The long wait
Liam Mynes, from Tork manufacturer Essity, looks at ways of improving hand hygiene in A&E departments, to prevent vulnerable patients from picking up a secondary illness in hospital while suffering through progressively longer waiting times.
In January, it was reported that UK Accident and Emergency (A&E) waiting times were now officially the worst on record.
Government targets dictate that at least 95% of patients should be seen within four hours of entering A&E, but figures released for December 2019 revealed that more than a fifth of people are being left to wait longer than this.
Meanwhile, the number of patients forced to spend more than 12 hours on a trolley has hit a new high with 2347 people – more than double the figure recorded in November 2019 – being left to languish in corridors or in side-rooms.
Reasons behind the crisis were given as a spike in winter flu levels; a shortage of social care and the ever-increasing difficulty in securing an appointment with one’s GP. But when people are lingering for longer periods in A&E, they are laying themselves open to new risks.
Some will have open wounds while others will be suffering from infections or viruses, so the risk of cross- contamination is high. During a wait of four hours-plus, most patients are likely to have to use the vending machines, the café or the washrooms – or perhaps all three. And in so doing they will come into contact with various potentially-contaminated surfaces such as door handles, light switches, tables, chairs and vending machine push- buttons. They may also be contaminating these surfaces with germs of their own.
Any extended wait could result in some patients becoming frustrated or impatient – particularly if they are under the influence of alcohol or drugs. This may result in vandalism
56 | HEALTHCARE HYGIENE
and unruly behaviour, and the washrooms might then become a place where they can let off steam – or even store and use drug paraphernalia.
However, despite being a risky environment in which tempers could spiral and germs could be spread, the washrooms also have a crucial role to play in any A&E department. For this is the place where patients are able to wash and dry their hands and remove those pathogens they may have picked up from other surfaces. Hospital managers therefore need to ensure that the washrooms are kept clean, well maintained and are well stocked at all times to encourage good hand hygiene practices.
Visitor numbers in A&E can vary enormously and supplies of toilet tissue and hand towels in the washrooms may dwindle fast – particularly when patients are suffering from stomach bugs or using paper to staunch their wounds.
High-capacity systems that naturally reduce consumption will prevent the issue of product run-outs between maintenance checks. A high-capacity soap system such as the Tork Foam Soap Dispenser is a good solution because this contains 2500 shots of soap, more than double the number in a liquid refill of the same size. Besides ensuring a continuous supply of soap the system is also particularly easy to use, even for the frail and elderly and other patients with low hand strength.
Paper towels are usually provided in healthcare because these avoid the cross-contamination risks of textile towels while also drying the hands more rapidly than air
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