The Royal Marsden Hospital Manual of Clinical Nursing Procedures - Lisa Dougherty [92]
Liquid soap dispensers should be positioned close to hand wash basins and care should be taken to ensure that soap cannot drip onto the floor from the dispenser and cause a slip hazard. Soap should be simple and unscented to minimize the risk of adverse reactions from frequent use. There is no advantage to using soap or detergents combined with or containing antimicrobial agents for routine handwashing. These preparations carry a higher risk of adverse reactions and should not be used routinely. Bar soap should not be used. A paper towel dispenser should be fixed to the wall close to the hand wash basin. Hand towels should be of adequate quality to ensure that hands are completely dried by the proper use of one or two towels. To conveniently dispose of these towels, a suitable bin with a pedal-operated lid should be positioned close to the basin, but not so that it obstructs access to the basin.
Alcohol-based handrub should be available at the point of care in every clinical area for use immediately before care and between different care activities on the same patient (NPSA 2008). Dispensers may be attached to the patient’s bed or bedside locker, and free-standing pump-top bottles can be used where appropriate, such as on the desk in a room used for outpatient clinics. Dispensers should not be sited close to sinks unless this is unavoidable because of the risk of confusion with soap, particularly if the dispensers are similar. Smaller sized personal-issue bottles are appropriate where there is a risk that handrub may be accidentally or deliberately drunk, such as in paediatric areas or when caring for a patient with alcohol dependency (NPSA 2008). Note: Antiseptic handrubs based on non-alcoholic antiseptics are available but evidence suggests that alcohol is the most useful agent in terms of range and speed of antimicrobial activity (WHO 2009).
Equipment for waste disposal
Also available should be disposal bags for domestic and clinical waste and a sharps bin if the procedure is to involve the use of any sharp single-use items (DH 2006a). The sharps bin should always be taken to the point of use (Pratt et al. 2007); do not transport used sharps in any other way or in any other container. Bags and containers used for hazardous waste should be coloured according to their final disposal method (DH 2006a).
Personal Protective Equipment (PPE)
Other equipment required for infection prevention and control will depend on the activity being carried out, but basic PPE to provide a barrier to body fluids and micro-organisms – non-latex disposable gloves, disposable aprons and eye protection as a minimum – should be readily available in the clinical area (Pratt et al. 2007), and particularly where regular use is anticipated. For example, it is appropriate to have dispensers for gloves and aprons situated outside isolation rooms. All PPE sold in the UK must comply with the relevant regulations and standards, including being ‘CE’ marked to demonstrate that they meet these standards (Department of Trade and Industry 2002).
Disposable gloves
Gloves will be necessary in some circumstances but should be worn only when required (Infection Control Nurses Association 2002). Non-sterile disposable gloves are most usefully available packaged in boxes of 100 ambidextrous gloves, in small, medium and large sizes. These boxes should be located close to the point of use, ideally in a fixed dispenser to make removing the gloves from the box as easy as possible. In the past, natural