Tuesday, February 16, 2021

German state of Hesse threatens to sue Rhoen over particle therapy

Therefore, if the clinician removes supplies from the nursing bag to obtain a patient's vital signs, hand hygiene is to be performed before direct contact with the patient. Hand hygiene is also required to be performed after contact with the intact patient's skin (e.g., when taking a pulse or blood pressure with equipment taken from the nursing bag) and after contact with inanimate objects in the immediate vicinity of the patient (e.g., the nursing bag). Anecdotally, over the past few years, there has been a shift in home care and hospice organizations using a barrier under their bag when it is a nonwheeled bag.

home health therapy bag

Nursing bags should be placed on a visibly clean, dry surface inside the vehicle. Environmental contamination plays an important role in the transmission of several epidemiologically important pathogens, such as methicillin-resistant S. Further research with a large sample size is needed to determine best practice. Until research data are available, these “bag technique” strategies are low-tech, low-cost, and easy-to-implement by home care and home care clinicians to protect our immunocompromised home care and hospice patients...and keep them out of the hospital and where they most want to be...in their homes. These principles apply to any carrying device brought into the home, such as a tote bag used to transport a scale to weigh the patient, or a laptop computer bag. When a monthly time frame is selected, this activity should occur close to the last day of the month to coincide with the date that medical supplies that expire in the same month will need to be disposed of and replaced.

Home Health Care Bag

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There has been a long-standing controversy in the home healthcare and hospice field over whether a surface barrier should be placed under a bag and supplies when they are removed. There are no regulatory requirements or evidence-based guidelines to require placing a barrier under the bag or supplies removed from the bag. The purpose of using a surface barrier is to prevent contamination of the external surfaces of the bag and the contents removed from the bag. It is the home care and hospice organization's responsibility to define in policies and procedures if and when a surface barrier is required.

“Clean Side” Versus the “Dirty Side” of the Bag

If there is no visibly clean, dry, flat surface available, always place a barrier under the bag, or hang it on a doorknob or on a hangar over a door. If a hand-carried bag is placed on a barrier on the floor, or a wheeled rolling bag is used, the bag should be kept closed when there are pets, there is a visible presence of pests (e.g., roaches), or young children (e.g., toddler and preschool age) are present. Rhoen is in talks to operate the facility jointly with the university hospital of Heidelberg, which has a similar particle therapy equipment, though it is not clear when these negotiations may be completed. Rhoen-Klinikum bought the hospital in central Germany from the state in 2006 and at the time promised to invest in particle therapy, a method for fighting cancer in which protons or charged ions are fired at tumours while sparing surrounding healthy tissue. Principles 5 and 6 that address the maintenance and management of equipment and supplies are addressed in depth in several other publications .

home health therapy bag

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Home Health: Start of Care template

Metrics FigureThe nursing bag has been used by home care visiting staff for decades as a means to transport patient care equipment and supplies to patients' homes. These supply bags can be back packs, “fanny packs,” shoulder or hand-carried bags, and wheeled rolling bags that contain vital sign equipment, computer tablets, personal protective equipment, and other supplies needed to provide patient care. What's most important is not the configuration of the bag, but rather how it is managed. By virtue of the bag coming in contact with the staff's hands, the environment of the staff's vehicle and patients' homes , pathogenic microorganisms can be brought into the patient's home or transferred from one home to another. This article will establish guidelines for the management of the “nursing bag” used by home care and hospice clinicians, and offer best practice guidance and strategies to prevent and control the transfer of microorganisms through its use. The interior of the bag can become contaminated when hand hygiene is not routinely performed prior to entering the nursing bag, and the used patient care equipment is not cleaned before being placed back in the bag.

home health therapy bag

Minimally on a weekly basis for the exterior surfaces and monthly for the interior surfaces, when a surface barrier is not routinely placed under the bag . Best practices for managing medical equipment and supplies stored in a vehicle. A nonwheeled bag should be placed on a visibly clean, dry, flat surface in the patient's environment, when available.

A tote or duffel-style bag can be washed in the washing machine and dried in the dryer on high heat for a full cycle . Visually, the bag should always present with a clean “professional” appearance, and be replaced when any vinyl on the bag's trim surfaces crack, especially the handles, and when the bag appears worn from normal wear and tear. When a wheeled rolling bag is used, the bag should remain on the floor.

Even if it is not an organization's policy to routinely use a surface barrier, it may always be used at the staff member's discretion. There is currently no research identifying the presence of pathogenic microorganisms on floors or other surfaces that bags may be placed on in the home, but it is likely that the surfaces in the patient's care area in the home would have the highest burden of potentially pathogenic microorganisms. When there is a concern of a bedbug infestation in the home, or the geographical area served by the home care or hospice organization has a higher endemic rate of bedbugs, the nursing bag should be placed in the vehicle inside a large plastic container with high sides .

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Bedbugs are notorious “hitchhikers” and when a surface barrier is not used, the bedbug can drop off the nursing bag inside the vehicle. Once bedbugs are inside the vehicle, it may be difficult or impossible to remove them. Bedbugs move by crawling and will not be able to crawl out a plastic container with smooth, high sides.

home health therapy bag

If the bag has a large front flap, it should be opened in a manner that does not permit the front flap to have direct contact with the floor. Some wheeled rolling bags that remain on the floor are heavily “front loaded” with supplies in the bag so that when the bag handle is fully retracted (i.e., pulled all the way up), the bag leans forward at such a steep angle that the front surface of the bag has direct contact with the floor. When this occurs, either a surface barrier needs to be placed under the bag, or some of the supplies need to be removed so the handle remains upright (at approximately a 90-degree angle) when fully retracted from the bag.

Surface Barrier Under the Bag and Supplies Versus No Barrier

The presence of pathogens on the outside and inside surfaces of the nursing bag suggests the potential risk for transmission of infection from one patient to another via a contaminated nursing bag. The nursing bag is considered a noncritical item and will never have direct contact with the patient's skin. What will have direct contact with the patient are the staff's hands. THE most important infection prevention activity the staff can deploy when implementing “bag technique” is performing hand hygiene. It is strongly suggested, but not required, that hand hygiene be performed before entering the nursing bag. It is required based on the Centers for Disease Control and Prevention Guideline for Hand Hygiene in Health-Care Settings that the staff perform hand hygiene prior to direct contact with the patient .

A surface barrier should always be used when a wheeled bag is transferred from the floor to another surface in the home. In addition, a surface barrier should be used if a nursing bag is not taken into a home and items are temporarily removed from the nursing bag to bring into the home. When these items are removed from the bag, they should be placed on a barrier in the home. Lastly, using a barrier under the bag in the home shows respect for the patient's personal property by not placing a potentially contaminated item directly on surfaces in their home.

Core and supplementary contents in the home care nursing bag. Etsy’s 100% renewable electricity commitment includes the electricity used by the data centers that host Etsy.com, the Sell on Etsy app, and the Etsy app, as well as the electricity that powers Etsy’s global offices and employees working remotely from home in the US. Hesse’s science ministry said in a statement it would file a suit against Rhoen-Klinikum no later than March 1 to safeguard its interests unless the particle therapy facility started operating by then. Rhoen-Klinikum had promised less than a year ago that it would start operating the particle therapy facility by the end of 2013. If it misses that deadline, the state could tell it to repay the 107 million euros ($146.5 million) the state had given Rhoen in 2006 to invest in particle therapy.

home health therapy bag

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