Providing Healthcare in a Public Health Emergency Part 2: Avoiding Missteps and Professional Consequences in Infection Prevention

Part 2: Infection Prevention

Welcome to part two of our ongoing blog series exploring how health care providers (HCPs) can avoid missteps and professional consequences in the face of shifting professional responsibilities and challenging work environments caused by the COVID-19 pandemic. In this installment, we will discuss the potential consequences of HCPs failing to follow infection prevention policies.

Infection Prevention

Infection prevention policies and procedures have been deployed across the health care sector to protect patients, HCPs and the general public from COVID-19. It is expected that HCPs will cooperate with these policies, as failing to do so could lead to civil liability for negligence on the part of the HCP or their institution. While not every patient who contracts COVID-19 relating to the receipt of health care will have a viable civil action, the failure to comply with infection prevention policies may well be determined to be a breach of the standard of care, founding a claim for damages.

Additionally, a HCP who fails to comply with health directives and professional guidelines relating to infection prevention may well face disciplinary action by their employer or regulatory college. Failing to follow such directives could be considered to be a breach of the standard of practice of the profession, and therefore an act of professional misconduct.

This is what happened in a previous infection outbreak, as illustrated by the case of College of Nurses of Ontario v Pamayah, 2007 CanLII 82764 (ON CNO). Ms. Pamayah, a nurse, was suspended for 12 months with several terms and conditions, and received an in-person reprimand for intentionally misleading her employers and breaking quarantine during the outbreak of Severe Acute Respiratory Syndrome (SARS) in 2003. Ms. Pamayah worked at two hospitals, one of which had active SARS cases, meaning that she was not permitted to work at another hospital for ten days. Instead of observing this quarantine period, Ms. Pamayah lied about her potential SARS exposure and went to work at the other hospital.

The Discipline Committee panel found that Ms. Pamayah failed to meet the standard of practice by not following the policies established by the Ontario Ministry of Health and her employers to curb the spread of SARS. As a result, the nurse was found to have engaged in professional misconduct, by failing to maintain the standards of practice of the profession and engaging in conduct which would be regarded by members as disgraceful, dishonourable, and unprofessional. In their Reasons for Decision, the Discipline Committee stated, “your attendance for work at [Hospital A] risked exposing your patients, your colleagues, staff members and any other persons entering [Hospital A], to the risk of infection from a potentially fatal disease”.

This is one example of how acts of professional misconduct may arise in the context of a public health emergency, and why, now more than ever, HCPs should ensure that they are up-to-date and familiar with professional standards. This includes public health directives and other policies that affect how HCPs deliver health services during the current public health emergency.

If you or your organization have questions regarding how to implement public health directives and other COVID-19 related policy changes, please contact us.

Check back for part three of our blog series, in which we discuss the HCP responsibility to maintain patient privacy during a public health emergency.

Additional resources for HCPs:

• Ministry of Health and Long-Term Care “COVID-19: Guidance for the Health Sector”

• College of Physicians and Surgeons “Covid-19: Information for Physicians”

• College of Nurses of Ontario “Covid-19: Information for nurses”

• Ontario College of Pharmacists “Novel Coronavirus (COVID-19) for Pharmacy Professionals”