Ip Newbe

Be a team player, but don't quit your day job

'The Just One More Thing Strategy'

By Patti Grant, RN, BSN, MS, CIC,
Infection Preventionist, Dallas

It is safe to say various professionals in healthcare are expected to participate in activities beyond their original area of expertise. This expectation does not seem so much a direct consequence of our struggling economy as a reflection of the attempt by various specialties to move from "silos" to a team approach to problem solving. Patient safety will most likely be less precarious in this multi-disciplinary improvement environment, but it can come with hefty growing pains.

patti GrantFor example, I recall helping two nurse managers co-chair a central line-associated bloodstream infection (CLABSI) prevention team. The team had been in existence for several years, establishing bragging rights by lowering CLABSI rates in all intensive care units by 50% for three consecutive years. However, the real challenge came when it was time to expand the ICU success to the entire facility. This new initiative arrived with deadlines, tool-kits, and a house-wide approach. Within several months, targets for assessment, action plans, and hard-wired implementation had to be coordinated between pharmacy, nursing, materials management, microbiology, infection prevention, organization development, physicians, and nursing staff. The patient population benefited, but the healthcare professionals might have earned some hard-earned victory scars.

If you have not yet been dubbed the "Master Patient Safety Planner," you might be tapped in the near future due to your ever-growing epidemiology training and a skill set applicable to a wide set of problems. Whether it is fall prevention, medication errors, decubitus prevention, or lowering blood culture contamination rates, the training you receive as an Infection Preventionist can be applied to most patient safety initiatives. Still, there's a Catch-22 in this equation: although your epidemiology training makes you a logical — and often the best choice — to lead teams, it does not necessarily make you the correct person for the job. Why?

As an IP you are highly specialized. Others cannot do your job when you are otherwise occupied. Your primary job responsibilities cannot be completed by others unless they are trained, a process that typically takes one to three years. No matter the new project, a balance must be found to maintain patient safety overall. So how do you function as a strong team player in patient safety initiatives beyond infection prevention and yet reserve the time necessary to safely complete your primary IP responsibilities for those within your healthcare facility?

When asked to head a team or take on another patient safety endeavor you honestly know will threaten your ability to function as an IP, consider trying the time-honored Just One More Thing Strategy:

  • Talk with your immediate supervisor and share your hesitation, and then,
  • Request a five-minute slot on the next executive team agenda to discuss the impact of the most recent patient safety initiative on the current infection prevention and control program.