[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):

[Leah]

A time that I recall not following IPAC practices is back during covid times before I was a nurse, when I was working in a long term care facility as a PSW.
The unit I was covering at a time had over 16 residents that were isolated with the coronavirus. It was busy, short staffed, and we all were trying to help each other to ensure quality level care to all of the residents.
I remember specifically, the nurse on duty came and got me reporting requesting help, as one of the isolated residents had fallen on the floor. My colleague and I scrambled to get the poor lady off the floor,having a hard time prioritizing gowning up, while hearing this poor lady scream. My co-worker couldn’t bear making the poor woman wait any longer, and entered the room with only a mask on. I followed behind her with the same attire.

There are always negative outcomes when not following proper IPAC precautions. My colleague and I both ended up testing COVID + a week later. Whether it was from this time or not, it has always reminded me of the importance of proper PPE, despite the feeling of “not having time.” It protects both yourself, AND the patient. It was a huge learning opportunity for us both.

[Emma]

Hello Leah, I can definitely relate to the experience you shared in your post! I have also found myself in similar situations. There have been many times when I was working as a PSW, or even now as a nurse, when I am stuck outside an isolated room trying to don PPE as fast as I can, meanwhile there is a person inside the room needing urgent help, either because of a fall or because they need to use the restroom ect.

It can be very stressful working short-staffed during these outbreak situations, especially when you feel like you are running out of time to help everybody. But you are 100% right that PPE protects both the patient and ourselves. I also think about the negative consequences of staff members becoming sick from not using PPE. The more staff that have to call off sick, the more often shifts are working short-staffed, leading to increased stress and workload, potentially causing people to skip on PPE due to feeling like they don’t have time.

[Nadia]

Hi Leah,
I so agree with “There are always negative outcomes when not following proper IPAC precautions” when I worked a PSW this was always a challenge for most when working under staff and was very frustrating for some staff since we all knew someone will be impacted. This is why also try to ensure that I am following the appropriate IPAC practice at all time to ensure the safety of everyone.

[Tammy]

Once during an outbreak, I was on my rounds to give meds. I walked into the resident’s room whom I was informed was not feeling well. I thought I’d just hand her the medication quickly and did not wear a mask or gloves. As I handed over the prepared cup of tablets, the resident vomited into a waste basket. Another colleauge took over so that I could continue my rounds. I did end-up sick the very next day. The mode of transportation was likely airborne and I could have helped by following the IPAC precautions.

[Leah]

I enjoyed reading your reflection this week Tammy. As a nurse, I have been in the similar situations as you described. It’s not uncommon for healthcare workers to think that since we are just going in for a short time that we will not affected by the “suspected” or undiagnosed pathogen.
As your reflection stated, following IPAC precautions could have helped and prevented you from being affected by airborne virus. From this weeks introduction readings, we can acknowledge that for the patients safety and our own, it is always important to follow IPAC precautions, and if we are not sure, to ask for clarification to ensure proper precautions.

[Sara]

I completely agree with your statement Tammy,

I have worked in LTC and as well as the community and I often find it more easy to follow IPAC guidelines in the community setting as it is more relaxed. We have 1-2 clients at a time in the community and we ensure we always have spare PPE with us for our shift, where as LTC we are responsible for 20-30 residents and as well as supervising our care team. I have observed multiple times when healthcare members will not don/doff inbetween residents and then they end up calling in sick the following days. It was especially worse during the COVID outbreak when supplies were limited. The pandemic was really an eye opener to see how easily sicknesses can spread in my personal life and as well as at work.

[Sophia]

Hi Nadia, this is similar to my story except I was in a retirement home and we ended up in outbreak because of the same type of thing and then also short staffed because we had a few people that ended up off due to illness so I get it trying to run in quickly to get your med pass done, but in the long run, it was not worth it for all of the travel and discomfort caused our resident our families and staff. It’s always better to just take the time and put on the PPEs

[Tammy]

Thanks Leah, I agree IPAC precautions are always needed! I enjoyed reading the reality of your story. Working during the coronavirus outbreak really challenged us. Modeling is such a powerful example, and when an emergency confronts us we tend to react similarily to those around us. With routine IPAC practices we can build better habits.

