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Hi Michael
Interesting topic.
I have been a manager of a sub-acute area where a staff member was required
to wear an upper limb lymphoedema sleeve post mastectomy.
I allowed it of course, as she was an excellent clinician, But we did make
some ground rules:
> She wore a glove(s) and changed them as per the 5 moments for all ‘clean’
(ie: low cross infection risk) care tasks (eg: medication administration,
observations and assisting patients with mobility, meals, toileting, simple
wound dressings using ANTT).
> She was the ‘2nd’ person re: washing patient’s in bed (thus minimising
risk of lymphoedema material becoming wet)
> There was an agreement and willingness with the ward clinical management
team (ANUMs) and her nurse colleagues (yes I asked every one of them) to
share work tasks if patients required maximum assistance with toileting
(particularly perineal hygiene) or showering activities. Those staff (x2 /
30) who did object, were not ‘buddied’ with her. Annoying, yes, but doable
due to low numbers resulting in low frequency of occurrence.The problem of course is that there is no requirement to alter the
workplace to accommodate these workers under an OHS Legislative perspective
given their illness did not occur as a result of the workplace. Given good
nurses are hard to find, I believe that these nurses could be adequately
accommodated in most clinical environments and they should be supported to
continue in their role if there are no other extenuating circumstances.
But, I would definitely check with the DON, NUM & ANUM teams first to gauge
their willingness and help identify potential unidentified risks AND of
course other powers (eg: RTW Coordinators, Lawyers) before taking it to the
team for consideration.In the end, it all comes down to risk assessment and whether or not the
hierarchy of controls that can be applied are reasonably practicable to
implement and the residual risk(s) to the individual and their patients is
tolerable.I would be interested to hear how you go.
Kind Regards,
Vanessa Watkins
RN, Quality Manager, IPC Lead
Donwood Community Aged Care Services,
Croydon, Victoria
email (home): vanessa.awd@gmail.com
email (work): vwatkins@donwood.com.auOn Mon, Sep 19, 2022 at 2:56 PM Michael Wishart
wrote:> Hi all
>
>
>
> I wonder how everyone manages healthcare workers who are required to wear
> lymphoedema sleeves, or braces/splints that cover the wrist and hand? My
> recommendations for these have always in the past been to advise that any
> device or garment worm below the wrist means no patient contact tasks can
> be performed.
>
>
>
> That usual recommendation is being challenged currently by staff who are
> required to wear (long term) lymphoedema sleeves that cover the wrist and
> part of the hand. I am being told I am discriminating against them.
>
>
>
> In the spirit of fairness, I have always been tolerate of garments worn
> below the elbow when there is a genuine reason to do so, as long as the
> wrists and hands are uncovered. But I draw the line at garments covering
> the wrist or below, due to the inability for that staff member to
> satisfactorily perform hand hygiene.
>
>
>
> So, what are the thoughts of the communal infection control mind? Would
> you allow a lymphoedema sleeve to be worn over the wrist and hand during
> patient care in an acute setting? Would you limit types of patient
> contact (eg no open wounds, no invasive devices)? Any other approaches?
>
>
>
> Thanks
>
> Michael
>
>
>
>
>
> *Michael Wishart *| Infection Control Coordinator, CICP-E
>
>
> St Vincents Private Hospital Northside | 627 Rode Road CHERMSIDE QLD
> 4032
>
> *M *+61 448 954 282 | *T *+61 7 3326 3068 |* F* +61 7 3607 2226
>
> *E* michael.wishart@svha.org.au |
>
> *W *https://www.svphn.org.au
>
>
>
>
>
> St Vincents Private Hospital Brisbane | 411 Main Street KANGAROO POINT
> QLD 4169
> *M* +61 448 954 282 | *T *+61 7 3240 1208 |* F* +61 7 3240 1166
> *E* michael.wishart@svha.org.au |
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Hi Christine
Happy for you to reach out anytime but not sure I will be able to help much
even with dumb questions. Though I am a firm believer if you dont know
the answer then it isnt dumb.I work in a Melbourne Metro residential aged care facility 105 beds across
3 wards but under the 1 roofline. I have been an IPC Lead post ACIPC
course Feb 2020.Cheers
Vanessa Watkins
RN, Quality Manager & IPC Lead
Donwood Community Aged Care Services
11 Diana St, Croydon
vwatkins@donwood.com.auOn Fri, 24 Jun 2022 at 1:56 pm, Christine Morrison wrote:
> Hi there
>
> I’d like to connect with other IPC leads who work in aged care.
>
> I am the IPC lead for Anglicare Southern Qld and support the IPCs in 8
> RACFs as well as an extensive home and community care service, homelessness
> shelters and foster care.
> I’d like to reach out to others in similar roles to do some bench-marking
> and ask questions…even dumb ones!
> Is this an appropriate forum for this?
>
> Kind regards
>
> Christine Morrison
>
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Hi Colleen.
In our dementia specific unit a staff member goes around to each resident
at the dining table and dispenses ABHR solution into each residents hand
at lunch and dinner and mimics the required actions. So yes this means that
she may perform hand hygiene x30 each meal service. The residents now see
her with the bottle and hold their hands out in anticipation.Whilst it may not be performed perfectly every time by every resident is is
better than not even trying.There have been no issues with dry skin as the residents have frequent hand
massages either through our visiting nail technician or our lifestyle
program.We tried to use wet wipes but this was more problematic as in another
person needed to follow with a rubbish bin which just didnt look good in
the dining room and there was also a bit of arguing between residents as to
where the used wipe should go – dont throw it on the floor, dont leave
it on the table, etc as you can imagine.Routine and consistently has been a winner with us!
Hope thats helpful.
Kind Regards
Vanessa Watkins
RN / Quality Manager / IPC Lead
Donwood Aged Care
Croydon, VictoriaOn Mon, 23 Aug 2021 at 12:31 pm, Colleen Read wrote:
> Hello
>
> I am hoping to develop a programme or just a talk to teach our residents
> and those with Dementia hand hygiene.
>
> I need something that’s simple and easy and I realise it may get a bit
> tricky with some of the residents particularly those with dementia.
>
> I already have the glitter glue for hands ( pending allergies of course)
> and the torch.
>
> Does anyone have any such programmes or have done this before?
>
> KInd Regards
>
> Colleen
>
> Colleen Read
> Registered Nurse & Infection Prevention Coordinator Woodlands
> T 07 5390 1610
> http://www.irt.org.au
>
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