Bodily waste management and related hygiene practices in nursing homes of Vaud: findings from a multicentre cross-sectional survey as a basis for targeted interventions.

Abstract

Introduction: Bodily waste management is a critical yet frequently neglected domain of infection prevention and control. We conducted a survey to examine various aspects of bodily waste management and related hygiene practices in nursing homes (NH) based on existing recommendations.

Methods: All NHs (n = 120) of canton Vaud in Switzerland were invited to participate in this cross-sectional survey between July 2022 and February 2023 using a questionnaire.

Results: Eighty-seven NHs participated in the survey (72.5%). Of these, 33% had internal protocols on bodily waste management, 98% had at least a dirty utility room (median: 4 per NH) and all a bedpan washer-disinfector (WD), yet only 66% met the cantonal recommendation of bedpan WD density (1/15 beds). Separation of soiled and clean compartments was present in 51%, complete hand hygiene supplies in 73% and personal protective equipment (PPE) in 30% of utility rooms. Fifty-four percent of NHs reported having a lid for each bedpan. Systematic use of lids was reported in 33% of institutions and of gloves in 98%, for the transport of used bodily waste collection tools. All surveyed institutions reported performing automated reprocessing of bodily waste collection tools in bedpan WDs and use of manual pre-cleaning was anecdotal. Regular maintenance and validation of bedpan WDs was present in almost all participating NHs.

Conclusion: Identified actionable priorities include making bodily waste management protocols accessible to staff, delineation of clean and soiled compartments in utility rooms and equipping them with PPE and hand hygiene supplies, as well as educating healthcare workers on best practices for the transport and disposal of bodily waste.