The reason for the steep increase in attendance has been blamed on various factors including an ageing population, a lack of access to GP appointments, people attending emergency rooms unnecessarily and an increasing number of NHS 111 callers being sent to A&E. But whatever the reasons, A&E departments are coming under increasing pressure to deliver good care, swiftly – and this must be achieved without cutting corners.
When staff are under pressure it is all too tempting to skimp on hand hygiene, particularly since WHO recommends that a thorough hand wash in healthcare should take between 40 and 60 seconds. The process should involve thoroughly cleaning the palms, fingers and backs of the hands with soap and water and drying them carefully with a single-use towel.
While there can be no shortcuts to hand hygiene, valuable time will be saved if sufficient hand washing stations are supplied and if these are kept well stocked with user-friendly soaps and hand towels at all times.
Long-lasting systems such as Tork Foam Soaps and the Tork Matic Hand Towel Roll will help to prevent the issue of supplies running out when staff need them most. These systems help to control consumption by giving out only one dose of soap or sheet of paper at a time, ensuring a long- lasting supply.
The need to avoid cross-contamination in healthcare staff wash stations is of course crucial. But it is also important to maximise hand hygiene in A&E visitor washrooms – and these environments present other challenges.
During a wait of four hours-plus, it is likely that many A&E patients will need to use the washroom. Some will have open wounds while others will be suffering from infections or viruses which means the risk of cross-contamination in the toilets will be high.
A few patients will be frustrated, impatient and in pain, while others may be under the influence of alcohol or drugs. This may result in vandalism – and the washrooms may also be used to conceal drug paraphernalia. All systems should therefore be easy to clean and designed to prevent cross- contamination where possible, while also being sufficiently robust to resist vandalism.
Bulk fill soaps were once a popular choice in hospital washrooms due to their low cost, but these lay the user open to infections because the soap is decanted into dispensers from large containers. Soaps supplied in cartridges that are tightly sealed before use – such as Tork Foam Soaps – provide a more hygienic alternative. The cartridge for Tork Foam Soaps contains 2,500 shots, which is more than double the number in a liquid refill of the same size. This helps to prevent the supply running out between maintenance checks.
Clean paper towels are generally considered the best hand drying option in healthcare environments. Not only do they avoid the cross-contamination risks of a textile towel, they can also dry the hands more rapidly than air dryers which means visitors are more likely to dry their hands thoroughly – and germs spread much more rapidly via damp hands than dry ones.
38 | HEALTHCARE HYGIENE
A high-capacity hand towel roll will provide a hygienic drying solution while ensuring that the product is unlikely to run out during busy periods. Again, the Tork Matic Hand Towel Roll dispenser is a good solution because it holds sufficient paper for up to 1,400 hand dries and gives out only one towel at a time. Besides helping to reduce consumption, the system also ensures that each user only touches the towel they take which helps prevent the risk of cross-contamination.
For particularly busy healthcare facilities, the Tork PeakServe Continuous Hand Towel system also works well. The high-capacity dispenser is unlikely to run out between maintenance checks since it holds up to 2,100 towels at a time, while the continuous delivery system means it will never jam and visitors will be ensured of a clean hand towel whenever they need one.
A good toilet paper system can also improve hygiene in the A&E washroom. Conventional toilet rolls present a cross-contamination risk because they are handled by everyone. As a result, jumbo rolls are often supplied instead – particularly in a washroom where traffic is heavy.
Jumbo rolls have the benefit of providing a long- lasting solution while protecting the paper inside from contamination before use. But the design of some dispensers leads to the end of the paper becoming ‘lost’ inside the unit, forcing the user to place a hand inside it. Again, the risk of cross-contamination is huge.
Toilet paper systems in hygiene-critical environments should therefore ensure that each washroom visitor only touches the paper they use. Tork SmartOne is particularly suitable for A&E washrooms since the paper is pulled out from the front of the unit, avoiding the need for any fumbling around inside the dispenser.
This system is also sufficiently robust to withstand vandalism and has been designed to incorporate no wide openings or flat surfaces where needles or medication could be stored – a perennial risk in the vulnerable hospital environment. And the Tork SmartOne is designed to naturally control consumption which is a major advantage in any facility where budgets are tight.
In order to supplement hand hygiene outside the washroom, hand sanitiser dispensers such as the Tork Alcohol Gel Hand Sanitiser should be placed in strategic locations for use by staff, patients and visitors.
Visitor numbers in A&E washrooms can vary enormously and supplies of toilet tissue and hand towels may dwindle fast – particularly when patients are suffering from stomach bugs or using paper to staunch their wounds. This makes it a particular challenge to equip and maintain A&E unit washrooms.
However, everyone in A&E should have easy access to the supplies they need to carry out good hand hygiene. The right products placed strategically in easy-to-use dispensers will allow this to happen and help put hand hygiene within everyone’s reach.
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