[John-paul]

Think of a time you or a colleague did not follow IPAC practices. Discuss the situation and potential negative outcomes for clients related to not following the appropriate IPAC practices. (post your answer in the discussion below):

[Catherine]

Hello everyone!

My name is Catherine Van Veen, RPN, BPH and I am a Professional Practice Associate at WeRPN, and the facilitator of your course. I am looking forward to connecting with you all as we move through each week’s modules.

Remember that each week you will engage with the posted learning materials and then post your answer to the discussion question. Additionally, you are required to respond to a colleague’s post. Meaningful engagement with both the content and your peers helps to create a more dynamic and valuable learning experience for us all!

I will be checking in throughout the week, but should you need any assistance, please do not hesitate to reach out to me at cvanveen@werpn.com.

Warm Regards,

Catherine

[Ochuko Bridget]

During one of my placements in a GTA hospital, I experienced a situation that showed me how important Infection Prevention and Control practices are in real life.
There was a time when, due to space constraints, two patients who were both on droplet and contact precautions were placed in the same room. On top of that, one of the patients kept being moved from one room to another, not just because of bed shortages, but also due to family dynamics and requests. At the time, it felt like staff were trying to manage a difficult situation and make things work, but looking back, it wasn’t the safest approach.
Because of all the movement and inconsistent isolation practices, there were lapses in things like proper PPE use and thorough cleaning of the rooms and beds between transfers. This created more opportunities for germs to spread. Unfortunately, not long after, two other patients on the unit tested positive for MRSA.
Seeing that happen made it very real for me. It wasn’t just a policy not followed. It had direct consequences for other patients. Those patients had to deal with additional treatment, longer hospital stays, and more isolation, which was stressful and uncomfortable for them and their families. It also increased the risk for other vulnerable patients on the unit.
This experience honestly stuck with me because it showed how small decisions, like moving a patient multiple times or cohorting without fully considering risks, can have a ripple effect. Even when things get busy or complicated, sticking to IPAC practices is critical to keeping everyone safe.

[Melissa]

Hi Bridget, I also remember situations when doing my med/surg placement where various patients on different isolation precautions were frequently moved from one room to another. Although it can sometimes be out of the hospital’s control, it is an unsafe practice that can cause many risk factors for the patient, healthcare workers, or visitors. For example, there is a chance that when a patient goes to a new room, proper isolation protocols get missed, resulting in healthcare workers or visitors not wearing the required PPE and possibly contaminating themselves and spreading the infection. This was a great reflection of how important infection prevention and control practices are in healthcare settings. ~Melissa

[Amanda]

Hi Ochuko,

I can appreciate your experience, as I don’t necessarily find it uncommon and can think of a few instances where that has happened on the unit I work on. It shows how easy it can be for errors to occur when there are extra pressures whether it’s space or time constraints. I also think it highlights the importance of advocacy and how these experiences can shape our nursing practice for the better. Lastly, it reinforces and connects the principle of nonmaleficience which is ultimately ingrained in IPAC standards. Following IPAC standards is ultimately about upholding our ethical responsibility to do no harm and keep patients safe.

[Melissa]

Hello, my name is Melissa. I currently work in a long-term care facility, supporting residents with their activities of daily living, who also live with some form of dementia. In which, due to being in close contact with multiple residents of varying ages and diseases, I need to maintain consistent hand hygiene to prevent the transmission of microorganisms.

I remember a time when a resident acquired C. difficile while hospitalized, and when she returned from the hospital, she was placed on contact precautions. A staff member, after providing personal care for this resident, used an alcohol-based hand sanitizer to wash their hands instead of soap and water. I watched to see if they would go to the sink to wash their hands with soap and water, but they went into another resident’s room to assist with personal care. Although this staff member used an alcohol-based sanitizer again before putting on a clean pair of gloves, I have learned that when hands are not washed with soap and water after providing care to a resident with C. difficile, the hands remain contaminated. The negative outcome of this situation is that this staff member could have spread the infection to the other resident, because C. difficile will remain on their hands until they wash their hands with soap and water. More importantly, this situation could have led to multiple residents acquiring the infection, resulting in a unit-wide outbreak and possible resident harm.

