When I first began working as a home care physical therapist I felt funny about bringing in a barrier to the patient’s home and putting it on their furniture to “protect my bag”. When I cleaned my equipment in front of the patient and their family members I felt as though I was saying to them “I don’t want your germs on my things”. I began making sure they saw me wiping down the parts of the equipment that touched me first before wiping down the parts that had touched them. Then one day one of my patients told me “I like that you clean your equipment. No one else does.” I was relieved that the patient saw my efforts as protection of her and not myself. I was dismayed that she didn’t see the same thing from the other professionals coming to her home.
No one likes to have an auditor follow you in a visit. I have had the pleasure of this twice. No one wants to have the patient watch you perform proper bag technique for the first time while an auditor is sitting there. How horrible it would be to have the patient remark “Oh, I’ve never seen you do that before.” Practicing good technique is important for many reasons and one of them is so performing proper technique is natural and easy when under the stress of a monitored visit.
After practicing longer I can tell you that I have seen situations more than once that made me understand why the barriers are important. I have seen cats throw-up on couches. I have seen urinals spill in the floor. I have watched other caregivers come in the rooms and place their bags on floor and cringed knowing that their bag would be placed in their car seat and carried into another home.
Once you become aware of cleaning techniques, you become acutely aware of situations that cause that need. How often do you see a patient stand from the toilet after cleaning themselves with only 4 squares of toilet paper and then put their hands on their walker. It is important to teach them to clean the grips of the walker after washing hands. I have seen more than once someone pick their nose and 5 minutes later reach for my pen to sign the form. Keeping a disinfectant wipe handy to wipe pens and computers down as you talk should be a habit.
People frequently don’t recognize their unclean personal habits. Try watching your own actions more carefully for one day and you will be surprised by the many opportunities for disease transmission. At this time of year when colds and flu are spreading remember to work to protect those most vulnerable to illness. WASH YOUR HANDS and CLEAN YOUR EQUIPMENT without apology.