[Emma]

When I first started working in Long term care I was working during a respiratory outbreak as a PSW. I remember walking down the hallway when I noticed a colleague entre an isolated room only wearing a surgical mask. At the time the resident required contact droplet precautions. After my co worker left the residents room I was able to remind them that the resident was on isolation precautions and pointed out that they had not worn the appropriate PPE.

My co worker and I ended up discussing the risks involved with not wearing the appropriate PPE. we talked about how important it is to prevent the spread of infection from one resident to another, to help ensure residents safety. But we also discussed the importance of protecting ourselves as healthcare providers by wearing the proper PPE when entering an isolation room. we discussed how with the care we provide we end up coming in very close contact with the residents so if we are not wearing PPE there is a possibility the we could also get sick.

My coworker and I ended up having a really good conversation about IPAC. Instead of making my coworker feel judged, we were able to have a productive conversation. I learned that they were feeling overwhelmed and rushed at the time, which contributed to them skipping some of the required precautions. This allowed me to provide more support to my coworker while also helping to ensure the safety of both residents and staff.

[Sara]

During my Level 3 nursing placement, I was caring for a resident who was positive for C. difficile on an inpatient unit. I found that he had pulled out his catheter and was having multiple loose bowel movements, so I used the call bell to call a colleague for help. When she arrived, there was not enough PPE available on the isolation cart outside the room. Wanting to provide immediate care and keep the resident safe, she assisted me without fully donning the required PPE. I remember her always looking at the door hoping the preceptor did not walk by!

At the time, it felt like the right thing to do because the resident needed urgent assistance. However, my colleague ended up putting herself and the other residents at risk as C. difficile spores can spread easily through any amount of contact!

It is so important to always restock PPE whenever you possibly can in all environments.

[Christianne]

I agree Sara that both the community and hospital/facilty settings are quite different in pace.

Having worked myself on a Med-Surg floor for a time and Community settings. Evidence shows clients at close quarters of each other in a facility vs community setting where you travel greater distances inbween patients can drastically change risk potential.

This giving community nurses often an easier time often to doff PPE and exercise thorough hand hygeine in between patients.

[Christianne]

I remember a time in my training at a med-surg placement there was a fraile elderly patient who was a high risk for falls.

They were on percausions I did not see when entering the room. Was in the hall with a co-worker and thier room door was open. We saw them ambulating to the end of the bed leaning on the bed.

This wasn’t my patient but we went in and assisted. Another staff member saw us assisting and informed us they were on percausions. We of course ensured patients safety and of course hand hygeine before exiting room and reviewing precausions.

Nothing came from this which was a releif and noticed the precausion posters wernet on the door yet as this was a new order.

It had shown me how quick things can change and happen.

[Nadia]

The first time I worked as a PSW at a long term care home facility was very interesting since this was during COVID and there was 30 residents per a floor. During this time we worked shorted of staff and needed to use PPE for resident who were under isolation for COVID. However, I notice some staff were not following the appropriate IPAC practices. Some PSW excuse were because they were short of staff and needed to get to the other resident and they were behind time already. Therefore , skipping the appropriate IPAC practices made worked faster. Due to this a lot more resident were infected with covid and also staff were impacted. This experience thought me that appropriate IPAC practice is proof of breaking the chain of infection disease. Also by educating each other of the importance of following appropriate IPAC practices creates safe environment for Staff and Residents.

[Sophia]

Sophie

A staff member on my unit was rushing in and out of rooms during med pass and wasn’t fully washing their hands between clients. One client had respiratory symptoms and was already on isolation, but the lapse in hand hygiene and precautions likely spread the illness. As a result, several more clients ended up on isolation. The staff member also became ill and was off work for several days.

[Author]

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