[John-paul]

Discussion Question: This reading discusses low compliance with IPAC practices by healthcare providers. Have you always followed IPAC practices in your workplace? What would you recommend at your current or a former workplace to ensure or increase compliance with IPAC practices?

[Melissa]

I have quickly learned that most staff understand the importance and follow IPAC protocol and guidelines, consistent infection control can be challenging especially during any outbreaks I.E COVID and recent Measles.
I do try my best to model proper IPAC practices myself, but there have been times I have not, such as hand hygiene and PPE use. This is usually due to time and being busy.
To increase compliance in clinic I would recommend:

1. Point- of – Care Risk Assessments
2. Clear visual reminders
3. Easy access to PPE
4. Dedicated isolation protocols
5. Pre -screening and triage
6. Team huddles/meetings
7. Vaccination Status
By having routine practices in place, I think this would make IPAC easier to follow, to protect staff and patients during high -risk times.

[Mauei Caela]

Hi Melissa,

You should be proud of yourself for doing your best to adhere to IPAC practices despite the challenges you may have faced. I find that when the IPAC team congratulates us for going over 80% of staff following IPAC practices, it makes us feel proud and happy, and it reminds us that we are keeping ourselves, the patients, and colleagues safe from spreading infections.

I do relate to your words very much, as heavy workloads can cause staff to skip a step to finish on time. Your recommendations are very important, and integrating them with the staff through multiple reminders, education, surveillance, and providing easy access to supplies will increase the staff’s compliance with IPAC practices. I believe that addressing staffing shortages as well will enable healthcare staff to perform tasks without rushing through them and skipping some steps.

[Esha]

Hello Melissa,

I really like the reccomendations that you provided for increasing compliance. I really like the group huddle reccomendations that you provided. At my facility, we do weekly group huddles where we speak about falls, risk mangement and also infection control as well. We speak about any mistakes that occured or if PPE was misused. There is also additional education provided as well. This is a new incentive that is always mentioned in the huddle sheet but now we often have conversations as well. I believe more education is the main way to increase compliance.

[Esha]

I usually try my best to comply with the IPAC practices and rules set out by my facility. I always ensure to clean equipment in between client uses and ensure I complete good hand hygiene no matter how demanding the day may be. I have noticed that many staff tend to have low compliance if equipment is not readily available. I would recommend more hand hygiene areas located throughout the hospital to make the task easier. I would also recommend more education provided to the staff. I find many of the older nurses have forgotten little details that can really aid in IPAC compliance. Educational pamplets or just information being provided in huddles would really enforce the idea into staffs mind.

[Mahnaz]

Hi Esha,

I like your ideas on how to ensure staff maintain compliance with IPAC measures. IPAC is definitely something we cannot just learn once and forget, it has to be enforced regularly. Your suggestion about using pamphlets and huddles is a great idea to remind the staff how important complying is. This can be done during shift changes or during team meetings.

[Rebecca]

I like your idea of better staff education about the importance of IPAC.
I found taking this course it was a great refresher on why IPAC is important in our nursing practice. Keep our clients safe in the environment that we provide for them is so important. We all need reminders of why.

[Diane]

Hello I really like the idea of pamphlets, IPAC is used daily in our workplace at times we can become complacent and take short cuts of out daily tasks at hand.
With IPAC it is good to gently reminder to staff/visitors/ families the importance of hand washing, donning doffing of PPE to help stop or continue the spread of germs.
Overall we can all play a part.

(remember education as little or as much will always benefit you, how to wash hands, PPE donning doffing)

Pre pandemic Id carry around hand wipes hand sanitizers in my vehicle, id always hand sanitize when returning to my car and as soon as i returned home id tell my family “go wash your hands”, my story, is that people would roll their eyes, lesson learned from me to my family Wah your hands!.

[Ibikemi]

Hello Esha, I agree that consistent hand hygiene and proper equipment cleaning are essential, even on busy days. Improving access to hand hygiene stations and providing ongoing education through huddles or reminders helps reinforce IPAC practices and improve overall staff compliance.

[Mauei Caela]

I previously mentioned in the Module 4 discussion question that I had to reuse the same gowns for each of my patients I was assigned to due to the low supply of gowns at that time (i.e. I have 4 patients, I have four gowns for each of them that I am reusing), which impacted my confidence and morale as a new graduate nurse.

Recently, my colleague shared her experience of breaking IPAC practices due to an emergency. In my unit, where we take care of patients on ventilators, we use this 3ml sterile normal saline (daypak) that we instill in the patient’s trach to loosen very thick secretions that make it hard to remove through suction or INEX. At that time, the attending nurse providing the INEX intervention realized that she didn’t have the daypak to loosen the patient’s secretion, and it seemed like the patient was having a mucous plug. She knows the importance of having the daypak at that time, but does not have the time to go to the clean utility room, so she ran to the next patient room and took some daypaks. Since this was reported by the nurse and advocated for the patient’s safety, the manager just started to have a checklist of important items, such as emergency ambubags, INEX tubes, Daypaks, suction catheters and their appropriate sizes based on the patient’s trach size, etc., to be initialled by night nurses during their shift to make sure that no important things are not restocked in each patient room. This was mentioned during huddles (shift meetings) and told all shift nurses to make sure to stock the rooms and communicate anything missing due to low supply or backorder. I think the checklist with the nurse’s initial will be really helpful and reduce the potential of breaking IPAC practices in emergencies.

