Week 2 Post

During one of my clinical placement with the Occupational Health and Wellness Department, I observed a safety concern outside the operating room when water began dripping from the ceiling after heavy rainfall. The leak caused water to collect on the floor in the hallway where surgical staff, patients, and transport personnel frequently passed through. Although no one was injured, the situation required an immediate response because a slip or fall in this area could have delayed patient care and caused serious injuries.

Elimination: The most effective solution was repairing the roof to stop the leak completely. Once the source of the water intrusion was identified and repaired by the Facilities Management team, the hazard was permanently removed.

Substitution: While repairs were being arranged, staff temporarily redirected patient transport and routine foot traffic through a nearby corridor. Using an alternate route reduced exposure to the hazard without affecting the surgical schedule.

Engineering Controls: Maintenance staff placed collection buckets beneath the leak to prevent water from spreading across the floor. Portable barriers were set up around the affected area to keep people away from the hazard, and Environmental Services cleaned and dried the floor regularly to minimize the risk of slipping.

Administrative Controls: The leak was reported immediately through the hospital’s hazard reporting process. Wet floor signs were posted, staff working in the surgical area were informed about the hazard, and the Occupational Health and Wellness Department coordinated with Facilities Management and Environmental Services to monitor the area until repairs were completed. Regular inspections ensured that additional water accumulation was addressed promptly.

Personal Protective Equipment (PPE): Hospital staff wore the required closed-toe, slip-resistant footwear while working in the area. Although appropriate footwear reduced the chance of slipping, it could not eliminate the hazard created by the leaking roof, demonstrating why PPE is the least effective level of control.

Reflection Activity: Hierarchy of Controls in a Long-Term Care Home and In the Hospital

While working in a long-term care home as a PSW and during my clinical placement in the hospital, I saw how important the hierarchy of controls is in preventing the spread of infections and keeping everyone safe. Each level of control played a role in protecting both residents and staff.

Elimination: If a staff member was feeling sick or showing symptoms of an illness, they were expected to stay home until they had recovered. This was one of the best ways to stop infections from entering the workplace.
Substitution: We often used disposable items, such as single-use medical supplies, like disposable gloves, mask and gown instead of reusable ones whenever possible. This helped reduce the risk of passing germs from one resident to another.
Engineering Controls: Hand sanitizer stations were available throughout the building, and residents with contagious illnesses were cared for in separate rooms with their own equipment. These measures helped limit the spread of infection.
Administrative Controls: We followed clear workplace policies, including regular hand hygiene, cleaning and disinfecting equipment after each use, completing daily health screenings, and following isolation precautions when needed. This ongoing IPAC section also helped remind me of the importance of these practices
Personal Protective Equipment (PPE): Depending on the situation, I wore gloves, a gown, a mask, and eye protection when caring for residents with suspected or confirmed infections. Wearing the right PPE helped protect both me and the residents from the spread of germs.

Looking back, I realized that no single control is enough on its own. It is the combination of all these measures that creates a safer environment for everyone. This experience reinforced how important it is to follow infection prevention practices every day, even during busy shifts.

As a nurse in a family medicine clinic, I use the hierarchy of controls every day to help prevent the spread of infectious diseases and protect both my patients and my coworkers. Elimination starts before patients even come into the office. When I answer calls or review appointments, patients are screened for symptoms such as fever, cough, sore throat, vomiting, diarrhea, or recent exposure to an infectious illness. If their concern can be managed without an in-person visit, the physician offers a telephone appointment instead. If a patient needs to be seen in the clinic but has respiratory symptoms, we ask them to wear a mask when they arrive and bring them into an examination room as quickly as possible to reduce contact with other patients. Staff members who are sick are expected to stay home until they are no longer contagious, which helps prevent illness from spreading throughout the clinic.

Substitution involves using single-use disposable supplies whenever possible to reduce the risk of cross-contamination. Throughout my shift, I use disposable gloves, syringes, needles, lancets, specimen containers, tongue depressors, and examination table paper. These items are discarded after one use instead of being cleaned and reused, which greatly reduces the risk of transmitting infections between patients. Even simple items like disposable covers on the examination table provide an extra layer of protection.

Engineering controls are built into our clinic to make the environment safer. We have alcohol-based hand sanitizer available at the entrance, reception desk, nursing station, and outside every examination room, making it easy for both staff and patients to perform hand hygiene. There is a plexiglass barrier at the reception desk to reduce exposure during patient check-in, and every examination room has a sharps container so I can safely dispose of needles immediately after giving injections or drawing blood. Biomedical waste containers are available for contaminated materials, and examination rooms are well organized to allow for effective cleaning and safe patient care.

