place of keeping people down and paying them accordingly. I ,sir, am an egalitarian and consider it as one of my duties to be "proactive" in helping our staff progress both academically and financially.

Wether you think I'm jealous of these people or not is immaterial as you suggested that because I may "..have no interest in that.." are my reasons.
I hope the above points have clarified your misconception, I do have concerns as to qualification and job suitability but not in the areas you suggest.

It is also not an "us and them" thing.
What I believe in is relevant to all fields/disciplines whatever their area of expertise.

My areas of concern relate more to things like Agenda for Change, NHS Modernisation and Professional Accreditation.
If you want to see an example of "finger pointing", and "jockeying" for position just look at the common pay spine. frown

Hope this is of some clarification Richard and I hope this doesn't cloud the initial of the original point. wink
Posted By: John Sandham Re: DIRTY equipment - 13/11/02 1:36 PM
Richard,
I know that Jill is a Clinical Technologist from Kent & Canterbury Hospital East Kent NHS Trust
with interests in Neonatology, and I agree with her that less qualified staff are perfectly capable of cleaning equipment, if that is part of their job description.

It is also a fact that (Nurses/ODA's/Doctors) The users are responsible for ensuring equipment is clean (even if they assign someone else to do it), this reduces the risk of cross infection.

I mentioned nurses because it was part of the discussion, nurses were mentioned in many of the previous posts. I try to concentrate of the facts, and not make too many assumptions.

DB9801 states that "a failure to have effective procedures in place will not only put staff and end users of equipment at risk, but also create a danger of liability being incurred"

We are all resposible for ensuring patient safety, that includes keeping equipment clean. If that means asking for a signed document to say the device has been cleaned then we should do it.

It needs a culture change, not just from users, but from everyone.

I am not being argumentative, We do enforce our decontamination policy, Our EBME Librarian will not move equipment without a contamination status notice.
Posted By: Anonymous Re: DIRTY equipment - 13/11/02 1:40 PM
I'm glad you got that off your chest.......
Posted By: Anonymous Re: DIRTY equipment - 13/11/02 7:17 PM
Dave H,

Reading your post, above, was really fun and very informative. It referred to loads of issues and other stuff that I didn't even touch on in my posting, perhaps I did mis-interpret your posting(s) but I do think my concerns about paranoia may be justified laugh At least I'm left in no doubt that my flippant remarks about "promordial-sludge" hit the spot! Thanks for the interlude and keep scrubbing, I'm sure you'll get the sludge off eventually. wink
Posted By: Ged Swinton Re: DIRTY equipment - 14/11/02 10:31 AM
Hi All

My 2p for what it's worth

I am a nurse who uses lots of medical equipment. I am also trying to help change the way we nurses work WITH EBME.
The problem of dirty equipment is a serious one. Users cannot put others at risk of contact with biohazardous material. The bottom line should be IF YOU USED IT YOU CLEAN IT! ,or delegate that responsibility to someone appropriately trained and protected to do so. If you find that your getting static from nurses on this issue ask them whose responsibility is it to dispose of sharps and why.(The same principle applies you used it you bin it.)

As a nurse I see infection control as a major part of my role and essential to patient care which is what everyone here is about(one way or another). The simple fact is that most nurses do not recognise the risk to others. And when faced with a choice between actual hands on patient care and cleaning a piece of kit I know what I chose.

I treat all procedures as a potentially biohazard and use universal precautions i.e. Gloves,apron, eye protection and handwashing. Surely EBME depts could do likewise as some of the spaces in equipment that can get containinated are not accessable for non-technical staff.

After saying that, the user is ultimately responsible for the cleaning of the equipment regardless of their academic qualifications need training in the local policies and procedures in cleaning equipment. Do they all get it?? Are they fully aware of their personal responsibilties under the health and safety at work act, Local infection control policies etc etc??

Equipment is often cleaned using inappropriate solvents/agents because no-one has told the person cleaning it that it can only be cleaned using XYZ and that sticking it in a bucket of soapy water is probably not the best way to clean it.

Does anyone involve your infection control people in your pre-purchase evaluation. I have heard of expensive equipment being purchased by surgeons that cannot be cleaned/sterilised because the hospital don't have the right type of v expensive cleaning kit.

