RE: Isolation and Infection Control Practice Differences

[Guest guest]

Carol-

You bring up an important issue. On my " wish list " is to find a clear

best practice regarding exactly what you are asking. Even our hospital

IC manager--who used to be a rehab nurse in a prior incarnation--has had

to improvise a bit in helping us with applying a standard policy.

Philosophically, our approach is like this: When the patient is in the

room, acute hospital standards apply. Essentially, staff wear barriers

to protect themselves and to prevent carrying the bugs outside of the

room.

However, when the patient leaves the room for dining or therapy or such,

the approach is to have the patient wear the barriers. (And by the way,

this same approach is used in the acute hospital when patients leave the

room for gait training or diagnostic tests.) Our staff will generally

wear gloves when doing hands on assistance, and also wear gowns if it

seems warranted to have more protection. It seems to work, we know of

no outbreaks of infection in our unit. I do think it's especially

confusing for family who might be moving about with the patient and not

understand the logic of what they are asked to do with wearing gowns.

I'm afraid I can't really address the issue of expenses; it just seems

to be part of the cost of doing business now.

Bob Perlson

Director, Rehabilitation

Rogue Valley Medical Center

Medford, Oregon

Isolation and Infection Control Practice

Differences

For those of you with IP Rehab Units within an Acute Care hospital, do

you follow the same Isolation and Infection control practices as is done

on the acute units? Or do you have a separate policy that more

specifically meets the needs of the way staff practice on the Rehab

unit?

Staff in all of our therapies find the practices which make sense for

acute, where patients are typically seen in their rooms, confusing when

attempting to apply to the Rehab unit where they are leaving their rooms

to come to clinics, dining rooms, etc.

We are spending a lot of money on gowns and gloves, taking them off

because we can't wear gloves in the halls when transporting patients,

but having to put them on again in the rooms or clinics, then reversing

the whole process when leaving the clinics, in order to be in compliance

with general policy. We are allowed to wear gloves in the halls only if

we are coming in " close bodily contact " during treatment interventions

in which we are using the hallway as a treatment area.

Just wondering if others have run into similar issues and developed

separate policies for Rehab vs acute floors.

Carol Rehder, PT

Manager, Physical Therapy

Genesis Medical Center

rehder@...

A J.D. Power and Associates

Distinguished Hospital for providing

" An Outstanding Patient Experience "

NOTICE: This communication is intended only for the use of the

individual or entity to which it is addressed and may contain

information that is privileged, confidential and exempt from disclosure

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[Guest guest]

Carol,

This should be discussed with your infection control personnel to help you

decide. The decision should be what works, but I would suggest having a policy

in place in the event you are reviewed by any accrediting body who would look

for consistency. JCAHO definitely would be looking for this if they are an

accrediting agency you use, and would ask your staff " why " they do what they do.

Make sure you show record of an inservice/competency with your staff in the

proper procedure.

Matt Dvorak, PT

Yankton, SD

________________________________

From: PTManager on behalf of Carol Rehder

Sent: Wed 8/17/2011 10:01 AM

To: PTManager

Cc: King, Jan; Sigler,

Subject: Isolation and Infection Control Practice Differences

For those of you with IP Rehab Units within an Acute Care hospital, do you

follow the same Isolation and Infection control practices as is done on the

acute units? Or do you have a separate policy that more specifically meets the

needs of the way staff practice on the Rehab unit?

Staff in all of our therapies find the practices which make sense for acute,

where patients are typically seen in their rooms, confusing when attempting to

apply to the Rehab unit where they are leaving their rooms to come to clinics,

dining rooms, etc.

We are spending a lot of money on gowns and gloves, taking them off because we

can't wear gloves in the halls when transporting patients, but having to put

them on again in the rooms or clinics, then reversing the whole process when

leaving the clinics, in order to be in compliance with general policy. We are

allowed to wear gloves in the halls only if we are coming in " close bodily

contact " during treatment interventions in which we are using the hallway as a

treatment area.

Just wondering if others have run into similar issues and developed separate

policies for Rehab vs acute floors.

Carol Rehder, PT

Manager, Physical Therapy

Genesis Medical Center

rehder@... <mailto:rehder%40genesishealth.com>

A J.D. Power and Associates

Distinguished Hospital for providing

" An Outstanding Patient Experience "

NOTICE: This communication is intended only for the use of the individual or

entity to which it is addressed and may contain information that is privileged,

confidential and exempt from disclosure under applicable law. If the reader of

this communication is not the intended recipient or the employee or agent

responsible for delivering the communication, you are hereby notified that any

dissemination, distribution or copying of this communication is strictly

prohibited. If you have received this communication in error, please notify me

immediately by replying to this email.

REMINDER: The disclosure of medical information is strictly prohibited by

federal regulation. Unauthorized release of medical information may result in

administrative, civil and criminal sanctions.