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anitalaff

anitalaff BSN, RN

Public health program evaluation
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anitalaff has 5 years experience as a BSN, RN and specializes in Public health program evaluation.

anitalaff's Latest Activity

  1. anitalaff

    All out of Sterile Gloves

    Hi Wuzzie; Funny you should mention that because that was the first thing we asked. You should have seen the manager's face while she thought about the cost. Honestly though, we have no qualms about pilfering some of those kits for sterile gloves. It's just that we don't have many in stock. It feels like a dumb thing to obsess about in the middle of a crisis for N95s (which we also don't have) but we have a lot of clients on chemo with PICCs and want to keep them as safe as possible.
  2. anitalaff

    All out of Sterile Gloves

    I'm sorry Hppy. I got rankled and you didn't deserve that response. You know, my infection control nurse said the same thing, but I just didn't want to accept it. OMG explaining this to clients who know darn well why we use sterile gloves was an experience. Also, many logistical problems arose from having to walk away to scrub in. I'm going to review simple asepsis and see what's what. Thanks for doing my homework.
  3. I am preparing to work in a city centre COVID+ shelter site. The employer is an association of physicians who have been working to provide healthcare to the homeless population in the city through cooperation with a number of shelters and support sites. They already have set up a hotel dedicated to people who are symptomatic and (hopefully awaiting testing) require monitoring as well. The second site is being set up right now and will be a dedicated COVID+ site- this will be my workplace. I am getting some EMR training by video conference tonight and I hope to hear more information about my new temporary workplace. I will be doing some introductory shifts at the first site in the meantime. I know nothing so far about the PPE situation with this employer, or infection prevention protocols they intend to use. I am trying to figure out how I will handle the 1hr-1.5hr commute, infection prevention, living arrangements, and all the mental health and addictions nursing skills that I have yet to learn. Can we all workshop an order-of-operation list for leaving after a shift? Please feel free to rewrite this list I have started- I am sure you all will have something to add. Change out of scrubs at work, including socks and shoes worn. Place dirty scrubs (and head band, socks) in a separate vinyl drawstring bag and wash hands. Wipe down shoes with disinfectant and place in vinyl drawstring bag dedicated to shoes. (Doing steps 1-3 in my underwear if there is a locker room? A locker room is unlikely.) Wash hands and change into street clothes. Disinfect ID badge, car keys, locker and lock. Store scrub bag in a box in the cargo hold (or trunk?) of car. Store shoes in footwell. Hand sanitize Drive home. Leave shoe bag in car or on from porch if possible. If not doing laundry immediately, store dirty scrub bag in plastic-lined garbage or green bin on front porch or entryway. Consider where street coat and clothes may have been in contact with work site before entering home. (Keep ID badge, car keys, and accessories where? Large ziplock?) Wash hands immediately and head to the shower. What have I missed? How would you get around not having a locker room to change in? It is entirely possible that HCWs will have a washroom to change in but I don't count on it having any showers. I am not planning on bringing a purse anywhere BTW.
  4. anitalaff

    All out of Sterile Gloves

    Hi Hppy; First of all, we are not wasting sterile supplies on procedures that are often done with clean technique. My question, which I will reword: What happens when you have no sterile gloves for procedures that must be asceptic for patient safety?
  5. anitalaff

    Covid-19 Among The Navajo Tribe

    I was moved by your post. Thank you for sharing this.
  6. anitalaff

    All out of Sterile Gloves

    Alibaba sellers have a lot of trouble differentiating between clean and sterile gloves. Has your agency bought medical supplies through this site before?
  7. anitalaff

    All out of Sterile Gloves

    HI eerrmm, I have looked through WHO sites and documents. I posted my comment in the hope that someone else has seen a resource that I have missed.
  8. anitalaff

    All out of Sterile Gloves

    I am in an ambulatory clinic and we are on our last box of sterile gloves. Does anyone here have experience with trying to be aseptic without sterile gloves? We do a lot of PICC and VAC dressings. I can't find any best practice documents that address a lack of resources. If you know of any references, please let me know.
  9. anitalaff