Just a thought or 2
Posted By: The Duke Re: DIRTY equipment - 14/11/02 11:44 AM
laugh Dave H 1 frown Richard 0

"BACK OF THE NET"
Posted By: BSM Re: DIRTY equipment - 14/11/02 12:08 PM
At our hospital, the powers that be have tried to implimenta system whereby the ward staff must complete a decontamination cert. & attach it to the faulty equipment before we will pick it up.

This is great in theory, except that the staff need to know about the system, have the correct paperwork and have time to do it.

It makes no provision for PPM work where you may turn up unannounced, or where it is a priority job/call out.

These issues have been raised by staff but any solution seems to have been 'put on the back-burner' as it were.

In the meantime, we continue as we did before the invention of this 'cover your ass at all costs' mentality which seems to be prevalent today.

I thought we were supposed to work towards a 'paperless society', presumably to save the environment? frown
Posted By: Dave H Re: DIRTY equipment - 14/11/02 12:09 PM
Good comments Ged laugh

I think your approach is spot on laugh

There has been a lot of "finger pointing" and "mud slinging" so far on this topic but your viewpoints are the way to go, inmy opinion.

Everybody is busy, everybody is under pressure to perform all the tasks required of them.

I know the issue is important but due to lack of finance, staff, space, time etc the argument tends to end up, as it has here, as a "pass the buck" exercise.

When we stand back and take stock, the issues that you have raised Ged stand out.

We need to accept that cleaning of equipment is vital and that the control measures needed to be put in place can't be swept under the carpet due to a lack of finance, staff, training, space etc.

I think management has to accept that it is a core issue and should be handled accordingly.

In my experience this has not been the case. It has been left to nursing staff, ward/department managers, EBME and teams like Control of Infection to sort out by themselves.

With the best will in the world we will not get passed what we have seen here, people having different solutions to how the problem should be solved.

Issues raised here by numerous people to do with dedicated cleaners, staff training, staff responsibility, EBME involvment etc etc are all relevant.

They are however, fragmented.

I know I've been emotive on this subject, it's because I see it as a crucial issue.

I would love to be able to say to my Trust, "Here is what we should be doing and this is what it is going to take/cost"

Unfortunately our system, whilst not the worst I've ever seen, is not perfect. It has evolved rather than been designed.

It would take a radical re-think to change to something we could be rightly proud of.
It would also take time, effort and resource and that is the problem.
frown
Posted By: Chris-H Re: DIRTY equipment - 14/11/02 4:28 PM
Yeap.
You cannot enforce what cannot be enforced!

Just accept it !

We are defeated comrades.

Chris-H eek

P.S (I am liking me new avtar image, although he seems a bit too hyperactive at the moment)
Posted By: Mark.E Re: DIRTY equipment - 15/11/02 12:03 AM
There ya go again Richard mis-interpreting me!
But I don't hold it against ya eek

I thought Jill comments where on the nail, and I whole heartedly agreed with her.

Anyway Richard since when have I been your agent! rolleyes
Perhaps next time I see ya it won't be raining and I can actually talk to you.. regards
and best wishes for Xmas
Posted By: WOM Davis Re: DIRTY equipment - 15/11/02 4:50 PM
Ged Swinton's input :-
“I treat all procedures as a potentially biohazard and use universal precautions i.e. Gloves, apron, eye protection and hand-washing. Surely EBME depts could do likewise as some of the spaces in equipment that can get contaminated are not accessible for non-technical staff.”
is the least risk path for us all.

Yes we should expect equipment sent to our departments to be externally clean but also be aware of the possibility of contamination e.g. behind the pump door cover etc.

Along with oil/gas production, marine, nuclear and powerline engineers, medical engineers are exposed to work place hazards. One of ours is exposure to biohazard contamination.

As suggested “Surely EBME depts could do likewise and use universal precautions i.e. Gloves, apron, eye protection and hand-washing, as some of the spaces in equipment that can get contaminated are not accessible for non-technical staff.”

Bill smile

(P.S. not to mention our main occupational hazard exposure to nurses!!) wink
Posted By: Mark.N Re: DIRTY equipment - 15/11/02 11:27 PM
Perhaps, I'm being overly simplistic but, if one makes a mess one should clear it up ones self and not deligate their mess to someone else.
If one gets in to deligating mode, one doesn't care.

cheers
Posted By: EH Re: DIRTY equipment - 16/11/02 5:28 AM
Wow dudes, this is getting heavy man, I agree with Dave, Ged and Louis, If you soil the goods, clean them up yourself man, Richard you seriously need to chill guy as you is putting stress on yourself and might trip out and maybe end up on some of this equipment yourself dude.

