Going to the doctor is never comfortable. Waits are long, paper gowns are revealing and doctor’s scales always seem to add an extra ten pounds. But inconvenience and embarrassment are the least of patient’s worries when they enter the exam room. Contracting a nosocomial, or Healthcare Acquired Infection, presents a real threat. Usually associated with hospitals, long-term care facilities and other acute care locations, nosocomial infections also occur at the doctor’s office, particularly in the exam room. This makes proper exam room cleaning an important part of every healthcare protocol.
An Evolving Issue
Hospitals, long-term care facilities and other acute care locations must follow strict infection prevention guidelines and procedures. The same, however, cannot be said for doctor’s offices, according to Dr. Kim LaFreniere. This lack of protocol poses several risks as more and more outpatient procedures now take place at the doctor’s office. “These facilities have no ‘zone’ that is exclusively dedicated to a patient,” she writes. The result is a space that is more vulnerable to germ contamination. The problem is compounded as successions of patients move quickly through the exam room decreasing the likelihood of thorough, post-patient cleaning.
A surprising number of nosocomial infections can be picked up in exam rooms from rhinoviruses to influenza to MERSA. More alarming, the Centers for Disease Control and Prevention reports that 75% of C. difficile infections occur in people recently cared for in a doctor’s office. This nasty bacterium causes diarrhea and is linked to about 14,000 U.S. deaths every year, according to the report.
Ironically, both patients and healthcare staff are vulnerable. Yet doctor’s offices often do not have one person charged with infection prevention. This means that maintaining a clean, healthy environment is everyone’s job.
Identifying—and Cleaning--the Hazard Zones
Individual patients and medical equipment/devices are the top two sources of nosocomial infections. A close third place goes to surface environments like exam room beds, tables and furniture. Even touchpoints like the pen used for patient sign in, doorknobs and soap dispensers represent potential hazard zones.
A varied approach to exam room cleaning will minimize risks. Mopping floors between patients is an unreasonable protocol as floors take too long to air dry. Mopping is also ineffective as it does not fully remove dirt and pathogens. A floor cleaning system that cleans fully and leaves floors dry offer a better choice.
Exam tables and furniture should be wiped down, preferably with a disposable, disinfectant wipe. Disposable wipes can also be used on touchpoints like doorknobs, soap dispensers and light switches. Don’t forget computer keyboards and cabinet pulls too.
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