engaging patients in hand hygiene
TRANSCRIPT
6/12/2012
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Intermountain APIC and Qualis Health
present
I-APIC HAI Prevention Learning Network Webinar Series
Engaging Patients in Hand Hygiene
June 13, 2012
Timothy Landers, CNP, PhD
Engaging Patients in
Hand Hygiene
Timothy Landers RN CNP PhD
Assistant Professor
College of Nursing
The Ohio State University
Columbus, OH
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Patient Hand Hygiene (PHH)
1. Identify current evidence for the role of
patients’ hands in the transmission of infection.
2. Describe current efforts to include patients
in hand hygiene.
3. Identify three important considerations of a
patient hand hygiene program.
Objectives
Does your hospital have programs in
place to increase patient engagement
in infection control and prevention?
A. Yes
B. No
C. Don’t know
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Does your hospital have programs in
place to increase patient engagement
in hand hygiene?
A. Yes
B. No
C. Don’t know
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Evidence that patients hands could be
involved in transmission of HAIs
• Our natural ecology
• Environmental contamination
• Direct transmission
• Endogenous vs. exogenous sources of
infection
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Man vs. microbe
• Number of organisms
– Man
60000000000
– Bacteria
5000000000000000000000000000000000000000000
• Biomass
• Time on earth
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Evidence that patients hands could be
involved in transmission of HAIs
• Our natural ecology
• Environmental contamination
• Direct transmission
• Endogenous vs. exogenous sources of
infection
Environment
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Environment
Evidence that patients hands could be
involved in transmission of HAIs
• Our natural ecology
• Environmental contamination
• Direct transmission
• Endogenous vs. exogenous sources of
infection
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Direct Transmission
• Patient cases linked with higher norovirus
transmssion compared to HCW staff (OR 4.8)
• Outbreak investigations
– (insert your recent outbreak here)
Patients are commonly colonized
• Enteroocci present on hands
– 10.7% nonhospitalized adults
– 62% hospitalized patients
• Coliform contamination
– 20.4% general medical
– 35.8% spinal ward
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48 hours after admission
39%
positive
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Patient Hand Hygiene (PHH)
1. Identify current evidence for the role of
patients’ hands in the transmission of
infection.
Objectives
• Transfer of pathogens in
environment
• Direct spread to other patients
• Transferring pathogens to HCW
hands
• Increasing own risk of infection
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Studies on patient hand hygiene
• Patients as monitors/auditors of HCW HH
compliance
– It’s ok to ask
– CleanYOURhands
– Partners in your care
Model of patient-centered care
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Studies on patient hand hygiene
• Only 50% of patients were offered HH after
using commode
• 64% of nurses reported offering HH opportunity
to patients
• 95-100% of patients and HCWs recognized that
HH is important in preventing infection
Patient Hand Hygiene (PHH)
Describe current efforts to include patients in
hand hygiene.
Objective 2 Review
• Most published programs include
patients as monitors/auditors of HCW
HH
• Including patients increases HCW HH
• Joint Commission standards require
including patients and visitors in infection
prevention activities
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Patient hand hygiene:
The need
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Patient Hand Hygiene (PHH)
Components of best practice
• Timing
• Technique
• Product formulation
• Education of staff, patients, and visitors
• Part of a multi-modal strategy
When implementing a patient hand
hygiene protocol, how concerned are
you about cost of such a program?
A. Very concerned
B. Somewhat concerned
C. Not concerned at all
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When implementing a patient hand
hygiene protocol, how concerned are
you about patient ingestion of
alcohol-based hand sanitizers?
A. Very concerned
B. Somewhat concerned
C. Not concerned at all
When implementing a patient hand
hygiene protocol, how concerned are
you about theft or shrinkage of
alcohol-based hand sanitizers?
A. Very concerned
B. Somewhat concerned
C. Not concerned at all
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When implementing a patient hand
hygiene protocol, how concerned are
you about environmental safety issues
of alcohol-based hand sanitizers?
A. Very concerned
B. Somewhat concerned
C. Not concerned at all
When implementing a patient hand
hygiene protocol, how concerned are
you about the development of
antibiotic resistance?
A. Very concerned
B. Somewhat concerned
C. Not concerned at all
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PHH: Timing
PHH: Timing
• After toileting
• When leaving and returning room
• Before eating, drinking, taking medicine
• Before invasive procedures
• After coughing, sneezing
• Before and after contact with visitors
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Please provide feedback on this quote
Hand hygiene: After pees,
wheeze, please, leaves, or
sneeze.
Do you think that this rhyme would be
useful in advocating for patient hand
hygiene?
A. Yes – very useful
B. Somewhat useful
C. Not at all useful
D. Somewhat unuseful
E. Make a mockery of HH and should not be used
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PHH: Technique
• Use of ABHR vs. soap and water
• Length of product use
PHH: Product formulation
• Gels, foams
• Soap and water
• Wipes
• Must address patient preference and
acceptance
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PHH: Part of a multimodal strategy
• Patient and family education
• Monitoring and feedback
• Organization commitment
• Consideration of product placement
Patient Hand Hygiene (PHH)
Identify three important considerations of a
patient hand hygiene program.
Objective 3 Review
• Timing
• Technique
• Product formaultion
• Dispenser location
• Part of a bundled approach!
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Patient Hand Hygiene (PHH)
1. Identify current evidence for the role of
patients’ hands in the transmission of infection.
2. Describe current efforts to include patients
in hand hygiene.
3. Identify three important considerations of a
patient hand hygiene program.
Objectives
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Contact Information
Quality Improvement Organizations
Jennifer PalagiQualis Health, Idaho QIO
Tina SchwienQualis Health, Washington QIO
Laurie Murray-SnyderAcumentra Health, Oregon [email protected]
503.382.3927
Timothy [email protected]
Intermountain APIChttp://apicintermountain.com/Trish Heath, Education Lead
[email protected] Maggard, President
This material was prepared by Qualis Health, the Medicare Quality Improvement Organization for Idaho and Washington, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human
Services. The contents presented do not necessarily reflect CMS policy. ID/WA-C7-QH-830-06-12
6/12/2012
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Save-the-Date: I-APIC HAI Series
CDC’s Epi-X: Spotting and Relaying Trends to ProvidersWednesday, July 11, 1pm MT/12pm PT
Jim Schwendinger, MSN, MPH, NPTeam Lead, Epi-X & HAN
Director, Epi-X & Team Lead, Epi-X and HAN Team
Emergency Risk Communication Branch
Division of Emergency Operations
Office of Public Health Preparedness and Response
Centers for Disease Control and Prevention (CDC)
Preventing Central Line InfectionsAugust Date May Change
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