Floyd cool
Posted By: Louis Lyniswern III Re: DIRTY equipment - 16/11/02 9:36 AM
Never a truer word spoken Floyd my bong toking fellow functional, never a truer word spoken my friend

Louis
Posted By: Anonymous Re: DIRTY equipment - 16/11/02 1:51 PM
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. frown

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 it?

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. mad

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 wink
Posted By: Mark.N Re: DIRTY equipment - 16/11/02 8:45 PM
I have empathy with Richard.

Yes, this subject is like a round-about,as someone has already said, and I've now got off it.

cheers
Posted By: EH Re: DIRTY equipment - 17/11/02 5:58 AM
Yo Richard dude, I was not trying to humiliate you at all guy. I was merely trying to suggest that you take the vibe to seriously man. Chill out dude. cool

Floyd
Posted By: Louis Lyniswern III Re: DIRTY equipment - 17/11/02 6:28 AM
Gentlemen, are we not all on the same ship here. Richard, you make excellent point's, How do you know that an item is “clinically clean”, simple, you don't. You take care. If Louis is performing a simple functional PPM and NOT a service, Louis will usually wear some protection ,i.e. gloves, as most items only require simple functional/calibratory procedures NOT INVOLVING THE APPLIED PART.
However, You employed a SPO2 probe in your analysis, that is an applied part, surely that probe was ready for the next patient. Louis would say this for all items in clinical areas, they are simply going to be used on the next patient, therefore they should be clean, If not then we have a serious problem on our hands.
wink
Posted By: Anonymous Re: DIRTY equipment - 17/11/02 1:28 PM
I agree with you Louis but we have a problem on our hands; it's not ours in the making and it can't be solved because other groups are responsible for it. We should do our bit and be able to trust others to do theirs, perhaps but this will not happen, until somebody picks up some really nasty infection in EBME and it's traced back to a piece of contaminated equipment that should have been cleaned.

Ok Louis, you wear gloves but what do you then do with the equipment after you've done your bit - shove it back on a shelf without anyone knowing its decontamination-status? I wouldn't blame you, since the response from some clinical-staff would be less than enthusiastic if you raised the issue but if you didn't raise the issue, wouldn't this be perpetuating the merry-go-round? The "Magic Roundabout", so to speak, where Florence is never seen wielding an azowipe.

That also brings me on to another issue - what is the status of the equipment after the "grubby little maintenance man" has finished with the kit? How do EBMEs fayre in this respect? Do you clean or decontaminate the internal (and user-inaccessible) circuit of anaesthetics systems during routine maintenance, as the MDA seems to suggest in its recent guidance, published on the internet? What handover arrangements do you have?

In my opinion, patients (you and me on occasion) should be examined and treated using clean equipment, they should expect no less. For example; I wouldn't want to be the next patient to have my bladder or heart imaged after somebody with raging skin-complaint or infection has been scanned unless the doppler-probe has had a bit more than a wipe with blue-roll - irrespective of whether my concerns are "evidence based" or unfounded in scientific terms - would you? Just in the same way you would not be particularly happy with wearing a BP-cuff that stinks of urine, faeces and vomit, or an oral or tympanic thermometer that is being used without probe covers stuffed in your orifices, Eh? We have all come across this and it is shameful.

Unfortunately, because of the culture we're in, if clinical staff - usually infection control, can justify to moaning EBME staff that equipment that's not regularly cleaned presents minimal risk to others it becomes acceptable to clinical staff that equipment cleanliness is low-priority, so they don't spend time an effort doing the housekeeping.

There is a wide range of general equipment out there which, may or may not, have had direct patient-contact but the common factor is that it's all used by clinical staff and it should be cleaned. These clinical staff take precautions by wearing the relevent PPE, etc, etc which protects them and they should ensure the equipment is cleaned every time it is used, to protect others. When they're finished with the kit it seems that there's no time to clean it (or it's not their job) before it's rushed off to another ward, used to treat another patient or just returned to a storage area. Not always the case but a fairly common occurrance, I think. The kit sits there, festers and just gets stickier each time it's used.

