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Smoke and Mirrors - Crimes Against IPAC? Presented by:

Madeleine Ashcroft, Network Coordinator and Donna Moore, Infection Control Consultant Mississauga Halton Infection Control Network

September 30, 2014

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Learning Objectives

• Explore common misconceptions and myths related to infection prevention and control (IPAC)

• Review some “crimes” against IPAC practices

• Investigate possible motives

• Share the inside information

• Set the record straight

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Misconceptions and Myths

• Misconception: a view or opinion that is incorrect because it is based on faulty thinking or understanding

• Myth: a traditional story; a widely held but false belief or idea

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Some IPAC Misconceptions and Myths

Warning! Sometimes just stating the myth can mistakenly reinforce it in some peoples’ minds – Don’t let this happen to you!

Hand Hygiene:

1. Washing with soap and water is better than using alcohol-based hand rub (ABHR)

2. Alcohol dries the skin and make hands sore

3. ABHR kills all germs

4. Wearing gloves replaces hand washing

5. Antibacterial soap is needed in health care settings - and maybe even at home (See resources)

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http://www.publichealthontario.ca/http://www.cbc.ca/news/technology/ban-antibacterials-triclosan-and-triclocarban-report-says-1.2703095 and http:/www.cela.ca/sites/cela.ca/files/TC-TCC-CELA-997.pdf

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More IPAC Misconceptions and Myths

Influenza:

• Flu shots give me flu

• I never get flu so I don’t need the shot

• Cold weather is good because it gets rid of bugs

Other:

• Over half of health care workers are colonized with MRSA

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Let’s Play Detective

• Fact can be stranger than fiction!

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Local Examples of Strange Behaviours

• Here are some real examples of local strange behaviours related to IPAC

• On each of your tables is one such example provided during outbreaks over the past year

• Please take 3 minutes to read this and consider: • What might be the motive (rationale)?

• Is there any evidence to support this?

• How would you respond (verdict)?

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Case #1

No serving of cold food during outbreaks

• Motive:

• Evidence:

• Verdict?

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Transporting specimens in glove boxes instead of cooler bags

• Motive:

• Evidence:

• Verdict?

• To obtain Blue Transport Bags for transporting specimens to a PHOL or to arrange the pick-up of a PHOL specimen; call the Customer Service Centre at 416-235-6556 or 1-877-604-4567 or your local Public Health Laboratory

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Case #2

Reference: PHO Specimen collection guide

http://www.publichealthontario.ca/http://www.publichealthontario.ca/en/ServicesAndTools/LaboratoryServices/Pages/laboratory-location-and-contact.aspxhttp://www.publichealthontario.ca/en/ServicesAndTools/LaboratoryServices/Pages/laboratory-location-and-contact.aspx

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Only placing one resident per line list during outbreaks

• Motive:

• Evidence:

• Verdict?

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Case #3

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Only providing bed baths during norovirus outbreaks

• Motive:

• Evidence:

• Verdict?

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Case #4

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After an outbreak is declared, waiting to send specimens to PHL until after you’ve spoken with PPH

• Motive:

• Evidence:

• Verdict?

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Case #5

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Reverse isolation of all residents for 48 hours if they spend a night away from the facility

• Motive:

• Evidence:

• Verdict?

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Case #6

Image source: Public Health Ontario, 2013

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PublicHealthOntario.ca 14 http://www.health.gov.on.ca/en/pro/programs/publichealth/flu/docs/patient_trsnfr_rtn_algo_en.pdf

http://www.publichealthontario.ca/http://www.health.gov.on.ca/en/pro/programs/publichealth/flu/docs/patient_trsnfr_rtn_algo_en.pdf

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Delaying initiation of Tamiflu until the following day when the ICP was in the building

• Motive:

• Evidence:

• Verdict?

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Case #7

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Sending specimen to PHO Lab with no resident identifiers on specimen

• Motive:

• Evidence:

• Verdict?

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Case #8

Image sources: Public Health Ontario, 2013

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Any other examples of an IPAC mystery or crime scene?

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