[Mahnaz]

I do my best to follow IPAC measures at work since it is the cornerstone of nursing. I do remember in one incident I did not don gloves when I should have, since I had to apply ophthalmic drops for my client.I had thought hand hygiene was enough but it was not. It was a lesson to be learned from as my client faced the consequence of me not following proper PPE protocol. I have made it second nature to always perform hand hygiene before any task involved with the client and their environment, wiping down equipment before and after use, donning a mask in every shift, in my particular situation, and checking medication expiry dates before administration. As a community nurse I often work alone, and there is less structure compared to a hospital, especially in regards to IPAC measures. To maintain compliance with infection measures I would recommend having a set of PPE always in stock at the home or a portable PPE kit with me at all times. I would also encourage family caregivers to get educated on proper handwashing, how to maintain a clean care area and when to wear gloves. By empowering family members with this sort of knowledge, the chances of staying consistent in IPAC culture will be high.

[Rebecca]

I do my best to follow IPAC practices. I know that occasionally I do not use alcohol based hand rub as much as I should.
After completing this course I realize how important the most basic IPAC practice hand hygiene is to keeping clients and co-workers safe.
I would recommend a peer audit of hand hygiene. A peer audit maybe less intimidating and be gentle reminder that as busy as we are as nurses hand hygiene is important.

[Megan]

I try to continue to remember to use sanitizer especially between client rooms and visits, but the PPE when going into an isolation room, especially during night shifts, I sometimes forget to wear it, but one thing for sure I would appreciate the reminder, like a peer-to-peer audit and just to watch to have the reminder of the wearing of PPE even if its just to check the client’s.

[Diane]

Hello all,
As RPN in LTC/CCP with 20-27 clients, 4 PSW’s I work hard to monitor everyone on my medication pass and rely on staff to report any new changes in clients on day to day.
I feel as a team we do really well with all IPAC, at times due to amount of clients/staff/visitors I reiterate IPAC measures such as proper use of PPE, if feeling unwell at stay at home, hand washing etc.
In the event that there is a change in health status I side of caution and review all IPAC practices in our facility, I inform charge nurse, ensure that staff are up to date on clients concerns, a client may stay on isolation until S/S have been noted and ensure no other concerns.
Due to many clients, staff, families I need to closely monitor those around me when staff are entering in and out of rooms and simple reminder of donning and washing hands. I feel with this course has helped me with being more vigilante and understanding process that our facility as implemented.

[Katrine]

In my work place I have often observed PSW’s not consistently following IPAC practices, particularly during busy shifts. Compliance with IPAC needs to be a shared responsibility and reinforced across all roles, not placed on one individual or group. Improving compliance starts with consistent expectations, education, role-modeling by all staff, and leadership support to ensure IPAC practices are followed as part of everyday care.

[Ibikemi]

I believe IPAC practices are well established everywhere health care is involved, but compliance is the key in any organization. The consistency in hand hygiene and use of PPE is not always there.
In my experience, time pressures at LTC, workload, and complacency can lead to lapses, even when staff are aware of the guidelines. Some PSWs will not wear complete PPE and will continue with care. Some will say the resident has been in isolation for 4/5 days, so there is no point in wearing full PPE.
As a Nurse I feel we should continue correcting them, and anyone flaunting this rule should be reported. As a nurse, I have made efforts to follow IPAC practices consistently, but I have also observed variability among healthcare providers, especially PSWs with long years of service in a facility, and when I report, the management will do nothing.
I asked my DOC if a particular PSW has a “share,” because no matter how you report this staff, nothing will be done.
To achieve/improve compliance, I would recommend ongoing education and reminders, auditing of hand hygiene and PPE with feedback every day, not just weekly.
Lastly, creating a supportive culture that prioritizes patient and staff safety can improve adherence to IPAC practices.

[Svetlana]

Low compliance with IPAC practice can increase healthcare-associated infection, outbreak, staff illness. From my point of view, not only education helps with improving compliance with IPAC practice but also IPAC lead support with easy access to supplies such as hand sanitizers, PPE, providing audit and feedback( regular hand hygiene audits, PPE compliance monitoring), updating IPAC policies that align with public health guidelines. All these strategies can help us to increase compliance with IPAC practice.

[Adeyemi]

Hello Svetlana, I agree with you that low compliance with IPAC practice can lead to an increase in healthcare-associated infection among residents and staff. I strive to always practice hand hygiene before and after resident contact at my place of work but at times things can become so hectic that I forget to do so. I believe that regular audits of compliance by staff combined with education can lead to improvements in adherence to IPAC practice in the workplace.

[Jessica-lyn]

In all honestly, When I first started nursing I didn’t follow IPAC as well as I should have. No seeing over the years how important it is, i try my hardest to ensure I am always following it. Though none is perfect. Really following our point of care risk assessments and following our PPE. Our practices are great, but compliance is a huge issue. So i like to make sure to mention hand hygiene often and educate when i need to!

[Diane]

Jessica Lynn, At first I also couldn’t understand and didn’t follow all the hype of IPAC/precautions, i felt it was wasting time, but over the years I’ve learned the why’s and how of PPE, I’ve been able to explain to my family the importance of handwashing and how germs are spread. Thank you for your post!

[Sheila]

In my practice, I make a conscious effort to consistently follow IPAC guidelines, including proper hand hygiene, appropriate PPE use, and equipment disinfection. However, I recognize that factors such as time constraints and workload pressures can sometimes challenge consistent compliance across healthcare settings.
To increase compliance, I would recommend regular refresher training, visible reminders (e.g., signage and sanitizer placement), routine audits with constructive feedback, and ensuring easy access to PPE and cleaning supplies. Promoting a culture of accountability and safety, where staff feel supported rather than penalized, can also significantly improve adherence to IPAC practices.

[Author]

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