infection prevention
infection prevention
By Constance J. Cutler, MS, BS, BSN, RN, CIC, FSHEA, FAPIC
Mentoring as Quality Improvement in Infection Prevention
Although a long, satisfying career is rewarding in itself, I want to help IPs with less experience learn faster by sharing my knowledge, having learned both the easy way and the hard way. Never was this more apparent than during the COVID-19 pandemic, which is not over, with more than 300 people still dying every week in the U. S.— Constance J. Cutler, MS, BS, BSN, RN, CIC, FSHEA, FAPIC
As an infection preventionist( IP) with many years of experience, I have been both a mentee and a mentor. At this stage in my career, I love mentoring IPs. Although a long, satisfying career is rewarding in itself, I want to help IPs with less experience learn faster by sharing my knowledge, having learned both the easy way and the hard way. Never was this more apparent than during the COVID-19 pandemic, which is not over, with more than 300 people still dying every week in the U. S.
I officially became an independent consultant in 2019, taking short-term assignments that interested me. Most involved my ability to walk into a large medical center as the director and lead infection prevention and control( IPC) teams ranging from five IPs to 11 full-time equivalents. Incidentally, my philosophy is that I do not know it all and never will, but I know from more than 40 years that I’ ll be able to figure it out by pulling from previous positions and circumstances.
This was proven in spades when I was hired in January 2021 as an interim director of IPC in a quaternary university-associated medical center in northeastern New Jersey, just outside New York City. The position was supposed to be for three to six months, and I flew back and forth to my home in suburban Chicago every other weekend. This network of hospitals had a newly formed quality improvement leader who was given a role in IPC, with a network infectious diseases physician. The network was starting a hand hygiene committee, and I volunteered to be a co-leader as long as it could be called a task force, since committees never die. In that role, I successfully evaluated the six current electronic hand hygiene systems on the market, convincing my colleagues, information technology, and administrators to select one that allowed person-specific tracking without the concern that“ Big Brother is watching.”
When I started there, I had six FTEs in IPC, three experienced ones with nursing backgrounds like myself and two new IPs, a microbiologist and a nurse from a unit with many COVID-19 patients. She was hired because of her assistance and obvious interest in preventing transmission in her 50-year-old unit housing elderly patients, with a poor heating, ventilation, and air conditioning( HVAC) system in its semi-private rooms. Transmission of COVID-19 kept occurring from patients in two rooms at the end of the long hallway where the HVAC was not adequate, so a hole was drilled in the special window covering to assist in providing negative pressure for these rooms. January 2021 was a critical time in the COVID-19 pandemic, which was now almost a year old. My IPs had blank, exhausted expressions when I arrived, so the first thing I did was rotate three-day weekends for two of them at a time. None had even had a typical two-day weekend since the pandemic began, and they were spent, physically and emotionally. I also had only a short time to evaluate each before the official end of the fiscal year for their raises, so I immediately started one-on-ones to determine each person’ s strengths and weaknesses, and asked them to honestly tell me why they liked or disliked IP. That gave me the ability to assess them in a short period and focus on their needs and desires to learn.
I quickly perceived that the microbiologist felt intimidated by the nurses in the department, even though she knew way more about laboratory work than they ever would. I asked her to teach the nurses a little about Gram-positive and-negative bacteria and viruses, helping her realize that nurses usually considered microbiology the worst requirement in nursing school.
Each nurse also had a specialty before becoming an IP, ranging from the emergency department to home health nursing. All those experiences were also drawn upon at this large, complicated hospital with many outpatient areas, subject to IPC surveys by the state and the accrediting agency, which had recently written up several opportunities for improvement in the next six months. Since COVID-19 vaccines were just becoming available for healthcare workers and clinicians, this resulted in fewer panicky phone calls as vaccinations were snapped up before this became a political topic. Units were flexed to house various increasing numbers of COVID-19 patients, ranging from the mostly critically ill ones to those too sick to remain in a long-term care environment or at home. Attention to HVAC was important because it was increasingly being recognized that COVID-19 had an aerosol component, not just during exposure-prone procedures, and utilizing N95s or PAPRs was better than surgical masks to protect vulnerable HCWs and HCPs. I knew at the beginning of COVID-19 that as more science was available, recommendations from the CDC were just that – recommendation – and wearing higher-level PPE and using more negative-pressure rooms if available would increase patient safety, preventing transmission to vulnerable patients and staff. I shared that and other topics at our weekly team meetings. Mentoring led to quality improvement and improved patient and staff safety, while helping my mentees succeed in this wonderful profession.
Constance Cutler, MS, BS, BSN, RN, CIC, FAPIC, is a lifelong infection preventionist, with 40-plus years of experience in IPC, nursing, and biology. She loves to teach, mentor, and collaborate to explain concepts related to the chain of infection and apply them to modern questions about the prevention and transmission of infectious diseases. With her background, she can compare past issues to current ones, addressing the fear that sometimes prevents people from understanding and appreciating science.
12 • www. healthcarehygienemagazine. com • jul-aug 2025