February 20, 2009 | | Comments 5
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Alcohol-based hand sanitizer abuse, courtesy of A&E

Hi everyone, it’s Scott Wallask posting today. I was catching up on recorded episodes of A&E’s series, Intervention, which my wife and I like, when we saw a scene that really hit home from a hospital safety perspective.

For those who’ve never seen it, Intervention features people with addictions who ultimately face a surprise meeting with a counselor. In one episode, family members had to admit an alcoholic to the hospital.

While he was in his room, the alcoholic — on camera — took a typical hospital cup, removed the lid, and proceeded to pump maybe a third of it full with alcohol-based hand sanitizer. The sanitizer dispenser was opposite his bed on the wall.

He then went to his bathroom, diluted the sanitizer with water, put the lid back on the cup, and drank the solution through a straw. He got a buzz in his johnnie gown while in bed.

Two major points struck me after watching this:

  • The hospital placed a known alcoholic in a room with a sanitzer dispenser and clearly from the tape, he was left at times without clinical supervision, which gave him a window to consume the sanitizer
  • The patient indicated the mixture of sanitizer and water didn’t taste all that bad

As of October 206, the Centers for Medicare & Medicaid Services requires hospitals to guard alcohol-based hand gels and sanitizers against inappropriate access from patients who may abuse it.

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Filed Under: CDC/infection controlLife Safety Code

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Scott Wallask About the Author: Scott Wallask is senior managing editor for HCPro's Hospital Safety Center (www.hospitalsafetycenter.com) and the award-winning newsletters, Briefings on Hospital Safety and Healthcare Life Safety Compliance. He has written about healthcare for HCPro since 1998, with a focus on occupational and building safety, emergency management, fire protection, and infection control. Prior to joining HCPro, he worked as a reporter for several newspapers in eastern Massachusetts. He holds a BA in print journalism, magna cum laude, from Northeastern University in Boston. Contact Scott at swallask@hcpro.com.

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  1. Hi Scott – I wonder about the risk to benefit associated with pulling hand sanitizers from patient rooms. The above scenario is fairly extreme – a patient admitted to a rehab facility. In my small rural facility, the benefit of having sainitier available appears to outweigh the small risk of abuse (behavior never reported at our facility. What exactly are the safetguards to “guard against inappropriate access’? Our dispensers are difficult to open, and more difficult to extract the product. Can I really not have sanitizer inside our ED rooms?
    Thanks for your input.
    Valerie Lambiase, RN, Infection Control Practitioner

  2. Hi Valerie —
    I agree with you that inappropriate access is a pretty vague term from CMS. That seems to go against common sense that you’d want hand gel dispensers in convenient spots.
    The big point, to me at least, is that if you have a behavioral patient who may try to smoke in bed, you wouldn’t put a lighter and cigarettes on the bedside table. The same argument could be made for an alcoholic left unsupervised near an alcohol-based hand gel dispenser.
    Thanks, Scott Wallask

  3. I’m a drug and alcohol counselor and have had many teachers ask about the safety of hand sanitizer in the classrooms. What is your thoughts on the subject.

  4. Hi Mandy —

    Based on my original blog post and other things I’ve heard over the years, if someone wants to get drunk off alcohol-based hand gel, it’s possible to do so. I’m not sure that’s a safety concern as much as a staff monitoring duty.

    However, there have been numerous reports in hospitals of staff members being burned by flash fires caused because they did not let alcohol-based hand gels or surgical preps fully dry before touching something metallic or electrical. Sometimes static electricity creates a spark, which then briefly ignites whatever remaining gel is on one’s hands. That stuff needs to be completely dry before you stop rubbing your hands with it.

    Also, sometimes the gel dispensers leak, which can lead to pools of gel on the floor or carpet, which then creates slip hazards.

  5. While there is no question that the ingredients are flammable, most hospitals are using a formula that includes moisturizers that effect the flammability. As with most issues, a little common sense always goes a long way.

    http://www.snopes.com/inboxer/household/purell.asp

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