Preventing Cross-Contamination With Scales Brought Into the Home

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The Outcome and Assessment Information Set (OASIS)-C2 requires that home healthcare patients be weighed, if possible, to complete M1060 as part of the comprehensive assessment (Centers for Medicare and Medicaid Services, 2016). If there is not a properly functioning scale in the home, home healthcare clinicians may bring an agency-owned scale, which needs to be managed in a manner that prevents cross-contamination, into the home.
To obtain a consistent and accurate patient weight, the scale needs to be placed on a flat, hard, level floor surface, and not an uneven or soft surface. Floor surfaces can be a reservoir for pathogenic organisms. Koganti et al. (2016) inoculated hospital floors in a patient room with a nonpathogenic virus, and subsequently found the virus on the patient's hands and high-touch surfaces in the room. More importantly, the virus was found on high-touch surfaces in adjacent rooms and at nursing stations, which suggests that floors could be a source for the dissemination of pathogens. Rashid et al. (2017) reviewed the literature for possible modes of transmission of pathogenic organisms from the floor to human contact and found methicillin-resistant Staphylococcus aureus, Clostridium difficile, and multidrug-resistant Gram-negative species on the floor that were most likely transmitted via direct contact or aerosolization. This same mode of transmission can occur in the home environment. Until research identifies which objects and surfaces pose the greatest risk of pathogen transmission, all noncritical surfaces that are touched must be cleaned–disinfected (Huslage et al., 2013).
Because the scale may come in direct contact with intact skin (but not mucous membranes), the scale is considered a noncritical item. All external surfaces of the scale are to be cleaned and disinfected after being placed on the floor and prior to being removed from the home. Use an Environmental Protection Agency-registered disinfectant to obtain a low level of disinfection using a manufacturer-prepared wipe or spray and keep the surface wet for the contact time specified by the manufacturer. If a contact time is not specified, and the surface is not soiled with blood or body fluids, keep the surface wet for 1 minute, and allow it to air dry. A scale is frequently transported in a tote bag and stored in the trunk of a vehicle when not in use. When the scale is removed from the tote bag, hang the empty tote bag on a doorknob or back of a chair. The tote bag should also be sanitized or cleaned on a regular basis with a suggested time frame of a minimum of once a month, or if it becomes visibly soiled (McGoldrick, 2017).
The floors in patients' homes are not typically cleaned at the same frequency or in the same manner as an acute care hospital, so it's even more important that the scales brought from home to home are managed in a manner that prevents cross-contamination.
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