1. vchn regional Health recently implemented an infection control policy and protocol on spills management. Protocol is given below

1.  VCHN Regional Health recently implemented an infection control policy and protocol on spills management. Protocol is given below:

Infection Control - Spills Management - Biological, Chemical and Waste Protocol

Procedure:
Risk Management: Because the status of all person regarding blood-borne infections are unknown, spills of biological fluids (blood and body fluids) must be considered to have the potential for infection transmission. To prevent the possibility of infection transmission, spills need to be dealt with promptly and effectively.

Equipment:

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  Blood spill kit for biological spills (containing Bio-waste absorbent)
  
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  Gloves, protective glasses and impermeable gown
  
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  Dust pan and scoop
  
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  Hazard signs
  
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  Paper hand towels
  
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  Neutral detergent
  
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  Mop and bucket
  
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  Infectious waste bag
  

Method:
Biological Spills

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  Biological spills are cleaned immediately
  
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  Collect spill cleaning kit
  
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  Don protective apparel from kit, including gloves, plastic apron, protective glasses
  
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  Place hazard signs around the spill
  
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  Pour Bio-waste infectious waste absorbent sparingly onto spill, wait until it turns into a jelly consistency
  
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  Remove as much of the spill as possible with the dustpan and scoop and dispose it immediately into infectious waste bag
  
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  Use more paper towel to wipe- up spill completely
  
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  Clean the spill site with hot water and neutral detergent
  
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  Place all materials used in infectious waste bag, including gloves
  
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  Seal waste bag, and place in appropriate waste storage area
  
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  Wash hands
  
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  The person who found and attended to the clean-up of the spill is responsible for restocking the spill kits and notifying the Infection Control Practitioner if additional equipment is required.
  
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  Complete Incident Report form
  
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  Chlorinated disinfection is only to be used for a highly infectious case, e.g. Avarian flu, CJD, gastro-enteritis.
  

It is likely that all products that can clean spills of blood on carpets will cause damage to the carpet.

Spills on carpet should be managed as follows:

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  Clean immediately
  
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  Place Hazard signs around the spill
  
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  Collect Spill Kit from pan room, decontamination room in theatre, east pan room in Residential Care and in the store room at Oncology Centre.
  
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  Remove as much of the spill as possible with the dustpan and scoop and dispose it immediately into infectious waste bag
  
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  Other body fluids spill shall be removed with an approved carpet cleaner or detergent in the same manner as non-carpeted areas
  
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  If staining of the carpet or upholstery is likely, notify the Nurse Unit Manager / After Hours Clinical Co-ordinator who will organise a professional cleaner as soon as practicable
  
• 
  Complete Incident Report form
  
• 
  Chlorinated disinfection is only to be used for a highly infectious case, e.g. Avarian flu, CJD, gastro enteritis
  
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  The person who found and attended to the clean-up of the spill is responsible for restocking the spill kit and notifying the Infection Control Practitioner if additional equipment is required.
  

Chemical Waste Spill:

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  Isolate spill and using signs keep area clear
  
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  Response will vary depending on the chemical
  
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  Relevant Material Safety Data sheets are available from the MSDS folder in the work area
  
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  Immediately notify the Environmental Services Manager or for afterhours contact the After Hours Clinical Co-ordinator
  
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  Complete Incident Report form.
  

General Waste:

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  Protective clothing shall be worn
  
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  Pick up waste with a dustpan and scoop and place in green waste bag
  
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  Mop area with hot water and neutral detergent.
  

Protocol reference number: 271

Date Issued: 18/9/2014

Date of Next Review: 9/9/2016

Approved By: Chief Executive Officer

Contact Person: Deputy Director of Clinical Services

Developing Team Lead: Janet James

How would you respond to the following scenarios? Read the scenarios and provide responses adequately referring to the protocol attached.

Ms. Pam Albert is a recently joined housekeeping staff at VCHN Regional Health. Mr. Ian Murdock is an EN and a member of Infection Control Committee (Better Practice Advisors) at this facility. Ian is delegated to monitor Ms. Pam’s work practices as part of quality and compliance monitoring.

