Infection control nurses step into spotlight
Every day Melanie DuBose begins her day by checking various databases used by Cincinnati Children's Hospital Medical Center to see if any patients have been admitted with or developed any infections.
A nurse by training, DuBose is part of a team of nine individuals that work to control the spread of infection in the hospital as well as providing information to colleagues, patients and families.
It is the team colleagues turn to when they have questions on precautions to take with highly contagious patients, what kind of personal protective clothing staff might need when caring for certain patients, or how best to clean a patient's room.
"We get questions every day – it might be a routine question on personal protective equipment or whether someone can leave their room and go to the gift shop," DuBose said.
"We work collaboratively with all areas of the hospital and try to educate. We provide education on how to manage patients, infection control procedures and hospital policy."
It is an area gaining more and more attention in the public eye after outbreaks of influenza, measles, and even the recent Ebola outbreak in Africa pose new challenges to health care professionals.
"Keeping people healthy is dependent on their environment,'' says Robin Wagner, an associate professor in the University of Cincinnati's College of Nursing, who serves as director of the nursing school's skills and simulation lab.
"We have to be educated on the chain of infection. All the pieces have to be there for infection to occur."
There are six parts of the chain, including the microorganism that causes the disease, where it lives and how it is transmitted and spread.
That information is an important part of what Wagner teaches her nursing students and the basis of what DuBose uses day in and day out, first as a nurse, then as an infection control practitioner the past three years.
"Times change and we might change the way we do things. We've gotten smarter or so we think – but to teach infection control … we go back to the Florence Nightingale environmental model," Wagner said. We can model what we do after the things she learned in her practice."
One of the most effective and basic practices is good hygiene – washing your hands, Wagner said, which goes back to Nightingale's Notes on Nursing book, published in 1859 in England; a year later, in the United States.
Another is wearing personal protective gear – gowns, masks, gloves, eye protection – when handling blood or body fluids.
Wagner also reminds her students that microorganisms can be transmitted by too long pants that drag on the floor or their shoes.
To illustrate that point, she puts Glo Germ powder on their hands in their first lab. When black light is shone on it, it shows germs. After students wash their hands as taught, the powder is put on their clean hands once again and put under the black light.
"We can see how good they did washing their hands. It gives them the idea where germs hide on your hands," Wagner said. "What we hit very hard on is the basic concept."
Powder put on the floor does the same thing to show germs on shoes or pants that touch it.
"If you understand the fundamentals, you can move forward," Wagner said. "This concept is not new to nursing."
DuBose agrees. She learned those basics and now reminds others of them as part of her role as an infection control practitioner. She joined the hospital's infection control team three years ago after working as a nurse for three years.
A year ago, DuBose received certification in infection prevention and control from the Certification Board of Infection Control and Epidemiology, Inc.
To get the certification, DuBose had to work two years learning her craft and taking courses before taking the certification exam.
"You learn as you go. We're investigators trying to put the pieces of the puzzle together. We're an integral part of the hospital. We work collaboratively with all areas of the hospital,'' DuBose said.
"It helps to have a nursing background. You understand the process, the lingo. We provide education anytime there's an outbreak of infections or disease. We provide information on how to stop it – interrupt the transmission from person to person."
Other tasks the team works on include employee health, safety, reviewing patient charts, interview patients coming in, checking their travel history, and similar duties.
"It's all about trying to brainstorm and think about people's behaviors and how we can best protect our patients and the institution, DuBose said.
"It's very interesting – unlike anything else I've ever done. I learn something new every day."
Additional resources
•Certification Board of Infection Control and Epidemiology Inc.: www.cbic.org
•Association for Professionals in Infection Control: www.apic.org
•Notes on Nursing, Florence Nightingale: http://bit.ly/1GPIgK0 or www.gutenberg.org/ebooks/17366