What I would like to know (perhaps John Sandham has already condsidered this) is how do we deal with this sort of problem when we're out there actually doing the job, rather than processing nice little "certificates of conformity", in the comfort of the EBME department? It's great making references to standards, etc, etc and ticking off "to do" lists and how well CA is being implemented and having meetings but sometimes I think we forget the reasons why all this is important. I doubt that new-starters fully appreciate it when they first walk through the door into a Hospital.

Anyhow, it's annoying that the people appointed to do their bit on the management-side (in clinical and non-clinical areas) can't seem to get anywhere close to solving this problem once and for all. In all my dealings with infection control and H&S, in the past, I have never come away from a problem satisfied that steps have been taken to avoid a reocurrance of the same problem. It is always a "I'll take it away and clean it" response - "problem solved" (for today). It's as if the H&S issues affecting other NHS staff don't matter in the scheme of things, when there's a "poorly-patient" or "overbearing consultant" to consider.

Time for lunch; I hope it's served-up on a clean plate........
Posted By: EH Re: DIRTY equipment - 17/11/02 1:54 PM
Wow man, I really dig the magic roundabout.
Richard Dude, your last posting contained 756 words consisting of 3,623 letters, Man you have a serious gripe dude, chill out babe.
Posted By: Anonymous Re: DIRTY equipment - 17/11/02 2:49 PM
Yeah, that's right - I can type pretty fast.
Posted By: Mark.E Re: DIRTY equipment - 17/11/02 5:40 PM
Who's rattled your cage then " Dick" ?

As always your very articulate; and thorough.

I would have too agree with you on all your points. shocked eek
Posted By: Mark.E Re: DIRTY equipment - 17/11/02 5:44 PM
Of all the EBME Department which I have encountered Wigan's is by far the best on all matters concerning clean equipment; before a repair is undertaken, and after it is complete. Perhaps the forum can contact Mr Woods or Mr Norris you ask how they set it all up?

It's enough to make you jealous!! :p rolleyes
Posted By: EH Re: DIRTY equipment - 18/11/02 5:26 AM
Who ate all the pies man,,,,Hego did cool
Posted By: The Duke Re: DIRTY equipment - 18/11/02 10:40 AM
Louis-----Floyd hmmmmmmmmmmm
are you as one with yourself?
anyway
treat it all as dirty and you wont go far wrong
the bugs you cant see are the ones that will get you not the ones you can.
Posted By: Dave H Re: DIRTY equipment - 18/11/02 11:33 AM
May I take this opportunity to applaud Richard, I believe he speaks passionately about a subject that should be close to our hearts and well-being. laugh

I agree with his view points and I don't think he is out of touch, if he is then I am as well.

We had a disagreement about a small issue, the main topic I think we are very similar in agreement on.

If more people were as concerned and forthright on the subject then maybe we would be closer, nationally, to sorting out this major issue.

What seems to be common is that we have all had similar experiences of poor equipment cleaning. This to me suggests that the problem is wide spread and "out-of-control".

Mark E highlights the example of Wigan. I would hope Stuart or Dave would give us the benefit of their in-sight as they are doing "cutting edge" stuff to do with decontamination and equipment preparation I believe.

I do agree with Richard as to training of all staff. Infection control knows no boundaries and so all staff are important in this issue.
I take issue with nursing staff on porters behalf when they are expected to handle equipment in a poor condition. I have the "attitude" to do this, unfortunately a porter does not always have the back up to refuse to handle soiled items.

I too have horror stories as to the contamination of equipment and being "swabbed" for nasties.

Keep banging that drum Richard I'm doing it too. laugh laugh
Posted By: Louis Lyniswern III Re: DIRTY equipment - 18/11/02 12:55 PM
My dear Mercury man, are you trying to suggest that Louis and Floyd are one, my dear friend that is preposterous, absolute baloney, complete rubbish, my friend, do you honestly think that I Louis Lyniswern III, son of Louis Lyniswern II and grandson of Louis Lyniswern, would even associate with a tree dwelling hippy let alone assume his identity, my friend grandpa Louis would roll in his urn at the mere thought of such a suggestion.

Louis frown
Posted By: John Sandham Re: DIRTY equipment - 18/11/02 9:40 PM
Richard
You have a good grasp of the problems we all encounter.

The root of the problem is training and implementation of cleaning and decontamination policies.