Administrative controls are a major part of my daily responsibilities. I help screen patients by phone before appointments, asking about symptoms and determining whether they should come into the clinic or have a telephone appointment instead. When patients arrive, I reinforce hand hygiene and ensure anyone with respiratory symptoms is wearing a mask. Between every patient, I thoroughly clean and disinfect the examination room, including the examination table, blood pressure cuff, stethoscope, pulse oximeter, thermometer, otoscope, countertops, and any other equipment that was used during the visit. I also follow strict hand hygiene by cleaning my hands before and after every patient interaction, after removing gloves, and whenever I move between clean and contaminated tasks. Proper documentation, specimen handling, and following the clinic’s infection prevention and control (IPAC) policies are also essential parts of my role.

Personal protective equipment (PPE) is the final layer of protection that I use throughout my shift. I routinely wear disposable gloves when drawing blood, administering injections, performing wound care, collecting specimens, or whenever I may come into contact with blood or body fluids. I also wear a surgical mask while providing patient care, especially when assessing patients with respiratory symptoms or performing procedures that require close contact. After removing my gloves or mask, I immediately perform hand hygiene to reduce the risk of contaminating myself or other surfaces.

Working in a family medicine clinic has shown me that infection prevention relies on multiple layers of protection rather than one single measure. Although PPE is important, I have learned that screening patients before they arrive, using disposable equipment, maintaining a clean clinical environment, and consistently following infection prevention protocols are just as important. Together, these measures help create a safer environment for patients, healthcare providers, and staff while reducing the risk of healthcare-associated infections.

Reflection Activity: Hierarchy of Controls

I have seen the hierarchy of controls used during both my nursing placement in the hospital and my work as a Personal Support Worker (PSW).

Elimination: In the hospital and long-term care home, residents or patients with infectious illnesses were placed in isolation to help prevent the spread of infection.
Substitution: Safety needles and other safer medical devices were used instead of regular needles to reduce the risk of needlestick injuries.
Engineering Controls: Hand sanitizer stations, sharps containers, and mechanical lifts were available to reduce the risk of infection and prevent injuries when moving patients or residents.
Administrative Controls: Staff followed infection control policies, hand hygiene, safe lifting procedures, and medication safety guidelines. During my nursing placement and PSW work, I followed these policies and completed the required training.
Personal Protective Equipment (PPE): I wore gloves, masks, gowns, and eye protection whenever needed, especially when providing personal care or caring for patients or residents with infectious diseases.

Summary:
Working as a PSW and completing my nursing placement helped me understand how the hierarchy of controls keeps everyone safe. I learned that using safe equipment, following workplace policies, and wearing the right PPE are all important steps to prevent injuries and the spread of infection.

In my healthcare workplace, the hierarchy of controls is used every day to prevent infections and keep patients, residents, and staff safe. Elimination is used by isolating residents or patients with contagious illnesses and limiting unnecessary contact to prevent the spread of infection. Substitution includes using needleless IV systems instead of traditional needles to reduce the risk of needlestick injuries. Engineering controls include hand sanitizer stations, sharps disposal containers, and negative pressure rooms, which help minimize exposure to infectious agents. Administrative controls involve following Infection Prevention and Control (IPAC) policies, completing mandatory staff training, practicing proper hand hygiene, and following screening and cleaning procedures. Lastly, personal protective equipment (PPE), such as gloves, masks, gowns, and eye protection, provides an additional layer of protection when caring for patients. Using all five levels of the hierarchy of controls helps create a safer healthcare environment for everyone.

The hierarchy of controls in Infection Prevention and Control (IPAC) reminds me that preventing the spread of infection is a shared team responsibility that begins with each one of us. Every healthcare worker plays an important role in protecting patients, families, colleagues, and ourselves. It starts in our own hands by consistently practicing proper hand hygiene, using appropriate personal protective equipment (PPE), maintaining environmental cleanliness, and following established infection control procedures.
The hierarchy of controls is based on evidence-based practices that have been proven to reduce the risk of infection. By applying these measures consistently, we create a safer healthcare environment and strengthen a culture of safety. This reflection reminds me that effective IPAC is not the responsibility of one person alone it requires teamwork, accountability, and a commitment from everyone to follow best practices every day.

In my workplace as a PSW in a long-term care home, I saw how the hierarchy of controls helped prevent the spread of infection.

Engineering controls: Isolation rooms and hand sanitizer stations were available throughout the unit.
Administrative controls: Staff received IPAC training, followed outbreak protocols, and completed daily screening before starting work.
Personal Protective Equipment (PPE): Staff wore gloves, gowns, masks, and eye protection when caring for residents on additional precautions.

This experience reminded me that preventing the spread of infection is a shared team responsibility that starts with each of us. By practicing proper hand hygiene, wearing the correct PPE, following workplace policies, and using evidence-based IPAC practices, we can protect residents, coworkers, and ourselves while creating a safer environment for everyone. –

In my workplace as a healthcare provider in a long-term care home, I saw how the hierarchy of controls helped prevent the spread of infection.

Engineering controls: Isolation rooms and hand sanitizer stations were available throughout the unit.
Administrative controls: Staff received IPAC training, followed outbreak protocols, and completed daily screening before starting work.
Personal Protective Equipment (PPE): Staff wore gloves, gowns, masks, and eye protection when caring for residents on additional precautions.

