By Lt. Don Lowenthal RN, BSN, PCCN
In my 12 years as a registered nurse, I have been constantly reminded of the importance of good hand hygiene and its role in infection prevention. Some things have changed since I became a registered nurse, but the importance of good hand hygiene has not. There are anti-bacteria soap containers attached to the walls in the hospital where I work. There are posters on the nursing lounge walls proclaiming the importance of good hand hygiene and its role in preventing infections. One of the most famous nurses of all time, Florence Nightingale, is known for many things, among them being one of the first medical professionals to link unsanitary conditions to the spreading of infection.
I can’t think of any time during my 28 years in law enforcement that anyone told me about the importance of hand hygiene, even though we deal with many of the same types of people that later become patients in hospitals.
In my opinion, the people that law enforcement officers encounter are sometimes even a bigger risk for spreading infection because these people have to be searched, handcuffed or subdued. Performing these law enforcement functions can place officers at a high risk of injury through occupational disease exposures. While there are many ways to maintain good hand hygiene in a hospital, in my opinion it is much harder to accomplish on the street. This article provides a brief guide to some of the bacteria you may be exposed to on the street.
MRSA
MRSA is methicillin-resistant Staphylococcus aureus, a type of bacteria that is resistant to several antibiotics. MRSA can cause skin infections and sometimes pneumonia. If left untreated, MRSA infections can become severe and cause severe infection to the body called sepsis, which can be fatal. MRSA skin infections can be red and painful. If you have a skin infection that is red and painful, you should consult your doctor. Good hand hygiene and the use of non-latex gloves can help stop the spread of MRSA.
VRE
VRE is vancomycin-resistant enterococci and is also a type of bacteria that is resistant to some antibiotics and that can also cause serious complications. Besides seeing a doctor for these types of infections, it is important to know that prisoners and suspects may have these infections. Treatment will include the prescription of the appropriate antibiotics and their wounds should be covered with a clean dressing. Even though these people are being treated for their infections, it is still imperative to keep your hands clean and to use non-latex gloves when possible.
Hepatitis C
Hepatitis C is a bloodborne virus that can infect law enforcement personnel if precautions aren’t taken. Hepatitis C can live in dried blood outside the body and can still cause infection. Hepatitis C is a chronic liver infection that without proper treatment can cause life-long health issues for the patient. Hepatitis C can be contracted by inadvertent hypodermic needle sticks when patting down or searching suspects being arrested for narcotics, so extreme care should be taken when investigating these suspects.
I have been told by many police officers that they have been stuck by a hypodermic needle being concealed by a narcotics suspect, even after the police officer asked them if they were concealing any uncapped hypodermic needles. Even though they are already under arrest or detention, some narcotics suspects will mistakenly believe they will not be searched. Do not be complacent while searching narcotics suspects, even if they are already in handcuffs or in a secure facility.
When you confiscate a hypodermic needle while searching a narcotics suspect, ensure it is safely handled before it is submitted to the evidence room or properly disposed of. Place the hypodermic needle in a container that is authorized for use with disposable sharp instruments; you can find several of these containers at your local hospital.
Hygiene tips
Even if your agency does not provide equipment to help with maintaining good hand hygiene, you could still obtain these items without spending too much money. When possible, it is also a good idea to wash your hands with soap and water when you have an opportunity, especially before you eat. On a final note, good hand hygiene can be maintained by keeping antibacterial wipes or gels in your work bag along with a healthy supply of non-latex gloves. The wearing of non-latex gloves should not be seen as a substitute for good hand hygiene. Law enforcement personnel using non-latex gloves should also wash their hands with soap and water or by using antibacterial wipes or gels.
Your gear can also be soiled with infectious bodily fluids while placing someone under arrest, performing first aid or any number of challenges that occur during a shift. Always refer to the manufacturer’s guidance when cleaning your duty gear, but it is a good habit to wipe down your gear periodically. You should also pay attention to your shoes. Wipe down your shoes after they are soiled or think about keeping your work shoes in your locker at work. Keeping your shoes clean or stored at work can prevent you from bringing infectious bodily fluids into your home.
In my experience as a registered nurse, I have found that maintaining good hand hygiene is achieved once it becomes part of your daily routine. When I work at the hospital as a registered nurse, I routinely wash my hands with anti-bacterial gel before I walk into a patient’s room and when I leave. Having anti-bacterial wipes and gels in your work bag is the first step to developing a routine that can help stop the spread of infection to you and your family.
About the author
Lt. Don Lowenthal has been the infection control officer with the Philadelphia Police Department since 2007 and a registered nurse at Thomas Jefferson University Hospital in Philadelphia since 2008.