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Are your patients in good hands?

U2.9.7 Are your patients in good hands?

I recently had a conversation about standards of hygiene in practice. There seemed to be a misconception that such matters were only for CLOs, in the consulting room, not a DO in the practice.

It does seem that attitudes to hygiene vary across the profession depending on whether you are a DO or CLO. This might not be surprising when CLOs (and trainee CLOs) have been trained in the need for the highest standards of cleanliness in the consulting room. We are all taught that patients are less likely to do what they are told but are much more likely to copy what they see their practitioner doing.

It becomes second nature to escort your next contact lens patient into the consulting room, seat them and then go to the wash hand basin to wash your hands. I use this occasion to chat to the patient, all the while watching their blink pattern, the state of their hands and judging their nervousness. Having mentally filed this away, I then proceed to the routine of checking or fitting the contact lenses. I know some practitioners have different routines but we all make much of washing hands before touching a patient or lenses.

Should a DO wash their hands between patients? What about the optical assistants? They might well ask the patient to sign a document with their own pen; could that be an area of cross-contamination?
While the dangers of infection in contact lens wear are high and the need for appropriate hand-washing is essential, there is probably less risk in the general dispensing area. However, standards of cleanliness must be maintained throughout the practice to protect staff and patients from cross-contamination.
There should be a protocol to ensure that carpets are vacuumed, surfaces are wiped regularly and telephones and keyboards cleaned and sanitised. This is especially important if a member of staff has a cold or goes off sick with a bug. Keeping hand sanitiser nearby, and being seen to use it regularly will reassure everyone. And don’t forget the door handles.

The frames on display can themselves become grubby and lose their newness as countless patients pick them up to look at and of course try them on. Modern hair products can be greasy and sticky and face make-up can adhere to the bridge and sides of the frame, making it unwholesome for the next patient trying on.

Washing frames regularly in warm water and detergent will keep them sparkly. All stock should be checked regularly for stiff joints, cracked or chipped display lenses and twisted fronts. A frame that looks well used will not be appealing and is unlikely to sell.

Practices have a duty of care for their patients; it is reasonable for a patient to assume that everything will be done to keep them safe while in your practice. It is not only good hygiene but it is also good business; a clean and tidy practice will give all patients confidence in the business itself and reassure them that they are in good hands.