IPC PROs Helping Each Other: How to Engage Employees and Staff in the LTC Setting

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In this installment of IPC Pros Helping Each Other, how do IPs keep those in their facilities to remember essential infection control practices?

IPC Bulletin board with crayons and pictures of butterflies and flowers.  (Photo courtesy of author)

IPC Bulletin board with crayons and pictures of butterflies and flowers.

(Photo courtesy of author)

Infection Control in Long-term Care Facebook Group

Infection Control in Long-term Care Facebook Group

Infection Control Today®’s IPC PROs Helping Each Other series features infection prevention and control professionals at all levels speaking with each other, giving best practices, and telling stories of what has worked—and not worked—for them in their facilities.

Do you have a best practice to share? A question you need answering? Or have an answer to the weekly question? If so, please send them to tmartonicz@mjhlifesciences.com and help others in the IPC community.

Next week: Do you have an answer to “Does your facility monitor outpatient CLABSI cases? Why or why not? If so, how do you do so? If not, why not?

I am Carmen Smith, LPN, IP, infection preventionist at Choctaw Residential Center in Choctaw, Mississippi. I have 4 children who are my world, and 4 grandchildren who are my universe. I have been a nurse for 14 years and a CNA (Certified Nursing Assistant) for 7 years before that. I have worked as an infection preventionist (IP) for the last 3 years. It has been a rewarding and eye-opening experience for me, to say the least. With little training in this role, I was practically thrown into an office with no orientation as to what needed to be done—like so many others I have been told—I had to figure it all out and make it look like I knew what I was doing at the beginning of the COVID-19 pandemic.

February Bulletin Board for Infection Control   (Photo courtesy of the author)

February Bulletin Board for Infection Control

(Photo courtesy of the author)

If you know, you know. Ha.

Infection Prevention Crossword Puzzle  (Photo courtesy of the author)

Infection Prevention Crossword Puzzle

(Photo courtesy of the author)

LinkedIn Followers Answered Too!

Emily Gaddam MHDS, RN, CIC, Nurse Epidemiologist - Infection Prevention & Control, Cedars-Sinai Medical Center

We use an accountability model.

I talked to some pre-op RNs the other day, and one of the nurses said while working in a COVID ICU, she got feedback from one of our nurses, and from then on, she hasn’t forgotten- that it stuck with her.

Jill Holdsworth, CIC, FAPIC, NREMT, CRCST, Manager, Infection Prevention at Emory University Hospital Midtown

I like to use modes of transmission to communication that people will remember and want to talk about. Two of my favorite books on this (introduced to me by Scott Criswell ) are “Drunk Tank Pink” and a second one called “Contagious—making your ideas go Viral.”
Learning ways to use humor, color, images, and other behavior modification techniques is where we need go with education and rolling out initiatives.

Janet Hsieh-Li, DNP, RN, CIC, Infection Control Coordinator

It is frustrating when staff forgets the most basic IC requirements. Some of the strategies that have worked are (a) cards that can be attached to ID badges for quick reference, (b) playing games with IC requirements and giving out small prizes to new employees, and (c) handwritten notes to employees with a copy to their supervisor when they remember and follow the correct IC protocol.

Barmak Kusha, MPH, CIC Infection Preventionist | Infectious Disease Epidemiologist

Multiple modes of information communication; repetition; rounding together to educate to the why; frequent quantitative and quantitative feedback

But through it all, we as a facility put our heads together and made it work. Now I focus more on preventing not only COVID-19 in our facility but other diseases as well. Education and comprehension of staff and residents have proven to be one of my biggest struggles, so I had to produce more ways to get the information out there and develop innovative ideas to ensure that it was received and understood.

Education plays a big part in the role of the IP in the LTC workplace, but how do we do that when it seems that over the last few years, the role of the IP has been so focused on COVID? We, as IPs, have to be creative and almost reinvent our role to include so much more than used to be required.

