How Sanitary is your Clinic?

[bdpoe]

After reading inspection reports from several states at the Association of Dialysis Advocates web site,
and after what I have personally seen as a dialysis patient, Hospitals and Clinics need to constantly strive
to improve sanitation standards.

Do you know that your local fast food joint (which is Gross) is scrutinized and inspected for cleanliness
and sanitation more closely and more often than your local hospital or clinic?

How about your clinic? Have you seen things that could be improved upon?

....bd

[thegrammalady]

my clinic seems clean. chairs and machines are wiped down with bleach at the end of each session. techs wash their hands frequently. there is someone who walks through frequently looking everywhere checking for dust etc. i realize that probably doesn't happen everywhere

[Chicken Little]

Not nearly clean enough.   

I brought 2 blankets, one under so I didn't have to touch the chair, and one over me.  I also wiped the tables, remote and BP cuff with Sani-Cloths before I'd even sit down.  Other patients started copying me.     I'm sure the facility director was glad to see me go back to PD.   

When I was in the hospital it was worse.  The splatter on the walls, hairs in the bathroom.  Icccccck! 

Can you tell I'm a clean freak?   

[livecam]

Not nearly clean enough.   

I brought 2 blankets, one under so I didn't have to touch the chair, and one over me.  I also wiped the tables, remote and BP cuff with Sani-Cloths before I'd even sit down.  Other patients started copying me.     I'm sure the facility director was glad to see me go back to PD.   

When I was in the hospital it was worse.  The splatter on the walls, hairs in the bathroom.  Icccccck! 

Can you tell I'm a clean freak?   

Dialysis units used to scare me that way.  My daughter who was 6 and 7 at the time came over quite often and would spend 1 or 2 hours in the unit before my wife would pick her up.  I used to tell her to touch nothing and especially to pick nothing up off the floor.  Of course being a little kid she didn't always listen.

Back in those days there weren't many choices for home hemo except for PD.  I would have loved to have installed a machine here,  bypassing the unit alltogether.  Back then it just wasn't in the cards.

It is true that there are bad pathogens lurking in dialysis units.  They might even be in the chair next door.  It is also true that everyone doesn't subscribe to the same standards of personal hygiene. 

Assembly line dialysis...ewww, iccckkk, etc.

[bdpoe]

Not nearly clean enough.   

I brought 2 blankets, one under so I didn't have to touch the chair, and one over me.  I also wiped the tables, remote and BP cuff with Sani-Cloths before I'd even sit down.  Other patients started copying me.     I'm sure the facility director was glad to see me go back to PD.   

When I was in the hospital it was worse.  The splatter on the walls, hairs in the bathroom.  Icccccck! 

Can you tell I'm a clean freak?   

Dialysis units used to scare me that way.  My daughter who was 6 and 7 at the time came over quite often and would spend 1 or 2 hours in the unit before my wife would pick her up.  I used to tell her to touch nothing and especially to pick nothing up off the floor.  Of course being a little kid she didn't always listen.

Back in those days there weren't many choices for home hemo except for PD.  I would have loved to have installed a machine here,  bypassing the unit alltogether.  Back then it just wasn't in the cards.

It is true that there are bad pathogens lurking in dialysis units.  They might even be in the chair next door.  It is also true that everyone doesn't subscribe to the same standards of personal hygiene. 

Assembly line dialysis...ewww, iccckkk, etc.

Unfortunately home dialysis isnt in the cards for me. I am amazed at the low standards
I hear similar horror stories about nursing homes.
....bd

[Sluff]

 One phone call to the Health Dept would fix most of these problems.

[George Jung]

I don't see anything that stands out at my unit.  Relatively clean and what I would expect overall for a medical unit.  I would not give it a 10 but there is no need for any phone calls.  Today I witnessed a tech pick something off of the ground and not change their glove afterward.  They did not handle any patients that I saw but I tend to think they were not conscious of it and would have interacted with a patient if that had been the immediate need.  I could be wrong.....but I don't think I am.

[Hawkeye]

One phone call to the Health Dept would fix most of these problems.

Unfortunately it takes a few calls before they send someone out, unless the accusations are really horrid.

