Not many things really leave me speechless. This situation did just that. I will start by saying this was a space the practice was using for 9-12 months while new office space was being built.
I had completed the facility safety part of my mock OSHA Inspection and was ready to ask questions about cleaning and disinfecting instruments.
I was told the office performed pap smears and some minor surgical procedures. I also knew they did some waived lab testing in the practice.
Usually the instrument disinfecting is done in the lab, so I asked the medical assistant to take me to that area. As we walked down the hall, it looked to me like we were headed to a door that was clearly marked “Restroom.”
She opened the door and said “this is where we clean instruments and do lab tests.”
I couldn’t control my shock and asked her if she was kidding me! She was serious. We both stepped inside the single stall restroom as she explained how instruments were cleaned; ON THE FLOOR!
There was an ultrasonic cleaner sitting on a plastic crate. The medical assistant explained how the instruments were cleaned in the sink (including vaginal specs!), dried with paper towels, then placed them in the ultrasonic cleaner.
She had to practically sit on the floor to put the instruments in the ultrasonic cleaner. AND, on another crate was a centrifuge that had test tubes in it.
To top it off, there was a patients’ urine sample on the sink and a urine pregnancy kit and Strep A test kit inside the plastic crate on the floor.
I told myself to take a breath and tackle one issue at a time.
First of all, a bathroom is used for one purpose only! If this was the only room where they could clean equipment and do lab testing, it could no longer be a restroom. I asked her to remove the “Restroom” sign and place a sign on the door that said “Authorized Personnel Only.”
Patients were to be forbidden from going in that room.
The problem was there was really no place in that small office to put a proper lab.
Keep in mind OSHA governs employee safety. Kneeling on the floor to clean instruments and prepare blood samples, was definitely putting the staff at risk for injury and NOT an appropriate technique for disinfecting instruments. Talk about infection control !!
I told the physician and staff that NO ONE was to use that room as a restroom. There was one outside the office in the hall. The crates had to be removed and a small cabinet placed in there to hold the ultrasonic cleaner. I requested that all lab testing and blood draws be sent out to a reference lab until they moved into their new space later this year.
The physician and staff truly didn’t understand why I was so upset with the way they were cleaning instruments and doing lab testing.
The staff was at risk everyday for injuries that could occur while bending and stooping down to disinfect instruments and process blood. And the unsanitary conditions of working in a restroom threw infection control out the door!
In a follow-up visit a week later, I was happy to see that the physician and staff did follow all of my recommendations and the door is now properly marked as “Authorized Personnel Only.”
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