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#1 Posted : 07 March 2005 11:55:00(UTC)
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Posted By J Knight Eeyup folks, I was talking to a friend of mine who's a third year physio student. She is on placement at a large general hospital nearby. The other day her ward (an orthopedic ward) was visited by an Infection Control hit squad; she reckons there were about nine of them. Physios use saws a lot (for making walking sticks; they can't yet do hip replacements on their own) and one of these infection control characters suggested that the saw could be used as an instrument of suicide. It's now kept in a locked drawer at reception and when needed has to be carried through the ward. This same H&S champion said that the studs holding leather upholstery on to chairs could be removed and used...as an implement for suicide. As yet they can't decide what to do about the chairs. It strikes me that I can kind of understand why this particular individual is so fixated on suicide; it must have accounted for an unconcionable number of their family and friends. Certainly, hearing about this kind of stuff makes me feel like ending it all. What has suicide got to do with infection control? What has any of this got to do with anything remotely reasonable? Or am I missing something? John
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#2 Posted : 07 March 2005 12:14:00(UTC)
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Posted By Jez Corfield John This kind of thing is a real problem - people get a bee in their bonnet and stick their noses in where they have no remit. Under the previous R&I regime I have seen reports for care homes with squeaky hinges raised as a H&S issue! This could be an internal NHS initiative - and therefore could be challenged and not legally binding. If this is a formal inspection (Healthcare Commission etc) then I would suspect that this would not be part of their remit, and could possibly be challenged (if feeling brave enough) - it would be interesting to see if they have cross referenced this to any actual standards or have done a report at all. Jez
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#3 Posted : 07 March 2005 12:27:00(UTC)
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Posted By Iain Milne It strikes me that to stop some invasion of infection into hospitals care homes etc., instead of these "Task Teams", the NHS should simply provide proper changing and storage facilities for Nurses etc., to stop them travelling into work wearing their uniforms and picking up goodness know what on their journey or bringing something "extra" in from home.
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#4 Posted : 07 March 2005 15:55:00(UTC)
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Posted By Roger the Dodger You wouldn't believe some of the over reaction that goes on in the NHS. I got asked to investigate a claim of staff distress because a patient had unexpectedly touched a nurse. The patient was old and has mental health problems
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#5 Posted : 07 March 2005 16:00:00(UTC)
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Posted By Robert S Woods Give this person some chair buttons, a saw, a bottle of gin and a Simply Red CD. Leave them alone in a dimly lit room for 24 hours. If this does not solve the problem then send in a half starved pack of pit bull terriers to finish them off. Yes I know it's not fair to starve dogs.
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#6 Posted : 07 March 2005 16:16:00(UTC)
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Posted By J Knight It's a good job they didn't find the simply red cd...
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#7 Posted : 07 March 2005 16:18:00(UTC)
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Posted By stuart cross Is the suicide potential to patients of the departments or (more likely given this OTT responce) to the phisios. If the risk is to the physios then locking the saw in the draw does not reduce the risk significantly as the phisios have easy access. Surely to ensure that the risk is removed the control measures need to be tighter here: Either sub contract the shortenning of walking sticks to a time served woodworker Remove all saw teath, ensuring the edge is left with a safety edge on it and all physios only to be allowed to use the saw under a permit to work! Stuart ;-)
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#8 Posted : 07 March 2005 16:25:00(UTC)
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Posted By J Knight Hi Stuart, Funnily enough they didn't seem remotely concerned with the risk of injury to the people actually using the saw, nor about their training in using it, nor about its condition, nor about the fairly obvious dangers involved in wandering about a busy ward carrying a loaded saw... John
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#9 Posted : 07 March 2005 16:33:00(UTC)
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Posted By Andy Petrie If you put your mind to it you can kill yourself with just about anything. It is probably possible for someone to commit suicide using the cupboard that the saw is locked in. Suggest this to the person who suggested the saw be locked in the cupboard and see what they come up with. Put the cupboard in another cupboard?
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#10 Posted : 07 March 2005 17:04:00(UTC)
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Posted By Stuart Nagle Hi, 'J'. Tell me... Is there a long list to draw out the saw from reception for the committing of suicide yet? or a que forming to stelthilly withdraw the buttins from the furniture.... With this death monger wandering about the place it's highly likely. What about the buttons on the chairs... are they the type with the short metal hook'eye on the reverse.... I could see the pateints plucking their eyes out with them, perhaps in a fit of rage over the colour of the hospital cabbage, but suicide!!! I suppose if they got them all out, straightened the pins out over a few days, with some stolen surgical tweesers, laid them all up on a board with some glue and dived on them from the fourth floor win....OH MY GOD.....THE WINDOWS.....ANOTHER SUICIDE RISK!!!!! OH NO.....DOES THE CHAPPY KNOW ABOUT THIS POTENTIAL RISK....!!!!..... then they might actually manage to kill themselves rather than plucking out viens etc...yukky.... perhaps you would be so good to give us a hint of where this place is .....so we can all avoid it like the MRSA..... Stuart
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#11 Posted : 07 March 2005 17:39:00(UTC)
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Posted By Ken Taylor The decisions are probably based upon the assumption that anyone choosing to be in an MRSA infected NHS hospital these days must be suicidal.