[kitkatz]

Now who was it who had the opussum in the clinic last year? Somewhere in Australia I think.

[Adam_W]

My former centre wasn't totally gross, but it could have been a lot better. The machines and chairs were wiped down after each treatment, but most of the chairs had old blood stains on them, and the floor wasn't always clean. Most of the techs were good at changing gloves, but one tech got in trouble because she started to take me off without putting on a mask. The training room of my new home centre is pretty clean, and I haven't seen any obvious sanitary problems. Now if only we could fix the squeaky blood pump on the training machine  .

Adam

[Sluff]

I hate cockroaches.

[glitter]

My husbands clinic is spotless-I am very impressed with how consciously they keep sanitary procedures in place.  When we went to Olando to see about the NX-Stage-one of the things that made him say he would wait for Nx-Stage to come closer to us, was the fact that the clinic in Orlando was filthy- the floors were dirty, and the bathrooms were not only dirty, but had bar soap, which just seems icky to me. I was totally shocked, I guess I thought all the clinics would be spotless too.

[kianhu]

The reason I am posting this is to note the bacteria in the soap dispenser.  My sure your clinic uses soap in a bag that is discarded when empty.  After reading this article, I stopped using the soap dispenser in public restrooms.  I carry my own hand sanitizer.   




BETHESDA, MD, 30 May 2001 — A practice designed to reduce medication costs led to a cluster of bacterial infections among patients treated at a Colorado hemodialysis center, say public health scientists.
Despite instructions in the product labeling to discard any unused portion of single-dose Epogen, by Amgen Inc., the hemodialysis center’s staff routinely withdrew and pooled residual epoetin alfa for later use. This practice, which involved repeated puncturing of the stopper on preservative-free vials, led to a rash of Serratia liquefaciens infections among hemodialysis patients. In all, 15 patients showed evidence of infection with S. liquefaciens, a gram-negative bacterium rarely found in humans, over a six-week period in 1999.

The source of the infections was traced by scientists at the Centers for Disease Control and Prevention (CDC) and the Colorado Department of Public Health and Environment, who reported their findings in the May 17 New England Journal of Medicine (NEJM).

The CDC-led investigation focused on 208 hemodialysis sessions involving 48 patients treated on days during which the hemodialysis center’s staff reported bloodstream S. liquefaciens infections. Twelve hemodialysis sessions were associated with bloodstream S. liquefaciens infection, and eight with fever indicating a possible infection. Five patients had a bloodstream infection or fever during two hemodialysis sessions.

Nearly two thirds of the 97 empty epoetin alfa vials kept by the hemodialysis center during the investigation were found to be contaminated with S. liquefaciens. In addition, a bacterial reservoir was discovered in a liquid-soap dispenser that had been repeatedly topped off with new soap instead of discarded or cleaned between fillings. The bacterium was also detected in a bottle of hand lotion located in the center’s medication room.

At CDC’s recommendation, the hemodialysis center ceased pooling preservative-free epoetin alfa and switched to disposable soap containers. These practices ended the S. liquefaciens outbreak.

The Colorado center’s policy of repeatedly puncturing epoetin alfa vials and pooling residual medication, said the report, seemed to be a cost-saving measure suggested to the nursing and technical staff. The investigative team was unable to pinpoint the origin of the suggestion.

The team found, through use of a survey mailed to 103 hemodialysis facilities, that lapses in infection-control procedures are common during preparation of epoetin alfa doses. Of the 71 centers that returned the anonymous survey, 82 percent used the preservative-free, single-dose formulation of epoetin alfa. Seventy-eight percent of these centers reported routinely puncturing the vials more than once to remove additional doses of medication. Sixteen percent of these centers routinely pooled residual epoetin alfa into a common container for later use.

The report estimated that a hemodialysis center serving 150 patients each year could recover up to $180,000 over the annual Medicare payment for epoetin alfa doses if the entire volume in each vial were dispensed. Discarding unused medication, in contrast, could lead to the "waste" of $1.1 million worth of drug each year. These estimates were based on the 1997 Medicare reimbursement rate of $10 per 1,000 units of epoetin alfa.