[Caroline]

Hi Melissa,

You have mentioned a situation that I have also seen. Sometimes people feel that the PPE is enough, and forget to to follow all the steps in order to break the chain of infection. I also think that sometimes people forget that an alcohol based sanitizer is not enough. Possibly providing a reminder to this colleague about the importance of had washing with soap and water for patients on precautions with C.Difficile. Maybe this colleague needs a refresher as to why the alcohol based hand rub is not enough in this situation.

[Catherine]

Hi Melissa, and Ochuko,
You both have touched on how the IPAC decisions we make during care can impact patients. Especially when busy, it is important to remember that IPAC policies need to be adhered to for the safety of patients, staff and visitors. Melissa, you commented that poor practice led to a near-miss, and Ochuko unfortunately recalled an instance where there was spread of illness on the floor. Your insights are going to allow you take a lot from the upcoming content. I am looking forward to reading your reflections moving forward!

[Amanda]

Hello, my name is Amanda and I work in pediatrics. I can recall a time recently where a student was doing their placement on the unit and I had witnessed them doffing the PPE correctly however they did not perform proper hand hygiene – neither alcohol based sanitizer or washing their hands. The student had appeared to be getting ready to chart on the computer just outside of the patient’s room. I reminded the student the importance of proper hand hygiene, particularly as this patient was on contact precautions. Potential negative outcomes if I had not intervened was the increased risk of transmission as another nurse could have touched that computer and touched another patient. Overall, it puts the nurse and all the patients on the unit at an increased risk.

[Caroline]

Hello, my name is Caroline.

In my practice I have unfortunately seen several circumstances where IPAC practices were not accurately followed. One such example is of a high falls risk patient. An acutely confused/delirious patient experiencing an infection, is unaware of their surroundings, may have a Foley catheter in place, may be connected to oxygen, may have IV fluids running, and they are trying to climb out of their bed or stretcher. Often a patient in this situation may be on droplet contact precautions due to pneumonia. However, if the patient is on the edge of the bed, about to pull out any of the tubing attached to them and about to fall, sometimes a nurse or a PSW may run into the room to catch the patient. Sometimes the extra few minutes of applying proper PPE is what leads to a patient falling to the floor.

Not applying the proper PPE prior to entering a patients room puts yourself at risk. You then enter another patients room, and can still transmit infections. Wearing the proper PPE protects yourself and others. A gown protects your arms and clothing so that when you enter another patients room you are clean. A mask and face shield protect yourself, but also protect others.

[Renee]

My name is Renee Johnson, during one of my clinical placements, I observed a situation where proper Infection Prevention and Control practices were not fully followed. A staff member provided care to resident and did not perform hand hygiene immediately after removing gloves. They proceeded to touch equipment before sanitizing their hands.

The situation is concerning because gloves are not a substitute for hand hygiene. Microorganism can still contaminate hands during glove removal , and skipping hand hygiene increase the risk of transmitting infections. Potential negative outcomes for clients include the spread of health associated infection, especially in vulnerable population such as elderly residents or those with weakened immune system. This could lead to complications like respiratory infection, urinary tract infection, or even outbreak within the facility.

[Yetunde]

My name is Yetunde. While I was on clinical placement, I saw a colleague go into a patient’s room on contact precautions to quickly drop off a cup of water. They only wore gloves and didn’t put on a gown, even though the room required both. I actually told them they also needed a gown, but they said it was just a quick task. The clinical preceptor then noticed and stepped in, reminding them that full contact precautions have to be followed no matter how fast the task is. She also pointed out that what seems quick can easily turn into a longer interaction once you’re in the room.

This made me realize how easy it is to downplay IPAC steps when things feel rushed, Not following IPAC practices like this can put patients at risk because microorganisms can be carried on clothing or equipment out of the room. This can lead to the spread of infection to other patients, staff, or surfaces.

[Author]

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