HospitalInspections.org

Based on observation, interview, testing, and operator's manual review, the provider failed to maintain the hydrocollator in a safe and sanitary condition. Findings include:

1. Observation on 3/6/12 at 10:00 a.m. with rehabilitation aide A in the physical therapy department revealed:
*The department had a hydrocollator, and it was in operation all of the time.
*The hydrocollator was cleaned twice a year usually in June and December. There was no record of when the hydrocollator had last been cleaned.
*The temperature was never monitored, and there was no log for the tracking of the hydrocollator temperatures.
*The physical therapy department had a thermometer, but it read 40 degrees Fahrenheit (F) room temperature. Testing of the hydrocollator with the provider's thermometer indicated the water temperature was 120 degrees F.
*Testing of the water temperature with this surveyor's thermometer revealed the water temperature was 170 degrees F.
*She was not aware of the manufacture's recommendations for the cleaning of the hydrocollator or what temperature it operated at.
*She was not sure where the operator's manual was or if the hospital had a policy and procedure for the operation of the hydrocollator.
*She agreed that not monitoring the temperature of the hydrocollator could pose a risk to patient safety.

Review of the provider's operator's manual for the hydrocollator revealed:
*"Caution: The thermostat is extremely sensitive and the slightest adjustment will altar the temperature several degrees.
*The recommended operating temperature was 160 degrees F to 166 degrees F.
*The temperature of the water should have been checked with a thermometer after every adjustment before using the SteamPacks."

The provider did not have a policy and procedure for the operation of the hydrocollator.

Based on observation, interview, record review, and policy review, the provider failed to supply adequate ventilation in one of one utility room in the emergency department where glutaraldehyde was in use. Findings include:

1. Observation on 3/6/12 at 10:15 a.m. in the utility room in the emergency department revealed a bottle of Metricide 28 (Glutaraldehyde) setting on the counter beside a clear plastic container with a green liquid in it.

Interview on 3/6/12 at 2:30 p.m. with the paramedic revealed:
*The clear plastic container had Metricide 28 in it.
*He used the Metricide 28 to disinfect laryngoscope blades after intubating a patient. He kept an activated supply of Metricide 28 even though they did not intubate very often.
*He was not aware the Metricide 28 should have been used in a well-ventilated area.

Testing of the ventilation in the utility room revealed it was a positively pressured room and did not have exhaust ventilation. The room would vent through the door into the emergency department.

Review of the manufacture's label for Metricide 28 revealed "Use in a well-ventilated area in closed containers."