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#12 Posted : 07 March 2005 22:22:00(UTC)
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Posted By Jason Touraine John Sounds like .[expletive deleted] to me. Are you sure your friend's not winding you up? They think you're one of those gullible safety folk.
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#13 Posted : 08 March 2005 00:32:00(UTC)
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Posted By John Murgatroyd Same old comments. You try keeping anywhere clean when there are 700 "residents", 1100 "staff" and over 2500 "visitors" in any one day. Plenty of moans about nurses wearing uniform away from work, none about patients family and friends crowded about the bed....many more than the "two visitors per bed" allowed. And all with dirty outdoor kit and shoes on. Not a lot of concern for their sick relative when they hand over papers, drinks etc....without washing their hands. Not too much in the way of running water when they go to the loo. I was in a food shop today...the staff were wearing plastic gloves....all the time...the SAME gloves were on their hands as they took and gave cash...as they made sandwiches and drinks and picked-up pasties etc....and you wonder why infections and food poisoning are rife. PEOPLES ideas of hygiene need to be increased GENERALLY, not just in hospital. What you also need to remember is that the disease MRSA became resistant because of peoples expectations in treatment for illness, go to the doctor and be given anti-bi's....as if life was that easy. everyone is responsible for MRSA, not just the health service.
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#14 Posted : 08 March 2005 09:38:00(UTC)
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Posted By Neil Pearson This has to be the best title for a thread I've ever seen.
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#15 Posted : 08 March 2005 09:43:00(UTC)
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Posted By David Mains I would generally agree with the comments in the last posting by John with regards to infections. It is worth remembering that a lot of the so called hospital acquirred infections that we hear of are actually community acquirred. With regards to the suicide risk, it really comes down to reasonably practicable. A general hospital ward would normally be regarded as low risk although this could obviously change with individual patients or the patient group. A psychiatric ward however would be a higher risk. There are standards that should be followed in patient areas with regards to windows and how far they can open. However, it is virtually impossible to make a general hospital ward suicide proof especially if you want it to remain as a working ward. Remember the singer Michael Hutchence? He managed to use a door handle as a ligature point.
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#16 Posted : 08 March 2005 10:08:00(UTC)
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Posted By J Knight Just to respond to a point; I am sure that the story in the original posting is entirely true. A few people have made the point that a serious suicide will use anything they can; I agree entirely and I have a story from within a care setting about this. Somebody wanted to kill themselves; they were quite serious about it, so serious in fact that they didn't tell staff what they were planning. This was a physically disabled person, but cognitively quite intact (very bright in fact) and relatively independent. They drank a cup of fairy liquid. Fairy liquid is not toxic, but a whole cup will induce vomitting, and this person then aspirated the vomit (possibly deliberately). Vomit in the lungs is potentially fatal, of course; it is even worse when the vomit contains a surfactant as this defeats the surface tension in the alveoli and causes the lungs to collapse. This person was so determined to die that they actually pulled out the tubes on the way to the hospital, but they did eventually make a recovery of sorts. Did we ban fairy liquid? Did we eckers like! This was a service for fairly independent people, who valued the freedom of doing their own washing up (and other kitchen stuff). We believed from the outset that the suicide attempt only used fairy because it was handy. This person would have been quite free to go to the supermarket and buy their own fairy liquid, come to that. They could, for that matter, have just sat in their wheelchair on the nearby main road on the handy blind bend. They were going to try and end it all, and they were going to do it without flagging it up and using whatever means they could. In other words, we did a risk assessment, and none of the enforcing or regulatory bodies involved ever suggested that we had reached the wrong conclusions. MRSA is a bad thing, it's something we struggle with in my current place of work. Maybe if the infection control person had said that studded upholstery is difficult to clean and could harbour MRSA it would be possible to take them seriously, but suicide! Good grief! The hospital in question is not too far from Sheffield, John
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#17 Posted : 08 March 2005 10:17:00(UTC)
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Posted By Robert (Rod) Douglas Hi Guys, I am just wondering what the hell are infection control personnel doing dabbling in this area? (I believe this would not be an area of their expertise) Did they look at the "Ligature Risk" to patients in this area? I doubt it, as David has stated the guy from INXS used a door handle... I come from a Military/Custodial background and people have been known to try (And almost succeed) and hang themselves using the bottom of a door. There are other issues, such as: Are there hot water taps in this area? (Scalding) Are they thermostatically controlled? (Scalding) The radiators surface temperature does it not exceed 43 Degrees Celsius? (Scalding) Are the windows made from toughened glass? (Cuts, Lacerations) Are patients assessed for the risk of “Self Harming”? (Their mental state) That is just an example at what I would look at for patients/inmates who would be likely to self-harm It is all very well coming in giving people problems; they should also be working with them to produce solutions. It is people like this that give our profession a bad name. "Elf & Safety" I am off my soapbox now…. Aye, Rod D
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#18 Posted : 08 March 2005 10:27:00(UTC)
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Posted By Andy Petrie A friend of mine works in a psych ward and someone hung themselves from the underside of the bed using a shoe lace, not a saw in sight. Rod, sorry to be pedantic but you get burns off hot radiators not scalds.