Ian supervised Ms. Pam while she was attending to a general waste spill (heavily soiled incontinence pads on the floor) in a medical ward. The following are the observations made by Ian on Pam’s work practices.

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  Pam used dustpan and scoop to pick up waste and placed in green waste bag.
  
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  Pam mopped area with hot water and neutral detergent.
  
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  Pam did not wear any protective clothing other than gloves while managing the general waste.
  
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  Pam did not use hazard signs while mopping the floor.
  

1.1	Discuss the infection control risk in this scenario (minimum 20 words).
1.2	Did Pam comply with the Infection Control - Spills Management - Biological, Chemical and Waste Protocol? Provide rationale to support your argument (minimum 30 words). However, Pam is in need of more training.
1.3	After monitoring Pam’s work practices, Ian discussed the observations with Pam. It was evident from the discussion that Pam does not possess an insight into Infection Control - Spills Management - Biological, Chemical and Waste Protocol implemented in VCHN Regional. Pam did attend the orientation provided to her on day one and two. However, Pam is in need for more training. Whom could Ian liaise with to organise further training or coaching for Ms Pam on Infection Control? Identify two significant personnel.
1.4	Write in your own words how Ian could provide a constructive feedback to Pam based on the discussions above. Include the information on the infection control protocol in your answer (Minimum 100 words.)
1.5	Ian considers the statement ‘Protective clothing shall be worn’ as vague. How could Ian re-write the statement to be more specific and clear to the staff?
1.6	Identify another possible area of improvement (any inadequacy) in the protocol.
1.7	What could Ian do to ensure these inadequacies are corrected and included in the protocol? Include in your answer how Ian could involve the healthcare team members in amending the protocol (minimum 30 words).
1.8	Adopting the role as Ian, complete the report template "from the Handouts for the unit and upload in the "Attach Files" section of the question.

2.  Crystal, enrolled nurse, is taking care of Mr. Adam who is infected with hepatitis B (HBV). Adam is concerned about the stigma and discrimination associated with his hepatitis B virus (HBV) status. Provide responses to the following questions based on this scenario.

2.1	Why is it important to maintain Mr. Adam privacy and confidentiality in relation to his infectious status? (minimum 30 words)
2.2	Explain briefly how Crystal could address the client confidentiality in this scenario?

3.  You observed that Emma, a student nurse, always takes one additional wound dressing pack while performing wound care to clients. This pack usually remains unpacked and is thrown away with the used materials. Is there any issue in this scenario? What could you do in this scenario being a responsible enrolled nurse? (minimum 30 words)

1.  Scenario A Nurse Provides prescription medicine without authority A Nurses Board received a complaint concerning allegations that a nurse (medication endorsed), whilst working in the emergency department of a hospital, practiced outside the scope by knowingly providing prescription only medication to a patient without the authority of a medical officer. When interviewed, the nurse stated the patient attended the emergency department for treatment and the department was busy at this particular time and the patient knowing this stated that they were not prepared to wait for treatment. The nurse made enquires of the patient’s allergies and responses to medication and then consulted a doctor. The nurse then obtained a packet of antibiotics and provided them to the patient. The nurse also made false entries in the medical record of the patient.(Adapted from Nexus, NBV, November 2008, Volume 16 Issue 2). Key points to elaborate (addressing performance criteria)

1.1 Discuss and explain how the nurse failed to use critical thinking and analysis skills effectively in this situation leading to unprofessional conduct? (150 words) 1.2 Reflect on the scenario and explain how the nurse failed to apply the foundations of contemporary nursing practice? (150 words) 1.3 Analyse and state the relevant legislation and professional regulations related to this case (Quote examples on how the nurse failed to follow those legislations and regulations). (150 words) 1.4 Propose 3 types of professional development you would recommend for this nurse to undertake and to prevent future such incidents and why? (150 words) 1.5 Explain and justify the seriousness of this issue in 150-200 words. Analyse and state how you can promote reflective practice of self and others.