Infection Prevention
When do we perform hand hygiene?
1) Start of session
2) End of a session
3) When entering/leaving a room
4) When hands are noticeably soiled
5) After using the restroom
6) Before/after eating
Name some common sharps that are used in our setting and describe how they are safely stored and/or disposed of
Scissors, tweezers, dry needles, etc.
- Stored out of reach or in a locked cabinet for security
- Disposed of in the wall mounted sharps containers
Where can our patients find information on their rights and responsibilities?
In the waiting room across from the front office desks
Where you can you locate our quality goals within the department?
The tracking board opposite the huddle board
Name some tips for responding to a surveyor
1) Relax, take a deep breath, you will be great!
2) Be polite and courteous, clear and positive
3) Answer ONLY the question that was asked
4) Don't guess
5) Ask for clarification if needed
What is the intended use and "wet contact time" for each of our wipes (Grey, Orange, Purple, Red, White)?
1) Grey - used for cleaning toys and equipment in patient care areas; wet contact time = 3 minutes
2) Orange - used for cleaning toys/equipment that have contacted a patient with C-Diff or other GI infection, contains bleach so needs to be rinsed off afterwords if contacting food; wet contact time = 4 minutes
3) Purple - used for cleaning the outside of WOWs (NOT screen)/hard non-porous equipment, contains alcohol; wet contact time = 2 minutes
4) Red - food safe, used for items that may contact food; wet contact time = 1 minute
5) White - used for cleaning of touch screens; wet contact time not specified = dry time
Bonus: Grab the appropriate cleaning wipe and demonstrate the cleaning process for a toy that contacted a patient without any known GI infections
How do we store human milk?
Trick question! In this setting, we don't!
What consents/paperwork are needed at a patient's initial appointment?
1) Admission consent/consent to treat
2) Parent guideline
3) Financial Consent
4) Applicable case history
What are some of Children's National Patient Safety Goals?
1) Identify patients correctly (use at least 2 patient identifiers - bonus: what are our preferred outpatient identifiers?)
2) Prevent infection with good hand hygiene
3) Reduce the risk for suicide
What do you do if you don't know the answer to a question?
1) Don't guess
2) Use your resources: other staff, Sharepoint, badge buddies, pocket pal, physical resources in the clinic
3) Walk them to the location where you can find the information so you don't mis-speak
Tell me or show me what our infection prevention policy says about TheraPutty.
Policy RHB 014
1) Inspect skin prior to use
2) Perform hand hygiene before and after
3) Once used, putty is placed in a sealed bag or container and labeled with the patient's name
What do we use our biohazard bags for? How do you dispose of it to prevent contamination of nearby areas?
Items heavily saturated with blood, urine, feces, or other infection bodily fluids
Bring biohazard bag to the contaminated item(s) (do not carry contaminated item(s) to the biohazard bag
What are special considerations for patients over 18?
Patient needs to sign their own consents; if unable to sign, it needs to be documented why.
Patient needs to complete the advanced directive questionnaire. If they have an advanced directive, we need to request a copy. If they do not have it with them, we need to document "document not available during registration, patient will provide later." If they do not have one, patient offered additional information regarding advanced directives (teaching sheet given if desired)
What are our Rehab department wide quality goals?
1) Fall prevention - appropriately identify patients at risk for falls and take appropriate precautions
2) Improve patient experience - patient satisfaction surveys
3) Process improvement - standardize description of food textures and drink thicknesses to improve safety for individuals with swallowing difficulties - implement IDSSI
What are the 4 As in regard to surveyors?
Surveyors can…
• Go Anywhere
• at Anytime and
• ask Anyone
• Anything.
How and when do we clean fabric items? What other precautions do we take when utilizing cloth/or other porous items?
Cleaned per the Manufacturer's Instructions For Use (MIFU - can look it up in oneSOURCE); cleaned/laundered when visibly soiled and a log is kept documenting when items were cleaned
Hand hygiene before and after; barrier placed between patient and item when able; oxyvir spray between patients
What types of items can be stored in hallways?
Emergency medical equipment only (no WOWs or other equipment)
How to we protect patient information?
- Privacy screens and screen savers
- Discuss patients in private
- Secure any information containing PHI
- Double check that communications containing PHI are routed appropriately
Name some Error Prevention tools we use routinely
Use your Badge Buddy!
1) Know my team
2) Team member checking
3) S.T.A.R.
4) SBAR communication
If you encounter a surveyor when you are busy with patient care, what should you do?
Provide an alternate time to meet with them. Do not say that you do not have time to talk to them.
Example: "I'm so sorry, but I'm with a patient right now. I'm free at 12:00, could we meet then?"
How do we clean and store transducer heads? Who can demonstrate? Do we use these for "critical procedures?"
RHB 014 (Infection Prevention)
Gel is wiped off immediately following treatment and ultrasound head is cleaned with a germicidal or alcohol wipe.
The clean probe is bagged between patient use; if the bag becomes compromised (torn, soiled, etc.), the probe is cleaned again using a germicidal or alcohol wipe and the bag replaced.
In the next 3 minutes, round in the nearby area with your team and find as many things as you can that may be out of compliance. Take photos.
What did you find?
When do we utilize an interpreter? What information needs to be documented when using an interpreter?
Any time patient's preferred language isn't English
Documentation for use of an interpreter includes:
• Live: interpreter’s name
• Telephone/Video: interpreter’s ID number
You come across a piece of equipment that is broken/not working. What do you do?
Mark it as "Broken, do not use"
Contact appropriate support service for repair/replacement (HTM for patient related equipment, facilities/engineering for building/non-patient care items)
What are some key words or phrases to AVOID using when speaking to a surveyor?
• "I don't know"
• "I think..."
• Absolutes or indefinites like “usually,” “always,” “never” and “sometimes”