Where couture meets culture (and sensitivities): Multidisciplinary involvement in education of transmission-based precautions

Abstract

ISSUE: Isolation work practice compliance was assessed with verbal and direct observation during mock tracer activities. A multidisciplinary work group was selected and given the task of identifying, defining, and prioritizing problems associated with the isolation process. PROJECT: Initial assessment was done randomly and informally during mock tracer activities. The initial assessments demonstrated misinformation and confusion regarding all components of the isolation process, as well as confusion related to new ante rooms in recently constructed patient care areas. Issues addressed by the work group included centralization of isolation equipment for easier access by all departments, employee isolation tip sheets for quick easy reference, misinformation regarding appropriate donning and removal of personal protective equipment, and familiarization of healthcare workers with current isolation information on the intranet. Education and training incorporated all employee disciplines that might go into an isolated patient's room. Education included a prerequisite intranet-based learning module prior to a 1-hour interactive presentation, with participants demonstrating appropriate donning and removal of PPE, appropriate decontamination of tight-fitting goggles, and a group activity where teams presented the appropriate isolation for case studies. The finale was a fashion show of isolation attire by physicians that was filmed and shown at annual education sessions and in the physician lounge. Post education assessment of practice was conducted 6 weeks later. RESULTS: Initial assessment demonstrated compliance with indicators of different isolation categories. The results ranged from 0% to 62%. Adherence improved to 50%-72% compliance. LESSONS LEARNED: 1) Identifying healthcare workers from various disciplines provided a much broader assessment of problems. 2) Educating all disciplines together provided an opportunity for various disciplines to problem-solve case studies together, which encouraged suggestions for improvement of the process. 3) Utilizing intranet capabilities during the required education, although time consuming, significantly increased the comfort level of participants. 4) Physician participation as models made the education memorable and engaged the medical staff in the education process, which can be a significant challenge. 5) Observational assessment of isolation practices continues to be a challenge due to limited resources.