Multiple Chemical Sensitivities
|QHC||Policy No: 2.3.2|
|Title:||Accessibility - Multiple Chemical Sensitivities||Original Issue Date: January 04, 2010|
|Department:||Corporate||Review / Revision Date(s): 01/04/2010|
Patients experiencing or presenting to Quinte Healthcare Corporation (QHC) with multiple chemical sensitivities will have all available interventions and alternatives implemented in his/her plan of care to accommodate his/her disability.
Multiple Chemical Sensitivities: "An acquired chronic disorder characterized by recurrent symptoms occurring in response to low levels of exposure to multiple unrelated chemicals" . (Southwest General Health Centre, 2002)
People with multiple chemical sensitivities may present at hospital not only for treatment of reactions to environmental or chemical exposures, but also for injuries, acute or chronic illnesses, and surgery. The objectives of care related to multiple chemical sensitivities is to prevent reactions, minimize discomfort, enhance patient confidence and trust, reduce families' fears, decrease length of hospital stay, and increase the likelihood of successful treatment outcomes (Marshall & MacIennan, 2001)
This policy will assist clinical staff to anticipate and meet the needs of those with multiple chemical sensitivities as well as to outline the management and nursing responsibilities caring for a patient experiencing multiple chemical sensitivities.
a. Admission Planning - In conjunction with the admitting physician, the team leader and manager (or designate), admission arrangements for admitted patients with environment-sensitive illnesses will be coordinated. If possible, preadmission is arranged in advance. A plan of care will be created and/or modified to identify the multiple chemical sensitivities of the patient and clearly indicate the alternatives to be implemented.
b. The person obtaining the patient's history (for example, the triage nurse) is responsible for discussing the multiple chemical sensitivities with the patient and notifying the department of the need for a "clean room" and any ways to assist to meet the needs of the patient. Due to the nature of chemical sensitivities patients' needs will vary significantly, for example a person may be allergic to latex, while another person may be allergic to scented products. Patient's reactions to chemicals will vary; some patients may experience skin rash from exposure to the chemical, others may have asthma.
The identification of multiple chemical sensitivities must also include the symptoms and treatment protocols (if known) as well as tolerated alternatives.
c. A "clean room" is a private room and is required if unable to protect patient's space from chemicals (these may include roommate's toiletries, visitors and flowers). As a medical necessity, the private room will not be charged to the patient. New rooms or recently renovated rooms should be avoided for sensitive patients. The "clean room" should be located away from high traffic areas, exhaust vents, parking lots, truck delivery areas, laundry rooms, laboratories, and photocopiers.
d. The designated room for the patient may have a window that can be opened to allow extra intake of fresh air and the escape of accumulated volatiles. If the window must be kept closed, an air purification system must be placed in the room. An air purification system is available at each site. AT BG and TM sites, please call the Resource Centre to obtain the unit. At the NH site, contact Facility Services to access the unit, at the PE site, the unit is stored in the former OR storage room. Patients are permitted to bring their own air purifier is they wish, provided it meets the requirements of QHC Policy 2.11.26 Corporate - Electrical Equipment Use - Non Medical.
e. If a patient is being transferred between units, for example to diagnostic imaging, the sending nurse must provide a report to the receiving unit and include information of the patient's multiple chemical sensitivities and provide information on any patient specific interventions in place to avoid exposure. Patients should wear face masks prophylactically when traveling outside the "clean room".
f. If a radiographic procedure requiring the use of contrast media had been ordered, the radiologist must complete an assessment of the patient related to the tolerance of the patient to the ingredients of any diagnostic contrast media. Ingredients of oral contrast drinks must be considered and an alternative investigated.
g. Patients requiring routine blood work will be treated prior to other patients to avoid the introduction of contaminants by other patients. Avoid use of alcohol swabs for patients with allergies or sensitivities as required.
h. If the patient has specific food allergies, the care provider must contact the Dietician or Diet Technician to interview the patient and to determine suitable menu items. Water in glass bottles will also be available from the Nutrition and Food Department for patients with sensitivities to chlorinated water and PVC bottles.
i. Wherever possible, the care giver will use products that can be tolerated by the patient.
Examples of such products are latex free medical and surgical supplies, non-metallic prosthesis, chlorhexidine swab rather than alcohol, unscented lotion, and hand hygiene products.
Patients are also encouraged to bring their own personal care products.
j. A notice will be posted on the door to the patient's room to indicate that the patient has a medically documented multiple chemical sensitivity.
k. QHC shall continue to take steps to reduce environmental contaminants. QHC only uses paints identified as containing low levels of Volatile Organic Compounds (VOC) and where available paints with no VOC. While cleaning chemicals must meet the Provincial Infectious Disease Advisory Committee (PIDAC) Guidelines, wherever possible, scent free or low scented products are used. When purchasing drapes, blinds and other furnishings, QHC will consider products that are identified to have low or no chemical off-gassing. QHC has prohibited smoking on its properties (policy 2.11.20). All staff must comply with the QHC Reduced Scent Policy (policy #7.9, Occ. Health and Safety).
l. Prior to stripping/waxing floors, the housekeeping department will send advance notification to all department managers. If a patient has identified sensitivities, the department manager must notify the Hospitality Manager who will reschedule the work to a more suitable time. A notice will be posted at the elevator or entrance to the unit to indicate that the floors are being serviced.
APPENDICES AND REFERENCES:
(Marshall L M Maciennan B A 2001 Environmental health in hospital; A practial guide for hospital staff. Part II: environment-sensitive care)Marshall, L. M., & MacIennan, B. A. (2001). Environmental health in hospital; A practical guide for hospital staff. Part II: Environment-sensitive care. Canadian Society for Environmental Medicine.
(Southwest General Health Center 2006 Multiple chemical sensitivity (MCS) protocol) Southwest General Health Center. (2006). Multiple chemical sensitivity (MCS) protocol. Retrieved December 31, 2008, from Indoor Environmental Quality Web site: http://ieq.nibs.org/rooms/app_c.php