Recently, it occurred to me that engagment and staff participation could effectively get everyone involved. How do I do that? Crosswood puzzles, word search games, big bright bulletin boards filled with information not only about COVID-19, but flu season, infection prevention, and washing hands. I hung these games and puzzles on the wall or the boards, thinking that if they came to the board for the games, they would see and read the information.

Using holiday themes and flyers from a consultant with TMF QIO organization was a tremendous help. I mentioned the idea to her, and she loved it, so I put on my thinking cap and went to work on researching, printing, and cutting out letters and pictures. She also invited me to be a guest speaker on a TMF QIO webinar, where I got to talk about all these ideas. After deciding which ideas to go with, I went a little crazy, I admit, but the results were amazing, and I got so much feedback from staff and residents.

The crossword puzzles were the biggest hit. Staff and residents even got together in groups to figure out the answers. Once they were finished, they brought it to me to check their answers and were ecstatic to hear they had gotten all the answers correct. I hung the completed puzzle on the wall next to the bulletin board for all to see with a 100% grade and big ole red smiley face. I even posted a picture on social media to an Infection Preventionist Group I follow on Facebook, with lots of positive remarks and comments received.

In February, I used the Valentine’s Day theme for the background of the bulletin board in the employee breakroom. Cupids and Hearts with bright red balloons were blown up and tacked to the corners of the board. It stood out as you walked into the breakroom; it was in your face, and you could not help but see it. Those attention-grabbing pictures and all the decorations were there to draw attention to what was happening in the background.

In March, I used St. Patrick’s Day, and in April, I posted pictures of butterflies and flowers that were out of coloring books with a bag of crayons hung near the board using the phrase “Help decorate Our Beautiful Butterfly Garden.” This was a big hit as staff would take time on their breaks or during stressful situations to just sit down, color, and relax. Once the pictures were colored in, I took them down and cut out the butterflies and flowers and posted them on the board around some infection control flyers I had posted and added comments of “good job,” beautiful,” “amazing work,” etc.

In May, I used a beach theme and decided to do awareness of one specific infection prevention each month as COVID-19 is winding down, and Centers for Medicare & Medicaid Services and CDC are not pushing as much about it. Even though I will continue to educate on the prevention of COVID-19 and vaccinations staying up to date, it is time to return to the basics.

"UTIs can be a beach." This was the theme for May: “LIFE IS JUST A BEACH, like UTIs.” Posting pictures of beaches and exotic flowers drew the eye to the board; once attention is focused there, the information just flows off to the reader.

In addition, I would make my rounds during the days and ask employees and residents their opinions on the boards, getting feedback on how much information was gained and retained. I got some excellent responses and excitement about how the pictures and information jumped off the boards.

So, in June, I am posting awareness of strep throat prevention. Again, I got a little crazy with it, but it keeps it fun and interesting. One of the phrases I typed up is, “After doing the doo, be sure to wash your hands, as strep loves to live on your bum.” Posting pictures of a toilet paper roll and a baby diapered with his bum in the air got several laughs. Isn’t that what we, as nurses and other nursing home staff, are here to do? Make patients laugh and be happy. They love it.

Future ideas I am still working on include resident mock rooms using a manikin in bed with all kinds of things wrong in the room related to infection control. Items such as a catheter bag hanging at the bedside but touching the floor, a used needle lying on the bedside table, a dirty accu-check machine, no hand sanitizer available, blood on the floor (ketchup, of course), and a note posted to the manikins hand that says please change me, which I will use to do check-offs on pericare. I plan to have a checklist or fill in what the staff sees wrong. Using a point system of how many each staff member gets correct, small rewards from a treasure box will be given. They will also receive credit for inservice hours, and things missed will be corrected verbally. I strongly feel this will stick with them each time they go into their residents’ rooms to make rounds. 

So, in saying all of this, I, as a nurse of 14 years, am encouraging all of you IPs to put on your thinking caps and get a little crazy with some ideas. Make it fun; keep it interesting. Ask for input—diverse cultures like different games and ways of communication. Do what works for you and your facility.

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