    Wound Vac

    I haven't had a scrotal vac before, but I have had good success with using a sheet of hydrocolloid on the periwound and everywhere the skin is inflamed. It's a lot of cut and paste. Then I put the vac dressing right over top, and give a border of vac dressing around the hydrocolloid to ensure the seal. In your case, that might just increase the angry area, but the hydrocolloid is really wonderful. It will probably come off with the vac each time though. Good for angry ostomies too. This issue of changes every 8 hours is really outrageous for a vac dressing that is meant to stay on for days. I would cancel it if I had any say in it. Without seeing this wound it's hard to say how to anchor the dressing apart from a lot more tegaderm, and getting the dressing on dry skin. If it's a question of hills and valleys, I have used ostomy paste to build up a vacuum dam before. Once he's healed, I have had good success with using Interdry on obese patients. It's a silver-impregnated cloth that you can cut to size, and use as a wick for moisture control. It works wonders for those skin fold rashes that get out of control, and prevents candida growth. It also adds comfort to sore skin. I made a scrotal sling out of it for one male patient to good effect.
  10. anitalaff

    Wound Vac Requisition

    In my clinic, we have a gentleman who has a vac between his great and third toe (second toe amputated), plus other wounds sites on the same foot. Great fun. We built up a 'dam' out of ostomy paste between the toes and wrapped the heck out that foot. Of course, this patient like to turn the vac off once he was home, so his foot stewed in the dressing, and we constantly struggled with maceration. Finally, we gave up on vac for this person. When vacs are shut off, they can cause a world of damage. Have used hydrocolloid a number of times, both to save inflamed skin from vac dressings, and to help with the seal. It's a good trick. I haven't had a coccyx vac yet- something to look forward to.
  11. anitalaff

    Wound with no change, good or bad

    Is this a stage II ulcer or stage III? How is packing appropriate for stage II? Maybe that's a typo. I'm sure your hands are tied on this one, but it sounds like the main barrier to wound healing is the spouse. His needs are being met before hers are. I would work on him first. You can't work miracles with wound dressings when 24/7 something else is working against your goal. If she doesn't already have a roho cushion, that would be a good start, but they cost $$. Seeing as this is a fairly dry wound, I would stop all the iodine, which has a drying effect. Have you tried hydrocolloid dressings already? They are great for shallow wounds with low exudate, and a product like Tegasorb will stay on through showering and transfers. If you have already gone this route with no success, there is always the Nanova dressing- small vacuum assisted dressing (not the big VAC) to stimulate tissue growth. Seeing intractable wounds like this is super frustrating and I feel for your situation, wanting to get a solution for your patient. I also feel strongly that the number one thing you can do is health teaching with the spouse until he is on board with getting this wound healed. He may be under the impression that how she spends her day is not important to wound healing. We know differently. I hope this helps.
  12. I would like to do some preliminary investigation into a target population of Millennials (18-35). I think that we are missing them (in our area) to some degree and I'd like to know how aware they are of public health resources. Before I approach my manager, and do the big ASK for time and materials on possible data collection, are there any theoretical frameworks, or studies already done that can guide me? I can dig through data collected for current programs, but I don't think it's going to address the population appropriately. The way I see it, this is almost a marketing survey kind of moment. What do they know about public health? Do they access any programs or resources currently? Should I look in marketing rather than health care for my template?
  13. anitalaff

    Preparing for Toronto Public Health Nurse Interview

    If you work with Toronto Public Health, I would love to connect with you and find out what aspects of your role that you're excited about.
  14. Hello colleagues; I am hoping to qualify to for an interview with Toronto Public Health. It appears that they are hiring a number of positions across the GTA. At present, I don't have any direction as to which positions, specifically, are available and in which areas. Of course I am willing to commute and make changes in my living arrangements for the opportunity to work as a public health nurse. This is my dream. I realize that when I have more information about the role(s) I will be better able to prepare, but I don't want to miss out on studying important foundational documents that would make a difference in my interview. Does anyone in public health have any advice about preparing for Toronto Public Health interviews in general? Thank you so very much in advance.
  15. Number OF leprechauns. *sigh*
  16. "Clinical trials for the efficacy of leprechauns in humor therapy showed that a statistically significant number leprechauns are just not that funny."