Confessions of an Undercover Infection Prevetionist's Physical Therapy Experience

Many of my postings aim to educate the public on how to ensure quality care in healthcare facilities. Healthcare facilities are not just brick-and-mortar hospitals; they can also be long-term care facilities, doctor's offices, or outpatient rehabilitation facilities.

Today, I will discuss my experience with a freestanding outpatient rehabilitation facility. I must preface this with the disclaimer that anytime I go to any healthcare setting, I always keep my background in infection control and regulatory compliance private. My goal is to let them work in a comfortable environment, but I pay attention the entire time I am there for many reasons.

As I enter the office and sign in, there is no visible signage for respiratory etiquette. The CDC has signs in every language that everyone should use during this respiratory season. I see no tissues, garbage containers, or hand sanitizer readily available. Upon signing in, I noticed there are community pens for the clients. (I always carry my own). The waiting area is small, and there are no masks for the people coughing, so the staff can suggest that they utilize them. I place my mask on for my safety. (Again, you can always carry your own.) I don't mask everywhere, but if I am in a confined space with people with obvious symptoms, I am pulling my mask out.

They called me back, and my therapist greeted me and asked me to begin on the stationary bike. I sat down and began my warm-up, noticing the others coming in while others were getting off of the bike. The handles used by the clients were not disinfected. I finished my warm-up and was escorted to my mat for my leg exercises.

The mat had a pillow for my head, but it was severely cracked in many places. My IP spidey senses are going off. When a surface is cracked, there is no way to disinfect it effectively. I asked if I could get a sheet on the mat because the leather against my skin would make me cold. (Yes, I lied so that my therapist could feel comfortable and I could feel safe all at the same time.) You can be friendly and polite while still protecting yourself.

I watched other clients get up from their tables, and the therapists prepared the station for the next client. They changed the pillow covering, sprayed the table with disinfectant, and immediately wiped it down. (Did you know that if you wipe up the disinfectant and don't allow it to stay wet for the required time, all you have done is make the germs smile at you?)

My therapist gave me my exercises to do, and I started. She guided me through each one with kindness and skill. She then went back and forth from me to the client next to me. Not sanitizing her hands in between. Then she asked me to move to the leg press machine. I watched as the last person got off, knowing that is usually how we ended. The arms to hold onto the machine were not sanitized after the person finished. I did my reps, and she checked my pain level, and we scheduled our next session.

I left the building and got in my car. I sanitized my hands thoroughly and then removed my mask. I wiped my door handles inside and out with an EPA-approved sani-wipe and drove home. When I got home, I washed my hands, removed my clothes, took a shower to remove germs from the areas on my body that were touched, and put on my comfortable clothes.

Can you see how a simple visit to any medical facility can put you or a family member at risk for a healthcare-acquired infection? One of the reasons J.A.D. Infection Control Experts focuses on risk assessments in the outpatient setting is because many need help understanding the hidden dangers in the heathcare system. We look to show opportunities for improvement and a roadmap to success. Hopefully, this article has enlightened and empowered you to protect yourself and those you love.