Everything is Infection Control. Everything.

Gather round for a story, about all the things that you should know because the people whose job it is to know them don’t always know them.

Our pharmacy director mentions in passing that the state board of pharmacy is coming in to one of our small sites.

“They are here to review the moving of the pharmacy”

Me: We’re moving the pharmacy? [which is just a small, dry storage room with a computer. No mixing.]

Her: Yes, we are swapping the nurses’ medication room with the pharmacy.  Nurses need more space.

Me: How did I not hear about this construction project?

Her: Oh, there’s no construction, just a swap.

Me: The nurses’ med room has to have a sink.  The current pharmacy space doesn’t have a sink.

Her:

Me:

Her: Really? Are you kidding?

Me: Nope, not kidding.  The facilities manager should have known that.

Her: Who says you have to have one?

Me: First, it’s good practice.  You should have one for handwashing, making G-tube slurries, disposing of IV bags.  For patient safety, all med prep should be done in one area---without having to leave the med room for things like water.  From an infection control view, staff should be washing hands immediately before med prep.  From a regulations view, it is definitely in the FGI guidelines, but there might be a different code book we are following.  But even if it’s not in there, I’d want a sink.

Her: mumbling and swearing as this makes a giant mess of a plan that was about to happen in a few days’ time. And she wants proof that this needs to be done.  Many phone calls are then made to many important people.  Nobody is happy. I have turned a furniture-moving event into major plumbing and renovation.

So I call the Facilities Director, who knows nothing about sinks in med rooms, or which guidelines we are following, or about any other AHJs in this matter.  So I ask if I can have access to his FGI guidelines.  Which he doesn’t have.  Seriously, does not own.  He refers me to the International Building Code, which, while applicable, is not useful in this situation. (IBC tells you what gauge of electrical wire or type of cement to use, not interior design and function). 

The guidelines that direct how to design, construct, and renovate healthcare facilities is not in the possession of the person who is in charge of these things. The read-only copy (which I’ve read, and so should you) is available free online, but it can be tedious to search.   So at 7pm, from home, I shell out $200 on my credit card for the applicable edition of the FGI manual.  And share a screenshot of the medication room guidelines with all interested parties.  All plans come to a screeching halt.  And that was my last day on that job, so I have no idea what happened after. (The pharm director was a very conscientious person, so the sink likely happened, or the move didn’t happen.)

Projects planning committees are crucial.  You must be on them.  Projects that nobody thinks are projects are often projects.  This is one of a dozen stories I could tell. 

There is a webinar coming up soon on using the FGI guidelines.  I hope you’ll sign up if you aren’t familiar with them.  You never know when you might need to know how to do someone else’s job for them.

https://www.fgiguidelines.org/aia-fgi-webinar-the-2018-guidelines-how-to-use-and-major-updates/