This experience reminded me that preventing the spread of infection is a shared team responsibility that starts with each of us. By practicing proper hand hygiene, wearing the correct PPE, following workplace policies, and using evidence-based IPAC practices, we can protect residents, coworkers, and ourselves while creating a safer environment for everyone. –

At the long term care home that I currently work in, we use all levels of the hierarchy of controls to help prevent the spread of infection. Elimination includes screening for symptoms, keeping sick staff home, and isolating residents who are ill. Engineering controls include hand sanitizer stations, private or cohort rooms, and dedicated equipment for residents on additional precautions. Administrative controls include IPAC education, routine cleaning, hand hygiene audits, and following outbreak protocols. Lastly, staff wear appropriate PPE, such as gloves, gowns, masks, eye protection, and N95 respirators when required. Using all of these measures together helps keep both residents and staff safe.

Reflecting on my workplace experience, I have seen how the hierarchy of controls is used to reduce health and safety risks. The hierarchy of controls is an effective approach because it prioritizes eliminating hazards before relying on workers to protect themselves. Looking back at my experience in a retail store, I can identify examples of each level of the hierarchy and understand how they contributed to creating a safer work environment.

The first level, elimination, involves removing a hazard completely. At my workplace, damaged shelving that posed a risk of collapsing or causing products to fall was removed and replaced. By eliminating the hazard, the risk of injury to both employees and customers was removed. This demonstrated that the most effective way to manage a hazard is to remove it entirely whenever possible.

The second level is substitution, which involves replacing a hazard with a safer alternative. My workplace switched from using strong chemical cleaning products to less hazardous, environmentally friendly cleaners. This reduced employees’ exposure to harmful fumes while still allowing cleaning tasks to be completed effectively. Although the hazard was not completely eliminated, the risk was significantly reduced.

The third level is engineering controls, which isolate workers from hazards. Examples at my workplace included installing anti-slip mats in areas where water frequently accumulated and using safety guards on equipment such as cardboard balers. These controls helped reduce the likelihood of injuries without requiring employees to change their behavior.

The fourth level is administrative controls, which focus on changing the way work is performed. My employer provided regular safety training, taught proper lifting techniques, displayed wet floor signs during cleaning, and required employees to follow established safety procedures. Routine inspections and hazard reporting also encouraged employees to identify and address potential risks before accidents occurred. These measures promoted a strong safety culture throughout the workplace.

The final level is personal protective equipment (PPE). Employees were required to wear non-slip footwear to reduce the risk of slipping and gloves when handling cleaning chemicals or sharp objects. While PPE provided an important final layer of protection, I learned that it is considered the least effective control because it depends on workers consistently wearing and using the equipment correctly.

Overall, this reflection helped me recognize that workplace safety is most effective when multiple levels of the hierarchy of controls are used together. Although administrative controls and PPE were the most visible in my daily work, elimination, substitution, and engineering controls provided the greatest level of protection because they reduced hazards at their source. Understanding the hierarchy of controls has increased my appreciation for the importance of proactive hazard management and reinforced the shared responsibility of both employers and employees in maintaining a safe workplace.

As a nurse in a long-term care (LTC) home, I have observed the hierarchy of controls being applied in several ways to prevent the spread of infections.

Elimination: When a resident is suspected of having a transmissible infection, they are placed on isolation precautions and separated from other residents to minimize transmission.

Substitution: We use non-contact (forehead) thermometers instead of axillary or tympanic thermometers for residents with suspected or confirmed infections to reduce equipment contact and the risk of cross-contamination.

Engineering Controls: A dedicated infection control cart stocked with the required PPE and alcohol-based hand sanitizer is placed outside the resident’s room to facilitate proper infection control practices.

Administrative Controls: We implement the appropriate additional precautions (e.g., contact or droplet precautions), increase environmental cleaning using a sporicidal disinfectant when indicated, and post precaution signage to ensure staff and visitors follow the required infection prevention measures.

Personal Protective Equipment (PPE): Staff don the appropriate PPE, e.g., disposable gown, surgical mask and gloves, before entering the resident’s room and safely doff it before leaving to prevent the spread of infection.

These measures work together to protect residents, staff, and visitors by reducing the risk of infection transmission within the LTC home.

Elimination:
Screening patients and visitors for infectious illnesses and postponing non-urgent visits when someone has a contagious infection to prevent exposure.

Substitution:
Using safety-engineered needles instead of conventional needles to reduce the risk of needlestick injuries.

Engineering Controls:
Negative pressure isolation rooms for patients with airborne infections and point-of-care sharps containers.

Administrative Controls:
Routine IPAC education, signage for Additional Precautions, active screening, electronic isolation alerts in the chart, and policies requiring staff to stay home when ill.

Personal Protective Equipment (PPE):
Wearing gloves, gowns, surgical masks, or N95 respirators and eye protection when indicated based on the patient’s required precautions.