• SSB

The Soap Dispenser

A good snapshot audit is a thing of beauty.

An easy, practice-level check that things are ticking along nicely in SSI prevention. A fast review of what's happening as measured against your local guideline, standard operating procedure or policy. Take Patient Preparation/Hair removal element: Hair removed with clippers? Tick. Area sufficiently clipped so that today's highly adherent/strong tack dressings can removed without serious pain /post-op hair removal? Tick. Are there enough electronic clippers available in the ward?, With chargers for each unit?, Diagram of area to be clipped available for staff and patient information? Tick, tick, tick...As I said, a good snapshot audit is a thing of beauty.

There is, however, a snapshot audit that I know will never receive my 'thing of beauty' status: Resources in the patient shower audit.

Actually, that's not entirely accurate. The snapshot I am referring to is Resources in The Private Patient's shower audit.

This is because in our private patient showers, soap dispensers have been deemed so ugly and abhorrent to the 'hotel experience' that soap must never be presented in a dispenser. Scented, luxury soap* must be in an ascetically-pleasing single-use bottles.

Now, I like cute bottles with luxury liquid soap as much as the next person. It's not about my preference though. What I worry about is the occasions when the attractive little bottle may not in shower. Over the years, in my experience, I have found that:

- Patients would prefer soap to be in a dispenser, always available in the shower cubicle

- Patients will wash without soap, if it is not available in the cubicle

Unlike static units, small bottles get dropped (not fun, if you are 3 days post op and worried about being in the shower in the first place). Small bottles are not easy to open and then squeeze, whilst simultaneously holding a shower head so as to avoid soaking the negative pressure dressing which they have been told to avoid. Nurses on the private patient ward have described it as 'embarrassing' to be assisting a patient with a wash, only to find there is no soap available.

One consultant told me that he had received a letter from a private patient praising the amazing skill of the surgeons and the excellent care by staff throughout his hospital stay. The patient finished the letter with, 'but why is there no dxxx soap in the showers?'!.

Why not have a stylish soap dispenser AND the cute bottles? Or large cute bottles mounted (ie. static) as a standard resource in the shower cubicle?

Is this an issue at other centres? Not sure. But as it goes, on our PP ward, it is the posh little bottle which must be replaced daily or nothing. It is style over substance? And actually, does it really matter? Soap is available in the little bottle, so I guess not. But why not design the healthcare system or process to remove the risk? Why not have the soap within a mounted soap dispenser as standard within the shower cubicle, like the water supply, rather than relying on someone placing a new little bottle every single day?

My suspicion continues that private patients are not asked their opinion on whether a soap dispenser would ruin the 'hotel experience' of their hospital stay. The recommendation from the Infection Prevention & Control team to have fixed units for soap available is ignored. The scenario of a non-PP using the room (and shower) without gifted soap is likely (without plans to bring their own, since the rest of the hospital has soap dispensers as standard). The snapshot audit of 'Resources in the Private Patient Shower' will remain frustrated (albeit despite the best intentions of everyone concerned).

It is something I would never think about, would never realise, should I not work in surveillance.

The humble soap dispenser is simply too ugly.

*I was always told not to gift someone perfume whilst they were in hospital because the scent would always remind them of a time when they were unwell. But I guess the same doesn't apply to perfumed soap.)