Waiting Room Safety: Infection, Furniture, and Power Outlets
Accreditation organizations (AO) don’t have a specific standard for infection control in the waiting room, but there are still issues to be alerted to.
This article was originally published on September 16, 2020 on PSQH
A patient enters your waiting room with a cough, a slight fever and shortness of breath. Her waiting room is overcrowded, so she sits down next to other visitors.
She left her cell phone in the car, leafing through a magazine and playing with the TV remote control. Her name is and someone will take her place as soon as she stands.
By the time you taught your patient how to treat these symptoms, several others would have come and gone from your waiting room.
This patient had the flu. But she could just as easily have had any number of infections, from the common cold to the SARS-CoV-2 virus that causes COVID-19.
Cleaning and protecting a healthcare waiting room is a daunting task, according to Jennifer Cowel, RN, MHS, a former executive director and CEO of the Joint Commission of Patton Healthcare Consulting. There are many elements to consider: furniture, sockets, disinfectant dispensers, toys, and items with high contact. And unlike patient rooms, there is no turnover time between people in which the room can be cleaned or checked.
“Waiting rooms are a challenge because you can’t control who’s in there or what they’re touching,” she says. “You can have children, adults or seniors. We should clean touch-sensitive surfaces, [and] If you have kids in the room, any surface can be high touch! “
Accreditation organizations (AO) don’t have a specific standard for infection control in the waiting room, but there are still issues to be alerted to. In her many years as a surveyor and health consultant, Cowel has seen (and inspected) many waiting rooms. She shared from the ground up some of the problems she’s seen the most.
“You will have children [waiting rooms, and many of those rooms] Do not have protective covers over the sockets. These child safety sockets are recommended because young children crawl under furniture and plug things into sockets, ”says Cowel.
“There are child-resistant outlets when you can replace your existing outlets,” she says. “The cheaper alternative is to put those little plastic caps over them so children can’t clog up there. The problem with this is that families routinely strip them off so they can charge their electrical appliances, phones, and the like.
“I would recommend replacing [your outlets] with childproof ones that the family can recharge with. I also suggest having enough cargo space because you see that often, [people] Move furniture to connect your devices. “
“When you have a kids’ area, you want to have things that the kids can use,” says Cowel. “But then they have to be cleaned immediately afterwards.”
If you can, after they are used to a “dirty area” where they will be collected and cleaned, bring your cleanable toys before going back to the play room.
(For an example of a toy cleaning policy, see below.)
If your waiting room furniture is in good condition, there is no need to replace it. However, if the cover of a chair or seat is cracked, the surface material is worn, or the protective cover has delaminated, that item must be repaired or replaced.
Some furniture surfaces are not considered cleanable and should never be used in a waiting room. An example would be furniture with a fabric covering or made entirely of fabric, as well as wall decorations that are considered unclean by surveyors. It’s possible to get a vinyl surface that mimics fabric and is cleanable, Cowel says.
Waiting rooms can have fabric curtains, but these should be cleaned frequently and you should consider replacing them with a different material.
There are also rules for wooden furniture with a polyurethane laminate.
“Once [the laminate] is worn, scratched, notched, milled and you can see the inside surface that can no longer be cleaned, ”she says. “If you have an original shiny surface, it can be cleaned.”
There are some materials and items that are touched frequently and simply cannot be disinfected. For this reason, Cowel does not recommend using books or magazines in your waiting room. These are unclean items with a high touch that pose a risk of infection.
Cowel says if you really want to give out books or reading materials, give it to visitors straight away and tell them to take it with them when they leave.
In 2020, there are plenty of entertainment options for non-high-touch people such as: B. TV (with remote controls inaccessible). And of course, many visitors bring their own cell phones and tablets.
“That’s entertainment enough,” she says.
With the novel coronavirus causing the worldwide spread of COVID-19, the best course of action is to have patients call with their symptoms before they come to the facility. The aim is to limit the number of visitors to your waiting room during an outbreak, be it COVID-19 or the common cold. However, this is not always possible and patients do not always listen. In this case, Cowel recommends adjusting the seating arrangement to create extra space between people.
“With COVID-19, there is enough space between the seating groups to ensure this [social] Distancing, ”she says. “This is an idea that you want to implement now and that is a good idea in the future.”
If possible, she recommends two waiting areas – one for people with potential breathing problems and one for people without.
Made of soap, signs and PPE
Check and check your hand sanitizer and soap dispensers to make sure they are full. Also, work with your facility team to make sure bathrooms are cleaned frequently and properly, and are adequately stocked with paper towels and other toiletries.
“Then leave enough hand sanitizer in the waiting room so people can clean their hands after they’ve touched a touch-sensitive surface,” Cowel says.
Also, make sure your waiting room is equipped with PPE for patients who need it. Put up signs so newcomers can identify symptoms of respiratory disease for themselves so they can get PPE.
“Do you have signs to tell people if they have a cold or a cough or something like that, you want them to identify themselves in advance,” says Cowel. “Because then you give them a mask to wear during their visit or for how long your infection control policy says.”
Cowel explains that during the COVID-19 outbreak, the CDC expects more frequent cleaning of surfaces with heavy contact with a hospital-approved disinfectant.
“Your infection preventionists should use the latest CDC recommendations as a guide in making your decision,” she says.
For all cleaning and disinfecting products, always check the expiration date and follow the manufacturer’s directions for use – concentration, application method, contact time, etc.
Speaking of COVID-19, Cowel says, “You should use a cleaner that is approved by the EPA for emerging viral pathogens, and the CDC has a list of those.”
In response to the COVID-19 outbreak, the CDC has issued recommendations on how to clean and disinfect your home for the virus. The lessons of these recommendations also apply to a healthcare waiting room.
The recommendations published by the CDC are summarized below:
- Wear disposable gloves when cleaning and disinfecting surfaces and discard the gloves after each cleaning.
- If reusable gloves are used, these gloves should be used to clean and disinfect surfaces for COVID-19 and should not be used for any other purpose.
- For information on the cleaning and disinfection products used, see the manufacturer’s instructions.
- Clean hands immediately after removing gloves.
- If the surfaces are dirty, they should be cleaned with a detergent or soap and water before disinfection.
- The use of EPA registered disinfectants should be effective for disinfection.
- If necessary, dilute household bleach solutions can be used for the surface. Follow the manufacturer’s instructions for use and proper ventilation.
- Make sure the product has not passed its expiration date.
- Never mix household bleach with ammonia or any other detergent.
- Household bleach that has not expired is effective against coronavirus when properly diluted.