Keeping it Clean: Lessons from the Surveyor’s Lens

It’s been a busy few weeks for our community! Between routine audits and recent state surveys, one theme is coming through loud and clear: Infection control during a med pass is just as important as the medication itself.

I recently sat in on a med pass observation where a surveyor was watching every single movement with a "white glove" mentality. While it can be nerve-wracking, it’s a great reminder that our habits are the first line of defense for our residents.

Based on those observations and some recent CRMA audits, here is a refresher on the "must-haves" for a clean, compliant med pass.

1. Prep the Surface

Before the first blister pack is even touched, your workspace needs to be ready.

• The Rule: Sanitize your medication cart top or the tabletop you are using before you start.

The Tool: Any approved sanitizing wipes will do the trick, but ensure the surface stays wet for the recommended "dwell time" on the container to actually kill the germs.

germs are every where.

2. Hand Hygine

This is where most "dings" happen during surveys. You must perform hand hygiene:

• Before starting the med pass.

• Before putting on gloves.

• After removing gloves.

  • Pro Tip: Whether you use a traditional soap-and-water scrub or an alcohol-based hand rub, make sure you are covering all surfaces of your hands, including between fingers and under nails.

3. The "No-Touch" Zone

It’s easy to get moving fast and lose track of where your fingers land. Surveyors are specifically looking for two things:

• Cup Rims: Never touch the top rim or the inside of the medication delivery cups. Hold them from the bottom or the sides.

• Utensil Etiquette: If you are using a spoon (for applesauce or pudding), always handle it by the handle. Touching the "business end" of the spoon contaminates the very thing going into the resident's mouth.

4. To Glove or Not to Glove?

There is often confusion about when gloves are required. Here is the general standard:

• Pills: Generally, you do not need gloves to administer oral pills as long as you use a "no-touch" technique (dropping the pill from the package directly into the cup).

• Everything Else: Gloves are a must for topical creams, eye drops, ear drops, or any administration where you might come into contact with mucous membranes or non-intact skin.

Audit Insight: During recent CRMA audits, we've noticed a "drift" in these habits—specifically skipping the initial surface wipe-down. Let’s tighten this up! These aren't just boxes to check for a surveyor; they are the barriers we build to keep our residents safe from outbreaks.