Letter to the Editor by Adeola on "Patient Safety: Who Guards the Patient?"

Patient Safety: Who Guards the Patient?

June 9, 2005
in response to topic Patient Safety: Who Guards the Patient? (September 30, 2003)

Dear Editor:

I write to share a way to make our patient care even safer. Patients go to health care facilities seeking to improve their health status. Unfortunately, some times our health care interventions actually make them sicker, for example by exposing them to infectionouss agents that put them at risk for acquiring nosocomial infections. This can happen with an activity as simple as checking blood pressure. Blood pressure cuffs are often used on multiple patients without cleaning them between patients.

The following scenario is an example of how easy it is to transfer microorganisms from one person to the other when unclean blood pressure cuffs are used. Imagine that a patient vomits on the way to the clinic, gets some emesis on his left arm, then wipes part of the emesis off the arm, while leaving some of it there to dry. Upon arrival at the clinic, the nurse, unaware of any danger, wraps the blood pressure cuff around the patient's left arm, which still holds some of the unseen, dry emesis. The nurse then wraps the blood pressure cuff, still containing some of the dry emesis, around the next patient's arm, and the arm of the next patient, and the next patient, and the next patient, thus possibly spreading infectious material to numerous patients.

Blood pressure cuffs are not routinely cleaned by many health care facilities; many facilities do not clean them at all. Although most patients have effective immune systems, those patients who have depressed immune systems find it very difficult to fight off infections that can be transmitted by equipment such as blood pressure cuffs. Some of the most difficult to treat microorganisms commonly seen in the health care facilities, and which can cause nosocomial infections, include Clostridium Deficile (C-dif) and Methicillin Resistance Staphylococcus Aureus (MRSA). As health care professionals, we must be aware that these cuffs do get contaminated and need to be cleaned. Institutions stand in need of a quick and effective system by which blood pressure cuffs can be cleaned after each use. An example of such system may be a disposable limb protector. A disposable limb protector is a thin sheet evenly wrapped around the limb. This sheet must be in place before wrapping the blood pressure cuff on the limb, thus, preventing contact of the skin and the cuff.

Mope T. Adeola, RN, BS
Clinical Nurse Specialist Graduate Student
School of Nursing
Purdue Calumet University
Hammond, IN
Email: adeolam@purdue.edu