Malpractice? Report or get over yourself?

[Inbetweenie993]

I observed something I can hardly believe and don't know what to do. My brother (I am his carer and he lives with me) has just had knee replacement operation. There has been washing regime to prevent MRSA. Head to foot for days. Went for last blood test before op, and nurse, after putting cotton wool on the site, taped it down with some plaster on a reel (like sellotape). SHE BIT IT OFF with her teeth !!!! I can barely believe what I saw, but I'm SURE. He is still in hospital. Reluctant to report in case there are repercussions. AIBU ? Get over it ? YANBU This is outrageous- report it???

That’s really odd, the tape is generally tearable so there would be no need to bite it to tear it.
Why didn’t you just say something at the time? You should have told her to get a new piece that hasn’t been in her mouth.
By all means mention that it’s likely a breach of infection control, it will not affect the care your brother receives.

This was before his operation- a straightforward blood test so we’re talking about a tiny pin prick puncture wound?

I don’t think it’s outrageous that her mouth touched the edge of the plaster., and not worth reporting.

You could have expressed your disproval at the time.

This could be described as “bad practice” but I wouldn’t escalate a complaint.

Medical malpractice is defined as neglecting to take action or provide appropriate care which results in injury, harm or death of a patient.

Those rolls of tape are fomites! They are covered in bacteria, bits of dead skin, fluff from pockets, dirt from the air and environment.
So, the nurse tearing it with her teeth is more likely to get and infection that your brother
Such rolls of tape are a real cause of infection

I'd have just mentioned at the time that you don't want her to apply it because her mouth was by it. I wouldn't report it.

I’m sure you want the best care for your brother and hope he recovers from his op soon.

However, using some non sterile tape to hold a clean piece of cotton wool in place over a needle puncture is not cause for alarm. The tape is not touching an open wound.

It’s really poor practice but as a PP said - more a risk to her than him. Sounds like an outdated habit she’s got into and is doing it automatically. We don’t routinely cover the skin anymore after taking blood - if it bleeds, we just apply pressure until it stops. Taking blood is a “clean” rather than “aseptic” procedure. But she was wrong to do that. It’s pretty rank actually- but more so for her.

washing “head to foot” won’t really impact on overall infection control as you can’t sterilise skin. thorough handwashing at the required times and use of PPE for wound cleaning etc is crucial.

I think you should raise it as practice you are unhappy about but it’s not malpractice.

What outcome would expect from reporting this? What outcome would you like from reporting this?

As pp said this is not malpractice and you should avoid using that description when (not if, from the hyperbolic tone of your OP) you report it to avoid appearing an attention seeking drama llama.

This is very poor practice & needs reporting to the ward manager, as this is a surgical ward. The human mouth carries more bacteria than a dogs. Make a note of the time, date & name of nurse involved & that of who you report it to. Ask that it's recorded in your brothers medical records too.

In terms of risk, this is about as dangerous as kissing the top of your brothers head when you visit him.

It’s important to keep perspective if you do want to politely raise it with one of the staff.

I would complain - I complained about something similar once - it is terrible practice and she needs to be urgently retrained.

It is not malpractice

It's poor practice so I would mention it to the ward manager so the staff can be retrained but it's not malpractice and that tear off tape is never going to be clean or sterile, most nurses carry it in their pockets

That's depressing

The tape should be clean, and pockets is also very poor practice.

I don't know where these poster go for medical treatment! When I was in hospital yesterday, the tape was stored on a steril tray, torn with gloved hands, and the ripped bits were laid out ready on the edge of a tray that had just been sterilised for that purpose. This is normal.

It might well be the case that this was a routine blood test as part of a pre op assessment so patients aren’t usually admitted to a ward at that point; just asked to pop in.
A lot of blood test sites don’t require a covering so a jumper sleeve is just as much as a formite.

It feels like this has been blown out of proportion perhaps because op is anxious about the actual surgery and aftercare.

Op’s observation could be noted as a general point. It’s ok to question a patients care as their advocate.

I don’t think it necessitates outrage.

And sadly, very true despite research showing their potential for infection, @justasking111

Oh, please. Don't dramitise

But the tape is NOT sterile! Just because it was precut on yhe trolley does not mean it is sterile

Indeed. Sounds more like a dressing change if a trolly was used. The dressing will be sterile and possibly a sterile type covering on top of that - but rolls of tape are not sterile nor are they intended to be.

a simple blood sample from a peripheral vein is NOT a sterile procedure and not the same as changing a wound. If not bleeding, the skin should be left exposed. If a cotton wool ball was placed on top - it would not be sterile either - so although what the nurse did was poor practise, she’s more at risk than the patient.

The post says recovering from knee surgery. I don't believe I've mentioned being outraged, just stated the most appropriate way to raise her concern. Other patients on the ward could be compromised by an infection risk like this one.

She should not have done this. I would report. So long as you are telling the truth, I don’t see the problem. It would only be mentioned to the nurse to the degree of concern held by Management.

She shouldn't have done this, but it's really not malpractice. You should mention it, but seriously, do just take a deep breath. There's considerably worse things happen - and the time taken up around a complaint in this vein would take time away from patient care.

Sorry- I was referring to Op’s comment “This is outrageous” rather than your measured response!

It was a pre op blood test I believe so not something that occurred on a ward? I was pointing that out.

A piece of cotton wool taped to a blood test puncture is used primarily as a “There there all better, I don’t want you to get a dot of blood on your shirt sleeve” approach.
It usually falls off after 5 minutes.