Infection prevention and control: Are standards being met?
Trudy, a registered nurse with 15 years of experience recently moved to a small community and is working at the long-term care facility. She arrives for a day shift and receives report that two more residents are presenting with gastrointestinal illness in addition to the four that developed symptoms 24 hours ago. She completes a morning round and assesses each of the six symptomatic residents. Given the increasing number of residents experiencing symptoms, she decides to hold a huddle with the staff. In order to prepare for the huddle, Trudy seeks out information about the infection prevention and control (IP&C) program at the facility, including any policies and procedures to manage illness outbreaks. However, she is unable to find updated information to support her.
What should Trudy do to address the lack of IP&C direction at her work place?
Trudy understands that it is her responsibility and accountability to adhere to CARNA’s Practice Standards for Regulated Members at all times. Specifically, she notes two standards that are of particular relevance to this situation including:
- Practice Standard 2.2: The nurse uses appropriate information and resources that enhance client care and the achievement of desired client outcomes
- Practice Standard 4.7: The nurse integrates infection prevention and control principles, standards and guidelines in providing care and service to protect the health and well-being of clients, staff and the public
The information Trudy presents at the huddle is to ensure that the assignment of care is appropriate for the current situation, to notify staff of the additional symptomatic residents and to reinforce precautions to be taken to prevent the spread of illness. She also notifies the residents’ physicians and their families about their status changes and works collaboratively to adjust their plan of care. Trudy is concerned that she does not have the most up-to-date IP&C information to guide her practice in dealing with the situation, and decides to contact her manager. She notifies her manager about the number of new symptomatic residents and asks her for any supporting documents to ensure they are following the most up-to-date IP&C practices. Trudy’s manager states that she has been reviewing the facility’s policies and procedures and is working towards updating the IP&C program. In the meantime, she provides Trudy with further direction to manage the situation. Upon receiving this information, Trudy takes the lead in ensuring all staff are updated with the recent direction provided by the manager.
CARNA’s Infection Prevention and Control Standards
Trudy is familiar with the documents and resources available from CARNA and knows that there are IP&C standards that nurses must comply with. She reviews CARNA’s document Infection Prevention and Control Standards, and reflects on the standards that are relevant to this situation. She identifies that she has met the following standards including:
- 1.3: identify the need for IP&C policy and question existing policy if it does not support best practice
- 2.3: consistently uses routines practices:
- perform a point of care risk assessment,
- practice the four moments of hand hygiene as outlined in theGuidelines for Hand Hygiene (CARNA 2016),
- use appropriate personal protective equipment (PPE) according to administrative controls and guidelines (e.g., gloves, gown, mask/shield/glasses/goggles),
- implement environmental infection control strategies to reduce transmission of microorganisms (e.g., sharps disposal, cleaning protocols for environment and equipment, ventilation, etc.),
- implement administrative controls such as IP&C training and required immunizations, and
- follow standards, administrative controls, and manufacturers’ guidelines related to safe use, cleaning, disinfection, and sterilization of medical devices;
- 3.1: reduce the risk of infection by maintaining IP&C best practices
- 3.5: advocate for an environment and equipment that reduces the risk of transmission of microorganisms
- 3.8: advocate for an IP&C program in their practice setting if not established
- 4.2: participate in quality improvement and innovation related to IP&C
- 4.4: Provide care and/or guidance to the client, staff, and public that have been exposed to microorganisms
- 5.2: take action when IP&C best practices are not met
- 5.4: ensure protection of themselves, the client, staff, and the public from transmission of infection
Disclaimer: Our case studies are fictional educational resources. While we strive to make the scenarios as realistic as possible, any resemblance to actual people or events is coincidental.