Long-Term Care Survey Alert

Balance fire and other safety issues with infection control.

When it comes to alcohol-based hand cleansers, nursing facilities find themselves between that proverbial rock and hard place.
 
The Centers for Disease Control & Prevention says the hand gels do the best job of disinfecting hands that aren't visibly soiled. "And epidemiological studies indicate that caregivers tend to use these hand gels better when the dispensers are  in the egress corridors," says Dean Samet, senior engineer associate director of standards with the Joint Commission on Accreditation of Healthcare Organizations.
 
Yet placing the hand cleaners in egress or exit corridors violates the National Fire Protection Association's (NFPA) Life Safety Code (LSC).
 
And even though health care facilities are allowed to place the dispensers in patients' rooms, that option allows cognitively impaired residents more unsupervised access to the hand cleaners. And you don't want residents to rub the alcohol-based gel in their eyes or swallow it.
 
Some nursing facilities are resolving the safety issue by placing the hand cleanser completely out of residents' reach. For example, staff in the transitional care unit at Wilkes-Barre General Hospital in Wilkes-Barre, PA carry the gel rubs in their pockets where they have immediate access to the hand cleanser, according to Tammy Gola, the certified RN assessment coordinator for the unit. Wilkes-Barre has also placed alcohol gel dispensers in the nurses' station and dirty utility room, she adds. Other nursing facilities are placing the hand-cleansing dispensers at a designated height designed to at least prevent residents in wheelchairs from tinkering with them.
 
Tip: Check with your state agency for guidance on handling the alcohol-based hand gels. To read Michigan's policy and information on the issue, for example, go to www.michigan.gov/cis/0,1607,7-154-10575-55731-,00.html.