A 1997 report by the Department of Health and Human Services' Office of Inspector General (OIG) stated that Amgen places an extra 25 percent volume of Epogen in each vial to compensate for material that cannot be withdrawn from the container. According to OIG, which communicated its findings to the Health Care Financing Administration, "there are indications that some free-standing dialysis facilities…use, on average, one half of the overfill which would materially affect each provider's cost."

The OIG report did not address whether facilities using the overfill had purchased multiple-dose vials, which contain a preservative.

[keefer51]

When we were Renal Care we had better supplies. Once Fresenius took over they got rid of some and starting using cheaper supplies. We no longer have throw away sheets for the chairs. They wipe the machine, chair, and tv down after each treatment. Most of the people at my center are elderly and one gentleman has down syndrome. I love him dearly but he has a facination with his nose. So if i sit in his chair after he leaves i usually have some little presents that they have negleted to wipe. I am on third shift 3-7. By the time i get there the floor is a mess. Blood, needle covers, food, etc... the chairs are old blood stained tape over holes and cracks. The tv's usually have a few surprises on them. The worst is the patient bathroom. Although the sign says "Patients only" no one obeys it. Delivery people, ambulance drivers, etc... use it all the time. Allot of the time after dialysis you have to get rid of more than blood but i would'nt sit on those seats if you would pay me! The walls are splattered with unknown fluids. They all wear the throw away lab coats and gloves. Only one wears the welders mask. When i had my catheter once i was sent home with the syringe still attached. Many times i went home without a cap or two. When a inspecter comes they all wear the appropriate gear.

[Sara]

When a inspecter comes they all wear the appropriate gear.

That is so irritating.  They can't even argue they didn't know any better.  When it comes to covering their asses they all follow procedure, but to protect the patients...no way.   

[okarol]

When Jenna was exploring the option of home dialysis, I asked her Neph about it because we have 4 kids and a busy household. I said "But I am worried about doing needle sticks at home, what about typical household germs?" His response was, "There are a thousand times more germs in the dialysis clinic than in your home."   

[Stacy Without An E]

We just moved to a brand new Dilaysis clinic so everything is pretty new and clean.  I do have the disadvantage of being one of the last patients of the day so I have to deal with the disgusting bathroom.  It grosses me out just thinking about what's left in there because people are too lazy to flush.

I have the opposite problem most people have on this site...I don't have much of a problem with the staff, it's the rude patients that drive me crazy.

[kitkatz]

Holy cow! Did I want to know all of this!   Eventually they are going to kill me off, huh?

[tubes]

Not nearly clean enough.   

I brought 2 blankets, one under so I didn't have to touch the chair, and one over me.  I also wiped the tables, remote and BP cuff with Sani-Cloths before I'd even sit down.  Other patients started copying me.     I'm sure the facility director was glad to see me go back to PD.   

Well I think I will be taking some sort of a sani-cloth with me from now on.
I have noticed that the tables connected to the arms of the chairs are not always very clean.  Sometimes I've seen faint blood stains that weren't wiped completely off.  And yes, I have touched 'em.  Eewwww! ! !  The little tables lay flat and you have to pull 'em up and lot 'em into place.  I'm gonna have to wipe 'em down before I touch 'em.  Also the tv remotes, I've never seen anyone wipe them down.  I had one that was just covered in...well only god knows what!  I don't even watch tv anymore.  I just hook up my ipod and go to sleep.  The nurses are really good with changing their gloves, wearing their smocks and masks and washing their hands.  I won't even go near the restrooms.  I think for the most part they are clean.  I went in once but it was just to check my hair. LOL....I just can't use public restrooms, or friends restrooms, I couldn't even use the bathroom at school.  I can only use my own or immediate families.
I'm totally loco when it comes to restrooms.   

[RichardMEL]

My unit is pretty good. Nurses washing their hands ad nauseum and if they need to go from one patient to another it's instant new gloves.. chairs wiped down after use inc machines, tables etc.. any spillage of anything - specially blood is jumped on and special stuff used to neutralise and clean it up. No real issues at all. I'm sure it's not perfect but it's hardly the worst either.

