I have enjoyed the series of articles about the Transforming Care at the Bedside (TCAB) initiative at Massachusetts General Hospital. So many of the suggestions can be readily implemented and are budget friendly.

I was especially interested in the sensory cart discussed in "Placing the Patient at the Center of Care" (May). I understand the benefit of using items to distract and soothe patients who are having difficulty, but I'm wondering how the nurses of White 10 kept them from becoming a source of infection.

Sara Pullen, RN

Silver Spring, MD

Author Amanda L. Stefancyk responds: All but three of the items on the sensory cart are one-time use only. The non-disposable items-a CD player with earbuds, a plastic tic-tac-toe game, and a set of checkers-are cleaned with one of our hospital disinfectant wipes and reused. The disposable items include spiny rubber squishy balls, playing cards, puzzle books, pieces of felt and yarn cut from larger pieces, foam squishy balls and squares, and small cups of lavender lotion. These items can usually be purchased inexpensively at toy, novelty, and dollar stores or online. The cost of stocking the cart is estimated to be less than $150 per year.