Table of Content
- Best Practices for Home Care “Bag Technique” and the Use of Surface Barriers
- Home Health Care Medical Supplies Printed Small Nursing Tote Bag, Personalized Gift for Traveling Nurse
- Release What No Longer Serves You (Women) Zipper Tote Bag
- Floor Surfaces and the Risk of Transmission
- Bag Placement in the Vehicle
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 common breach in infection prevention and control practice made by home care and hospice clinicians is reentering the bag while wearing gloves that had patient contact. This failure to remove the gloves and perform hand hygiene before going back into the nursing bag with “used” gloves on inadvertently contaminates the interior contents of the bag. Remove the gloves if worn, perform hand hygiene, and then reenter the bag. It is suggested that the hand hygiene products and supplies be stored in an outer pocket of the bag that can be easily accessed. Currently, there are no data that serve as evidence of a home care or hospice patient developing an infection from a pathogenic microorganism brought into a patient's home via a nursing bag. There is however, evidence that the bag may serve as a reservoir for multidrug-resistant organisms, thereby suggesting a potential risk for indirect transmission of microorganisms from one patient to another via a contaminated nurses' bag.
Best Practices for Home Care “Bag Technique” and the Use of Surface Barriers
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 .
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 Care Medical Supplies Printed Small Nursing Tote Bag, Personalized Gift for Traveling Nurse
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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.
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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.
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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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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 .
There is abundant evidence in the literature of extended survival rates of human pathogens on environmental surfaces (Huslage et al., 2013), and the recent data on the contamination rates of floor surfaces in healthcare facilities provide support for this practice. Patients are going home from acute care facilities colonized or infected with a multidrug-resistant organism or C. Difficile and their homes often are not as well hygienically maintained with daily cleaning and disinfection, as is performed in a healthcare facility. When choosing a bag to transport patient care equipment and supplies, select a bag that has an exterior surface material that is of a smooth, noncanvas nylon or polyester fabric, or vinyl material for ease in cleaning the bag's exterior surfaces. Unlike a hard, nonporous surface that can be disinfected, the surface of the nursing bag can only be decontaminated and cleaned to reduce the number of pathogens.
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.
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