[Hawkeye]

When we were Renal Care we had better supplies. Once Fresenius took over they got rid of some and starting using cheaper supplies. We no longer have throw away sheets for the chairs. They wipe the machine, chair, and tv down after each treatment.

I do know that the supplies Fresenius uses are not the highest quality in the world, but there is no reason you should not be able to get drape sheets for your chairs still.  All the clinics in my area use them and I couldn't see not using them.  Besides they are a non-inventoriable item so they dont effect your PI-17 in any way.  Tell who ever orders your supplies to add part number 17-0159-2 for drape sheets to the order.

[bdpoe]

From reading the postings on sanitation and cleanliness. many of you mentioned dirty patient bathrooms, stained chairs
and side tables, remotes not being wiped down, amoung other gross things. Some mentioned the cliinic's name and others did not. Many of the same problems exist in Hospital units as well.

Is this dangerous? Most definitely! If these things you've noticed are lacking, what else is going on that you
don't see?

Please all of you let us know how is your clinic when it comes to sanitation and cleanliness.
 THANKS
.........bdpoe

Not nearly clean enough.   

I brought 2 blankets, one under so I didn't have to touch the chair, and one over me.  I also wiped the tables, remote and BP cuff with Sani-Cloths before I'd even sit down.  Other patients started copying me.     I'm sure the facility director was glad to see me go back to PD.   

Well I think I will be taking some sort of a sani-cloth with me from now on.
I have noticed that the tables connected to the arms of the chairs are not always very clean.  Sometimes I've seen faint blood stains that weren't wiped completely off.  And yes, I have touched 'em.  Eewwww! ! !  The little tables lay flat and you have to pull 'em up and lot 'em into place.  I'm gonna have to wipe 'em down before I touch 'em.  Also the tv remotes, I've never seen anyone wipe them down.  I had one that was just covered in...well only god knows what!  I don't even watch tv anymore.  I just hook up my ipod and go to sleep.  The nurses are really good with changing their gloves, wearing their smocks and masks and washing their hands.  I won't even go near the restrooms.  I think for the most part they are clean.  I went in once but it was just to check my hair. LOL....I just can't use public restrooms, or friends restrooms, I couldn't even use the bathroom at school.  I can only use my own or immediate families.
I'm totally loco when it comes to restrooms.   

[bdpoe]

Let me rephrase this question. How clean and sanitary is your nurse, facility, hospital or doctor's office and what improvements would you like to see? Please note your city and state if possible.

In Duh Vita is bad gr8ful, a nurse manager I think, said her dad caught MSRA a hospital born illness and I recently
read that something like 1 out of 136 patients are harmed in some way in the hospital. Those aren't very good odds
in my book. Now think about it in your clinic.

Sanitary Clinics, hospitals, restaurants, food and tap water are big issues with me.
"You should've seen just what I saw" Bo Diddly
.......bd <-----Monked Out To The Max

From reading the postings on sanitation and cleanliness. many of you mentioned dirty patient bathrooms, stained chairs
and side tables, remotes not being wiped down, amoung other gross things. Some mentioned the cliinic's name and others did not. Many of the same problems exist in Hospital units as well.

Is this dangerous? Most definitely! If these things you've noticed are lacking, what else is going on that you
don't see?

Please all of you let us know how is your clinic when it comes to sanitation and cleanliness.
 THANKS
.........bdpoe

Not nearly clean enough.   

I brought 2 blankets, one under so I didn't have to touch the chair, and one over me.  I also wiped the tables, remote and BP cuff with Sani-Cloths before I'd even sit down.  Other patients started copying me.     I'm sure the facility director was glad to see me go back to PD.   

