iP Newbe

Keeping 'emotional bank accts' out of red

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

Patti GrantI previously shared some thoughts on communication styles and keeping a log of questions — along with your answers — that come through your Infection Prevention & Control (IP&C) Program.

The purpose is to help keep the continuity of your messaging clear, especially as a novice. Yet, there is more to this "IP&C Consultation Log" approach than simply documenting your conversations.

Have you discovered that you spend a lot of time dedicated to hallway conferences? Phone Calls? Literature reviews directly related to those hallway and phone question/answer sessions? Have you already (begrudgingly) determined that all this activity — albeit directly necessary for the success of your IP&C Program – is not reflected anywhere in traditional formal surveillance activities?

As an iPNewbie you may have already figured that much of your time is dedicated to securing abundant positive "deposits" into what author Stephen Covey calls "Emotional Bank Accounts," 1 effectively communicating with those who can physically intervene and stop infections at the bedside. These include:

  • Bedside Staff — On-hands application of evidence-based practices
  • Managerial Staff —Front line observations for compliance with feedback to staff
  • Medical Staff — Compliance with regulatory/accreditation 'MD-driven' initiatives and programs
  • Administrative Staff — Positions the house-wide 'Culture Attitude' toward patient safety and controls the budget requirements to promote IP&C compliance and resources

So how do these two invisible activities — Emotional Bank Account balances and non-outbreak investigative/surveillance IP&C work — get documented toward your overall productivity, i.e., get used in a formal way? One approach is to start linking formal documentation of your question/answer activities (consultations)2 with components of the recommended practices for surveillance.3 It is not a leap of faith to draw a parallel between keeping an IP&C Consultation Log with three of the seven recommended surveillance practices. Here's how:

  • Assessing the Population: With each consultation you perform, internally or externally, related to your facility activities, you are doing just that — assessing the population with your fellow healthcare professionals or the general public. They have observed something questionable, or have noticed a new product is being piloted that you weren't aware of, or have an organism transmission prevention query. Each time you interact with your environment you are assessing the population.
  • Selecting the Outcome or Process for Surveillance: Over time, as you keep your IP&C Consultation Log, trends may start to develop that may cause a mid-year and/or annual IP&C Program alteration. Is education needed based on a consistently-asked question? Are the IP&C resources not readily accessible based on perception or reality? Did one question lead to an entire process improvement change once you delved into it?
  • Collecting Surveillance Data: Your IP&C Consultation Log is a 'living and breathing' reflection of the ongoing risk assessment of the environment you practice in. Make this function a formal report, at least annually, and include it as a process surveillance function in your IP&C program.

This approach enriches those Emotional Bank Accounts and shows others that you value their input enough to document their observations and alter practice as appropriate. Actions speak louder than words. The practice of documenting your 'Q&A sessions' facilitates mutual understanding by sharing expectations and decreasing the potential for miscommunications, keeping those delicate balances out of the red.


  1. Training-time.blogspot: http://bit.ly/zEI46V (Accessed Feb.20, 2012)
  2. Grant P, Kim AT. Infection control consultation in a 150-bed acute care hospital: Making this unobserved and unmeasured critical job function visible. Am J Infect Control 2007;35:401-6.
  3. Lee TB, Montgomery OG, Marx J, et al. Recommended practices for surveillance: Association for Professionals in Infection Control and Epidemiology (APIC), Inc. Am J Infect Control 2007;35:427-40.