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Tip of the week: Ensure your infection control training is up to par

Residency Program Connection, September 15, 2009

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Health officials are already warning that this winter’s flu season will be severe largely due to the highly contagious H1N1 virus. It is imperative that residents receive robust infection control (IC) training and comply with all rules. Consider implementing the following tips to keep residents safe:

• Monitor compliance. Despite the significant amount of IC training residents receive, reaching compliance is a major challenge. For example, residents understand the importance of hand hygiene, but it is difficult to get them to put it to practice consistently. Tackle this problem by enlisting IC department employees, nurse managers, and unit receptionists to monitor the ward and report residents or veterans who violate hand-hygiene procedures. When a breach occurs, the observer should intervene and correct the resident. If the monitor does not feel comfortable intervening, he or she should report the issue to an attending physician who then speaks with the resident. When noncompliance becomes a chronic problem, the information is relayed to the resident’s immediate supervisor and then up the chain of command to the program director.
• Know personal protective equipment (PPE) inside and out. Residents sometimes become lax about wearing PPE because putting it on and discarding it can be an arduous process that adds several minutes to seeing a patient. Instructing residents on the proper way to wear gloves and gowns is critical, and involving program leadership in the training will make the lesson resonate more with residents.
• Teach proactive isolation precautions. Another challenge is teaching residents the importance of taking precautions and isolating a patient. For example, residents often wait for lab work to come back before isolating a patient, but it may be too late to prevent exposure. Tell residents to isolate patients based on their symptoms rather than wait for empirical evidence. By looking at symptoms and taking proper precautions early on, residents can prevent transmission of the disease to others.
• Teach residents to take care of themselves. Residents who feel ill are in a difficult situation. Not only do residents hate missing time away from the program, they may feel pressure from fellow residents to avoid missing work because the other residents would have to cover for them. However, it is crucial that ill residents stay home, and programs need to convey that message during training. Ask a supervisor—a chief resident or program director—at the training session so residents know that leadership is behind the policy.

This week’s tip is from the monthly newsletter Residency Program Alert, published by HCPro, Inc.

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