Well I think I will be taking some sort of a sani-cloth with me from now on.
I have noticed that the tables connected to the arms of the chairs are not always very clean.  Sometimes I've seen faint blood stains that weren't wiped completely off.  And yes, I have touched 'em.  Eewwww! ! !  The little tables lay flat and you have to pull 'em up and lot 'em into place.  I'm gonna have to wipe 'em down before I touch 'em.  Also the tv remotes, I've never seen anyone wipe them down.  I had one that was just covered in...well only god knows what!  I don't even watch tv anymore.  I just hook up my ipod and go to sleep.  The nurses are really good with changing their gloves, wearing their smocks and masks and washing their hands.  I won't even go near the restrooms.  I think for the most part they are clean.  I went in once but it was just to check my hair. LOL....I just can't use public restrooms, or friends restrooms, I couldn't even use the bathroom at school.  I can only use my own or immediate families.
I'm totally loco when it comes to restrooms.   

[Chicken Little]

Well, I have yet to be in any medical facility that was cleaner than my home.  And I have a very hairy and rambunctious dog. 

Walls and furniture need to be washed, just like floors, and it needs to be done well.  Ceiling tiles and vents also need to be cleaned and replaced frequently.  Sometimes I feel like I am the only one who sees dirt.   

[bdpoe]

What is your hospital, clinic or facility doing to increase sanitation and
cleanliness? Chances are not much aside from a little lip service.

With several states, including Florida, faced with dramatic cuts in social services Healthcare is targeted to take a direct hit which has doctors,
clinics and hospitals worried.

In the USA your chances of getting a Hospital-acquired infection (HAI)
are approximately one in 136. But some feel that number is lower
than what it should be as many cases are denied, contested or simply overlooked. Officially the US rate of infection is about half of what it is
in Britain.

At issue are dramatic cuts in Medicare and Medicaid at respectively the
state and federal levels. Then, in Florida, Governor Crist's recent mandate
that all agencies cut spending by 10%. That means less monitoring, less inspecting, less staffing while the chronically ill and medically needy suffer a reduction in services. A prescription for suffering.

Medical Bills are the #1 cause of bankruptcy and homelessness here in
the USA. Aside from lip service and phony promises, our candidates,
legislators and elected officials seemingly fail to realize the seriousness
of our health care crisis and make the cure a top priority.
...bdpoe

Dirty hospitals must clean up, says Brown


Jo Revill, Whitehall editor
Sunday July 1, 2007
The Observer


A drive to slash the rates of MRSA and other hospital infections is being masterminded by Gordon Brown, who is convinced that the public's perception of the NHS has been swayed by concerns over cleanliness on the wards.
Brown has told close colleagues that they will never win 'hearts and minds' over the health service reforms until they can demonstrate that the wards really are cleaner, and that they are cutting the numbers of patients being infected.



The Prime Minister and his aides have become alarmed that one in four hospitals is still not meeting the hygiene targets imposed in November 2004 by the then Health Secretary John Reid. Hospital-acquired infections (HAI) now affect some 300,000 people a year, and despite better control measures appear to be epidemic in some areas. The government is unlikely to meet the target it has set itself, of halving the numbers diagnosed with MRSA by next April.
Brown chose to highlight the issue of hospital cleanliness yesterday, on his first visit to a hospital - Kingston, in south-west London - as Prime Minister. A team of experts is being set up within the Department of Health to look at new measures to deal with the problem. The new health minister, the surgeon Professor Ara Darzi, will be asked to devise a new strategy to combat the infections.

Since MRSA first hit British hospitals 10 years ago, it has spread across the country, as an increasing number of people became resistant to antibiotics, coupled with poor cleaning on the wards and the fast turnover of patients.

In recent weeks, Brown has been touring the country listening to Labour supporters and the public. One aide told The Observer that the Prime Minister had been dismayed by the numbers who put MRSA top of their priorities for the NHS. 'We've been thinking that tackling the waiting lists is the number one issue, along with better access to the GP, but we know that dirty hospitals are in the public mind,' the aide said.

The new Health Secretary, Alan Johnson, visited Kingston hospital with Brown yesterday, where they learnt how the hospital had managed to reduce its MRSA rate by 47 per cent.

The hospital imposed a stringent system of hand hygiene compliance and general cleanliness. Posters have been put up urging visitors and staff to wash their hands, and a team goes around the hospital every week and observes staff to give them a hygiene compliance score.

Other hospitals are also tackling the superbug. In the final quarter of last year, 1,542 patients had MRSA infecting their bloodstream, seven per cent fewer than in the previous quarter.