With nearly 10% of patients (and staff) aquiring infections whilst in NHS Hospitals costing the NHS millions ££ we need implementation plans for policies. (not that this is about money!!)

I am working with the Clinical Governance team, EBME staff, and users to develop a plan for implementation of training. This (I believe) is the root cause, and our EBME Training officer includes cleaning and decontamination in his equipment training, and induction training.

This has resulted in more awareness and understanding. I agree that we are fortunate to have an equipment library, and dedicated staff for collection and delivery who are also trained to insist equipment is cleaned between patients.

We have also worked with portering and they now also insist on the correct paperwork when moving equipment (They operate the library out of hours). The form we use to say equipment has been cleaned is quick and simple to fill out.

We have in no way 'cracked it' but we are part of the organisation and doing everything we can to improve the situation.

Other countries in Europe have cross infection rates as low as 3%. The NHS should and can do better.
Posted By: Cyberdog Re: DIRTY equipment - 16/05/06 1:28 PM
I think you'll find that most trusts already have a decon policy, and that it has been forever lost in time as no one enforces it.
Posted By: Anonymous Re: DIRTY equipment - 16/05/06 5:00 PM
Quote:
I think you'll find that most trusts already have a decon policy, and that it has been forever lost in time as no one enforces it.
Yes that's probably true - especially when it's 4 years down the line from when the original thread was started.
Posted By: Geoff Hannis Re: DIRTY equipment - 17/05/06 12:04 PM
Surely it is enforced each time a biomed refuses to accept contaminated equipment into the workshop? smile
Posted By: exitwound Re: DIRTY equipment - 19/07/06 11:49 AM
Right on Geoff.. wink

Any equipment we receive has to be clean enough for patient use. Can't say we've ever had a problem with this, maybe once or twice we've sent something back. rolleyes

I just love the idea of allowing staff to graffiti equipment with their thoughts and feelings with marker pens.. I assume they would always know which pen was water soluble and which was indelible!! laugh

My favourite is a Genius thermometer with a 'low battery message' on the screen which has subsequently been covered with an (adhesive dried and set) sticky white label upon which is written 'low battery' ...TOO MUCH!! We send them back or invite the staff down to remove the label themselves! laugh
Posted By: Geoff Hannis Re: DIRTY equipment - 20/07/06 12:41 PM
Nice solution!

Is that you in the car, by the way? smile
Posted By: exitwound Re: DIRTY equipment - 21/07/06 8:04 AM
Posted By: PaulKWJ Re: DIRTY equipment - 19/09/06 12:42 PM
Has anyone ever notified the infection control department in their hospital when they have received dirty equipment sent from a ward into your workshop??

Only guessing, but wouldnt a slap on the equipment users hands from the infection control have a bigger impact than just a mear techie giving them a ticking off??

wash your hands before having this food for thought
Posted By: Pete M Re: DIRTY equipment - 19/09/06 1:11 PM
Hi Paul,
Yes, we report incidents to infection control & in serious cases also record it as an adverse incident for investigation by the Governance / Risk department.
Certain items of equipment are not even accepted into the workshop without a signed Decontamination Certificate.
Pete
Posted By: Geoff Hannis Re: DIRTY equipment - 07/08/07 7:27 PM
We just don't seem to get "classics" like this thread on the forum any more! Put the kettle on, pour yourself a cup of tea (coffee) and browse through the whole eight pages. You'll be glad you did! smile
Posted By: Mark Radbourne Re: DIRTY equipment - 07/08/07 9:32 PM
Just have and no I'm not. smile

Posted By: Geoff Hannis Re: DIRTY equipment - 08/08/07 5:35 AM
Maybe it just needs to be summarised, then, Mark. smile
Posted By: Mark Radbourne Re: DIRTY equipment - 08/08/07 6:08 PM
I was only joking. blush

Amazing how this is still a huge issue 5 years on and not a lot seems to have changed. If you were outside looking in, you would think that this would be easy to fix but apparently not.
Posted By: Geoff Hannis Re: DIRTY equipment - 08/08/07 6:38 PM
It's been an issue for at least thirty five years! It's really about human psychology and peopleís assumed and presumed status in relation to others (ie, the perceived pecking order, and the "Iím not doing that!" syndrome). Some people have always been too proud to do the shitty jobs, and now that nursing is a degreed profession, I can only see the situation getting worse.

Filling in forms is one thing, but maybe the real answer is (as John Sandham has mentioned) to promote the new career of Equipment Cleaner!

