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CS Questions & CS Answers
Temp. conversions; handling trash; de-linting towels; labeling BI
capsules
with Ray Taurasi
Editor’s Note:
Questions can be emailed to:jakridge@hpnonline.com, called in to Jeannie
Akridge at HPN, (941)927-9345 ext.202, or mailed to: HPN CS Questions,
7650 So. Tamiami, Ste.10, Sarasota, FL 34231. Names and hospital
identification will be withheld upon request.
CS Question:
My staff often gets confused between the difference of Fahrenheit,
Celsius and Centigrade temperatures. Is there an easy way to help them
understand this?
CS Answer:
It is very important to clarify temperatures as serious problems
could result if one confuses Fahrenheit and Celsius. Centigrade is the
same as Celsius. Outside of the U.S. Celsius is the standard used for
temperatures. Fahrenheit is commonly abbreviated as " F"
and Celsius as "C"
following a numeric temperature e.g. 60°C
or 140°F.
To convert from Celsius to Fahrenheit multiply by 1.8 and then add 32.
To convert from Fahrenheit to Celsius subtract 32 and then divide by 1.8
Example:
60°C
60 x 1.8 = 108 + 32 = 140
thus 60°C = 140°F
140°F
140 – 32 = 108
÷ 1.8 = 60
thus 140°F = 60°C
CS Question:
Plans are underway to do some renovations in the surgical suite and
CPD. The plans call for sending all soiled laundry and trash from the
O.R. to the decontamination area. From an infection control perspective
I do not feel that this would be proper technique or appropriate to have
CPD techs involved in this process. Handling trash and linen will
further reduce my staff’s productivity. Could you possibly tell me if
there are any rules or regulations against this practice?
CS Answer:
To my knowledge there are no standards or regulations against the
practice of trash and soiled linen being returned to the decontamination
area. Of course there must be attention paid to following the
appropriate procedures to contain the soiled goods in transit and
handling. There are guidelines, regulations and standards of
practice that do address such protocols. You may refer to AAMI, OSHA,
EPA, ASHCSP, and IAHCSMM documents and technical manuals
for more detail. You should also carefully review your local and state
DPH regulations for handling bio hazardous waste. There are stringent
environmental and traffic control protocols that apply to this. To
do the process appropriately you will need appropriate and adequate
space, equipment and personnel. To make your case, aside from addressing
the technique issues, a thorough cost assessment may be the deciding
factor – do a cost analysis of the various options. Include all
transporting and relative equipment, labor requirements; include cost of
space utilities, etc. You may prove your point by showing the
duplication of space, utilities, equipment, personnel, standards, etc.
is very costly and inefficient.
CS Question:
We utilize green O.R. linen towels on our back table as padding and as a
packaging aid for instruments. Since these towels never come in contact
with the patient or the surgical site and are just a packaging aid, is
it really necessary to de-lint and inspect each towel for holes?
CS Answer:
In the best interest of patient safety and welfare it is absolutely
necessary and imperative for each towel to be carefully inspected for
lint, holes, frays, or other foreign matter. Even if the towels do not
come in direct contact with the patient or the surgical site it is
possible for any foreign matter such as lint remaining on the linen to
adhere to an instrument or implantable medical device. A minute particle
of lint could easily adhere to or catch onto the intricate crevices or
working mechanisms found on many medical devices and go unnoticed. The
foreign body could therefore easily be deposited in surgical site and
remain in the patient post surgery. Foreign matter such as lint
remaining in the human body following a surgical procedure poses a
serious risk to a patient’s health, safety and life. Problems associated
with foreign bodies include granulomas
adhesions, infections, swelling,
severe pain, rejection of implants and many other adverse conditions
affecting a patient’s well-being and quality of life.
CS Question:
We recently started using a fast response
BI in our O.R. It has always been the policy for the nurses to label
each BI capsule with a piece of tape or a sharp marker identifying the
O.R. the instruments were from. The CPD manager has instructed us to no
longer do this with the new system. He was unable to give any rationale
other than it wasn’t necessary and it wasn’t a good practice. We have
been labeling the capsules for years and have had no problems at all.
Why wouldn’t it be a good practice?
CS Answer:
While I don’t know what exact product you
are using, most rapid response BI systems utilize a fluorescent reader.
Placing a label on the BI or even writing on it with a marker could
obstruct the fluorescent reader resulting in a false positive or
inaccurate interpretation. Of course BIs do need to be identified – you
need to consult your manufacturer’s instructions for use. There you will
find complete directions for utilizing the BIs, the fluorescent reader
and labeling instructions. Most manufacturers provide appropriate labels
and record keeping systems. In rapid response systems it is important
that no labels, tapes, or markings be placed on the BI below the cap
level or the areas that are inserted in the reader. This was not a
concern in the previous system you were utilizing as the BIs were
inserted into a thematic incubator and the results were interpreted by a
visual inspection for color change verses the fluorescent scan
technology used in the rapid response systems.
About the Author: Ray Taurasi is Director of
Professional Services for Case Medical Inc. Ridgefield, NJ.
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April
2006
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