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#19 Posted : 08 March 2005 13:07:00(UTC)
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Posted By John Webster Suicide risk and MRSA are, quite rightly, serious issues in the healthcare environment. In the past year there has been an enormous effort within the NHS to reduce the incidence of HAIs (healthcare associated infections, formerly known as hospital acquired infections - but thats spin for you), and the positive results are really starting to show. We just need to convince some of the senior medical practitioners that washing hands is a good idea!! The NHS has also highlighted the risk of suicide, and has required all healthcare premises to check for possible ligature points and, where possible, reduce the risk of patients acquiring ligature material and finding somewhere to use it. So curtain track attachments must now break away if loaded, likewise things like shower head fittings. We have all been asked to remove the plastic dust strip from the top of curtain rails and cut it into short lengths before replacing it. In the latter case, risk assessment has determined that this is not a good use of our overstretched maintenance staff, and we have opted to do this only in higher risk areas. As the other John quite rightly says, real suicides will stop at nothing. Unfortunately, the effect on staff is highly traumatic. Even for a failed attempt, they are left wondering why they did not anticipate the danger of the agent used - we had one smashed a CD to get a sharp edge. I find it impossible to visit every corner of our premises as often as I would like, and with all the other "inspectors" departments have to entertain, its probably just as well. So when I see an infection risk, I will point it out, just as I would expect the infection control team to do the same with a safety problem etc etc. Of course with any crusade come the zealots, those who can see every possible risk but have no real idea of proportion/priority/practicality/pragmatism/price (goodness, have I just invented a rule of P's?). The important bit that seems to be missing here is communication, ie yes note concerns about suicide risk, but report them back to the relevant competent person(s) for assessment.
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#20 Posted : 08 March 2005 13:25:00(UTC)
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Posted By Zoe Barnett I think that the physios should ignore the advice and get the saw back out. If the person who made the recommendation challenges them they should ask him for his opinion in writing, backed up with a comprehensive risk assessment, a summary of the numbers of hospital suicides involving saws, and copies of his H&S qualifications. If no-one's brave enough to take this approach, would they be able to use one of those rotating saws which are used to remove plaster casts? These don't cut skin and even should foil even the most determined suicide attempt. I also whole heartedly agree with the posts about MRSA. It's passed on by people, not by cobwebs. (Which is just as well, given the state of my house!) Or - oh no - given the tensile strength of spider web - have I just unwittingly uncovered a whole new hanging hazard?!
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#21 Posted : 08 March 2005 13:34:00(UTC)
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Posted By steve williamson Ee bah goom, Sounds like you Yorkies need to start using some of IOSH's Healthcare specific training packages PDQ so you understand who's responsible for what a bit better. We advise, managers manage. Cheers, SteveW
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#22 Posted : 08 March 2005 14:31:00(UTC)
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Posted By jackw. Hi friend of mine swears by a jim reeve record and a good strong rope.. never fails to kill them off. pity this "nut" didn't actually concentrate on the real issues of infection in our hospitals MRSA etc. hmm had a late thought why not put him/her to good use as an extra cleaner in a hospital.. trying to really clean a ward in the time they are given by those lovely contracted out service companies..would make them suicidal. cheers ya all.. keep healthy but remember if you don't you may survive in spite of the hospitals best efforts!!!!!
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#23 Posted : 14 March 2005 20:30:00(UTC)
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Posted By Graham S Dawson On a more serious note; introducing positive ions into the area not only improves a sense of well-being (obviously essential if you are visited by an infection control team) but also reduces the incidence of infections such as MRSA - which keeps the infection control teams away! Double plus good or what!
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#24 Posted : 15 March 2005 00:26:00(UTC)
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Posted By John Murgatroyd That's negative ions, positive ions are supposed to be responsible for people feeling ill. Although tests on each have shown that any effects are short lived and very sporadic. Bad "negative ion generators" can produce ozone, which, again, makes you feel ill. Don't believe me ? Google it. the BMA reckons it's all tosh, neither have any effect.
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