Perhaps the biomed shop of the 21st Century should comprise not only clinical engineers and biomedical technicians, but Equipment Trainers and Equipment Cleaners as well. These last two posts to be funded by Nursing, seeing as though they are too busy (or elevated) to take care of these important functions themselves. How about that? smile
Posted By: webbie Re: DIRTY equipment - 21/08/07 11:10 AM
I think the point is that equipment should not be moved around the hospital in a contaminated state, to EBME or another ward. The nurses can always get the healthcare assistance to clean hte equipment as they often do in our hospital, but it should be done before being moved out of the ward.
Posted By: RDS@MES Re: DIRTY equipment - 22/08/07 9:33 AM
We have invested in one of these devices Genie - ATP Monitor

Before foramalising as a validation to reject dirty equipment - have set up evaluation protocol to randomly test 100 devices over august & september. Highest result logged so far @ 7,947 on a tympanic thermometer !.
Posted By: RDS@MES Re: DIRTY equipment - 08/07/08 8:16 AM
Department has now been offered a regular training slot within Infection Control lectures to Clinical Staff in which to emphasis about cleaning equipment before service/repair. Hence am on the look out for any pictures of dirty equipment. Please email as jpegs to richard.steventon@sath.nhs.uk - Thanks
Posted By: Huw Re: DIRTY equipment - 08/07/08 8:50 AM
One or two to start you off in the gallery.
Posted By: Huw Re: DIRTY equipment - 08/07/08 2:41 PM
Some more pictures have been submitted smile
Posted By: Geoff Hannis Re: DIRTY equipment - 08/07/08 3:34 PM
... I was wondering what that smell was! frown
Posted By: Eddie Re: DIRTY equipment - 09/07/08 2:41 PM
I think i will cancel that pizza order! Not to hungry now!

Eddie
Posted By: Eugene Doherty Re: DIRTY equipment - 10/07/08 1:58 PM
when I calibrate the typmanic thermometers here I find that low readings are invariably due to dirty probe tips that staff don't think to clean

mucky tip
Posted By: Garrith Re: DIRTY equipment - 28/02/13 10:57 AM
As the issue of equipment being presented for 'service or repair' without a declaration of contamination status form (not that filling out a form is any real proof the device has even been cleaned tut!)- even though it is a recommendation within MHRA DB2006(05) November 2006 section 9

I have been tasked with finding out what happens elsewhere, so:
in your workplace:

Is decontamination / cleaning included in your MD Policy ?
Is all equipment presented clean ?
Do you reject 'dirty' equipment ?
How do you reject 'dirty' equipment ?
Who is responsible for cleaning the equipment ?

Obviously, these issues will always be with us, but we have to reduce the likelyhood of moving infection arround the hospital. smilewink
(as a footnote - we tend towards - No status form - we'll clean prior to working, clean again afterwards, it just increases the time spent on each repair or service - not ideal I know, but we then have a better level of assurance).
Posted By: Lee S Re: DIRTY equipment - 28/02/13 4:06 PM
Is decontamination / cleaning included in your MD Policy ?
Sort of
Is all equipment presented clean ?
Mostly
Do you reject 'dirty' equipment ?
Yes
How do you reject 'dirty' equipment ?
It is returned to sender without any remedial work having been carried out.
Who is responsible for cleaning the equipment ?
The "Nurse" who used the equipment or they may delegate to others (Housekeepers etc) however the nurse is the person responsible, she (or he) will know if the equipment has been exposed to bodily fluids etc and the medical condition of the patient from this knowledge they can ensure the equipment is cleaned/decontaminated in an appropriate manner.

As for your foot note how do you know what standard to clean/decontaminate to?
As for cleaning items when they come in; I haven't got time to send this email let alone clean up after everyone else. Do the staff not clean items between patients?

Lee
Posted By: Geoff Hannis Re: DIRTY equipment - 28/02/13 8:03 PM

Originally Posted By: Garrith

How do you reject 'dirty' equipment ?


A couple of contaminated suction pumps tossed in the incinerator generally gets the Ward Managers' attention. whistle
Posted By: SUZUKI Re: DIRTY equipment - 01/03/13 8:11 AM
At Walsall we have a policy for Decontamination of medical equipment prior to repair.

Also if no decon cert with equipment then it don't get repaired.
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