How to Teach Staff to Think Like an Infection Control Preventionist

Infection prevention education in long-term care can take many forms, from annual in-services to policy reviews and required competencies. While these are all important, they do not always indicate that staff feel confident in identifying infection prevention concerns in day-to-day resident care. Staff may understand infection prevention principles in theory while still struggling to identify risks as they occur during daily resident care.

Environmental infection prevention rounds frequently reveal recurring concerns involving hand hygiene, isolation practices, equipment storage, environmental cleaning, urinary catheter management, medication security, treatment supplies, and contamination risks. However, repeated findings can create a persistent challenge for infection preventionists (IPs): How can staff move beyond passive education and begin identifying concerns through the lens of infection prevention?

At a skilled nursing facility in New Jersey, a photo-based educational initiative titled “Be the IP” was developed as part of a 2-week interdisciplinary infection prevention skills fair involving approximately 200 staff members. The purpose of this activity was to encourage frontline staff to become active observers rather than passive learners by thinking like an IP.

Instead of relying solely on lectures or written competencies, staff were shown photographs taken during infection prevention rounds across the facility. They were asked to look at each picture and explain what was wrong, why it was a problem, what risk it could pose to the residents, and what should have been done differently. Depending on the situation, discussions also included possible survey implications and related F-tags.

For example, some staff shared that clean linen was being stored in resident rooms because there was not enough linen available on the floor or not enough

linen carts for the number of staff working. Other staff shared that they knew supplies were needed but were not always sure where to get them if they were not already stocked in the unit.

Instead of focusing solely on what was wrong in the pictures, the staff explained why some of these issues were occurring. In some situations, changes were made based on staff feedback. For example, linen levels on the units increased, more linen carts were purchased, and designated storage areas were created for clean supplies and shared equipment when not in use.

Environmental and Equipment Storage Concerns

A common concern identified during rounds involved equipment and supply storage. Linen carts were often left in the hallways, and this became a problem because residents could not always safely use the handrails when walking. Wheelchairs, Hoyer lifts, and standing scales were also being found in shower rooms or bathrooms. When staff were asked about it, many explained they did not have another place to put these items when they were not being used.

After talking through the problem with staff, one change involved using day rooms that were no longer in use. These rooms were cleaned out and turned into storage areas. One side was used for equipment such as wheelchairs, Hoyer lifts, and scales, while the other side was used for clean supplies, linen carts, and ready-to-go isolation supplies.

Urinary Catheter and Privacy Concerns

Urinary catheter concerns were also commonly identified during rounds. Some residents using wheelchairs still had bedside drainage bags attached instead of leg bags, catheter bags were occasionally found resting on the floor, and privacy covers were sometimes missing.

During the discussion, some staff explained they did not always know where extra supplies were located, especially if the item was not stocked in their unit. As a result, additional education was provided on catheter care, privacy practices, and where to obtain necessary supplies.

Food Storage and Resident Hoarding

Food being stored in resident rooms came up more often than expected, especially on units caring for residents with dementia. During rounds, milk, juice, yogurt, and other food items were found left in resident rooms after meal trays had already been picked up.

When staff were asked about this, many explained that residents often wanted to save items from their trays. What staff did not always realize was that certain foods should not be left at room temperature for long periods. This led to additional education with both staff and residents about food safety.

Additional Nursing Findings and Isolation Education

Nursing-related concerns also arose frequently during the activity. One of the biggest issues involved medication carts. During rounds, medication carts were sometimes left unlocked, medications were found sitting on top of the carts, and computer screens were not always put on privacy lock when nurses stepped away. Coffee cups, soda bottles, and other drinks were found on carts throughout the building.

Treatment supplies were another area that frequently came up. During rounds, wound care supplies, creams, powders, and medicated products were sometimes found left at the bedside or stored in resident drawers. In some situations, wound care supplies had already been opened or set up ahead of time.

Isolation Education and Common Misunderstandings

Isolation education also became a large part of the skills fair. One station included laminated isolation signs placed on a Velcro board. Staff were presented with different infection scenarios and asked to place the appropriate isolation sign. Examples included COVID-19, influenza, MRSA, C. diff, and gastrointestinal illnesses such as norovirus.

During these activities, a few patterns began to emerge. One common issue was confusion between isolation precautions for influenza vs COVID-19. Another area staff struggled with involved gastrointestinal illnesses, especially understanding when soap and water should be used instead of alcohol-based hand sanitizer for illnesses like C. diff and norovirus.

After the skills fair, fewer repeat findings were noticed during infection prevention rounds. Because some concerns were more common among newer staff, parts of the education were added to new employee orientation so staff could review common infection prevention concerns before starting work on the units independently.

Staff Engagement and Unexpected Benefits

One thing that was not expected was how much the staff enjoyed the activity. The photographs used during “Be the IP” had been collected over about a month of infection prevention rounds across all units and shifts. Care was taken to avoid any HIPAA concerns, and no room numbers, resident identifiers, or staff names were included in any of the pictures.

Even without identifiers, staff often recognized the situations shown in the photos. It was not unusual to hear comments such as, “That’s my cart,” “That’s my unit,” or “When did you even take that picture?” Staff often joked that the IPs must have been a “ninja” because many did not realize pictures had been taken during rounds. The activity generated a lot of laughter and discussion among staff while maintaining the focus on infection prevention.

At times, staff became defensive, especially when discussing concerns that happened often in the units. Instead of focusing on blame, conversations focused on understanding why things were happening. Staff were encouraged to explain barriers they were facing, and discussions often centered around, “Help me understand so we can fix it.”

Practical Takeaways for Other Facilities

One thing this activity showed was that infection prevention education does not always have to be done through lectures or written competencies alone. Staff responded well to using real situations that had happened in the building. Because the pictures came from their own work environment, staff were often more interested in the discussion and more willing to talk openly about what was happening.

For facilities wanting to try something similar, one thing that helped was collecting pictures over time from different units and shifts. Because real pictures were being used, care was taken to avoid resident information or anything that could identify a resident. Staff also seemed more willing to talk openly when they understood the goal was education and problem-solving, not getting anyone in trouble.

In the end, the activity became more than just education. Staff were able to identify concerns, discuss why they were happening, and develop ideas to improve things moving forward. More importantly, the activity helped staff start viewing infection prevention concerns differently and encouraged them to think more like an IP in day-to-day resident care.

References

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2. Centers for Disease Control and Prevention (CDC). Standard Precautions for All Patient Care. April 3, 2024.Accessed June 3, 2026.
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3. Transmission-Based Precautions. CDC. April 3, 2024. Accessed June 3, 2026.
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4. Isolation Precautions Guideline: Preventing Transmission of Infectious Agents in Healthcare Settings. CDC. Accessed June 3, 2026.
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5. F880: Infection Prevention and Control Program (42 CFR §483.80). Accessed June 3, 2026. CDC. August 8, 2024. Accessed June 3, 2026.
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