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St. Joseph's Health Centre Toronto

Making infection protection fun

How the IPAC Olympics – and chocolate pudding – put a new twist on infection prevention learning

Nov. 8, 2019 – It’s not every day that Dianagris Balakrishnan finds herself covered in pudding at work. But one day this summer, she had so much of it on her personal protective equipment (PPE) gown and gloves that it was dripping onto the floor. The pudding had been spread by Cameron Thomas, an infection prevention practitioner, as part of an education session at St. Joseph’s Health Centre called the IPAC Olympics. Balakrishnan’s task was to remove the gown and gloves without getting any pudding on her skin or clothes underneath.



“It was gross,” the registered practical nurse said, laughing. “But it was a good reminder that there’s a lot of other stuff we could have on us when we leave a patient’s room.”

The game was meant to mimic the potential for transmission of all types of bacteria by nurses and other health care providers. Walking in and out of different patients’ spaces means providers may be taking more than they’d like when they leave, potentially spreading something to other areas of the unit, other patients or themselves. This can be especially dangerous for patients with a weakened immune system and during high volume times – like flu season.

The PPE and pudding game was just one of four that was brought to the hospital’s 4M unit to help engage staff and visually show the significance of proper infection prevention practices.

“Working in health care means you get the same information over and over again but the message gets lost because it’s always the same – clean your hands, clean shared equipment,” said Rosalyn Espiritu, the unit’s educator. “I heard that other hospitals had tried this interactive way of providing education and thought it would be impactful here because it’s new and exciting. People came over curious about why there was pudding on the table.”

A common issue in health care is that people use gloves for extended periods of time, often instead of regular hand hygiene. So in another game, staff members put gloves on and had Glo Germ powder — a visual tool used in cleaning education which shows up only under UV light — sprinkled on top. They rubbed their hands together to mimic the friction of providing care and then had to remove the gloves without contaminating themselves. Thomas then used a UV light to see if any Glo Germ remained.



“When I took the gloves off, I could still see some spots on my arms,” said Vina Magno, a registered nurse on the unit. “It’s so scary because normally we can’t see what’s there.”

Many staff members also had Glo Germ on their fingers and hands because of defects in the gloves.

“People have a mistaken idea that gloves are impermeable and that’s why they don’t need to be as good about hand hygiene when wearing them,” said Thomas. “Staff were surprised to see powder on their hands and the reality is that Glo Germ powder is still bigger than microorganisms that could get through, which is why it’s so important that gloves be used in addition to really good hand hygiene.”

Feedback on the IPAC Olympics was overwhelmingly positive from staff on 4M, so much so that other units have requested a shot at playing the games, which also included one related to cleaning shared equipment and another that tracked bacteria growth in microlab plates before and after practicing hand hygiene. The infection prevention team is exploring ways to continue this work to engage all staff members who interact with patients in a way that will hopefully stay with them.

“A lot of the time, we talk in health care about the moments when you’re supposed to clean your hands but not really the why,” said Thomas.

“But when you think about what you touched last and what you’re touching next, it makes a lot more sense why you should stop and make sure your hands are clean. Maybe next time someone on 4M is taking their PPE off, they’ll think about the pudding and be aware that just because they can’t see something that could potentially be harmful, it doesn’t mean it’s not there.”

 

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