Quote from jmRNip
Infection control nurse here to weigh in. First, you don't necessarily need to close units with an outbreak. There are other interventions that can be instituted prior to doing that. You do not know what is going on behind the scenes and with administration, so please don't be so quick to judge.
Second, and I say this to all of the nurses that complain about families lacking in PPE use - YOU are responsible for their education and compliance. Your facility probably has one infection preventionist for every 100-150 beds. You have no idea what their responsibilities entail and I can assure you they are overloaded. You are on the unit with your patients. If you find families non compliant, please educate them so they are compliant. I'm certain that if you need assistance from your ICP/IP, they will be happy to help. They cannot be everywhere at once.
I find this daily on my rounds. It is the responsibility of every caregiver on the unit to enforce proper use of PPE. OP, if you have specific questions, feel free to PM me.
In the recent past, we've had so many isolation cases on our floor that we've had to close down beds because we ran out of private rooms. Also, because of the nature of our unit, we have plenty of neutropenic patients around, too. And sometimes, administration just doesn't think. Just a couple of days ago, they admitted a patient to our floor and then
informed us they were a "potential meningitis case". Their room was just across the hall from two
neutropenic patients. Or the time when bed allocation wanted a terminal clean of a room done in 13 minutes because the ER was so overloaded (yeah, I understand the need for beds, but you can't rush a terminal clean!)
Also, I find most visitors do ok with PPE, but every now and then you get a certain few who refuse to wear any of it. I once had the wife of a patient refuse to wear PPE. If you explained it to her, showed her the gowns and gloves, it was like she wasn't listening or she couldn't understand English (Italian was her primary language), but for all other communication, she was perfectly fluent in English. And because she wasn't wearing a gown, the other visitors would see and ignore the gowns and gloves, too. Every single day, we were reminding them about the PPE, and then some would reluctantly go back out into the hall and put it all on. And again, this is right near some neutropenic patients.
I'm just frustrated because it always seems like everything is pinned on the nurses. Yeah, we're right in the patient rooms and in contact with the patients, but we're not the only factor. I've learned that one housekeeping staff has already been fired for not doing a proper job with cleaning rooms, which I think is a step in the right direction, at least. Still, just yesterday, one nurse said after a supposed terminal clean of her former isolation room, a table was still visibly
dirty. I feel like I have so many other things to do already besides chasing down people who aren't following proper procedure!