In my current workplace, we use different levels of the hierarchy of controls together to prevent and control the spread of infections. As a bedside nurse, PPE is the one I use most frequently. However, I learned that PPE is actually one of the last levels of control, and there are other types of controls that we need to focus on as well.

For example, things like isolation rooms, different types of isolation signs, clear PPE requirements, PPE carts placed outside the patient’s room, sharps containers in the room, alerts in the system, IPAC team follow-up orders, and swabs can all help reduce the risk before healthcare workers are exposed.

I see these signs, equipment, and procedures naturally in my daily work as a bedside nurse, but I did not really think about the importance behind them until I learned about the hierarchy of controls. Now, I have a better understanding of why we use all these measures together instead of relying only on PPE.

This helped me realize that infection prevention is a shared approach, where different levels of controls work together to reduce the risk and protect both patients and healthcare workers.

I have enjoyed this module as it makes me think beyond the bedside nursing I do and the not so visible team behind the field of health and safety.

The WHO, Health Canada , Ontario Health to name a few of many.

Reflecting on where they fall on the Hierachy of Conrols is an intiguing reflection.

At my place of work in the community we follow stricked self screening before each shift. Staff are removed from shift if risk of illness/disease is pressent as the care provider. (Elimination).

Our line of work is sensative to many immunocompromised . (Substitution) of staff. Picking up shifts or filling in for one is part of the job.

We have numerious clients over the years in my job who have or had a Cleo 90 or a variant of it as part of thier care plan. A neet device. Each staff also has our own personal supplies of Alcohol based sanitzers from our office. (Enginering Control).

Each year as part of our performance reviews we review new policies, IPAC donning and doffing. And have a health and safety commitiee, IPAC committee, newsletters and more. Always having open doors to us at the office to pick up supplies as well. (Adminastrative control).

More on the open door with the office, being a community nurse we are often out in the field. With that said we are always greeted with flexible options to pick up more supplies from the office including PPE. (PPE).

In my workplace, we use the hierarchy of controls measures to prevent injuries r/t lifting and transferring the residents

1. Elimination: Having a ‘no lift policy’ in place eliminates the need for me to manually lift my residents. Instead, my co workers and I have to use the appropriate lifts and assistance which eliminates the hazard of manual lifting.

2. Substitution: At my workplace, staff can move up a level of transfer equipment when needed for safety. We will collaborate with physio, and substitute the current method of transfer to a safer option (like a Sara lift to a Maxi lift ) if it’s determined more appropriate.

3. Engineering Controls: Such as, the way I use the mechanical lifts, adjust the bed height as well as the ceiling lift controls to reduce physical strain on myself

4. Administrative controls: My work provides many education days for us which reviews proper lifting and transferring techniques, and reviews the policies in place. Audits and mobility assessments are also completed to ensure appropriate MOT.

5. PPE: For this specific example, appropriate PPE such as non sip footwear is a huge aid in reducing risk of falls and protects me while performing my job duties.