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Good Infection Prevention Habits Don’t Just Happen

Categories: Hand Hygiene, Healthcare-associated infections

Elaine Larson, RN, PhD, CIC, FAAN

Elaine Larson, RN, PhD, CIC, FAAN

Guest Author – Elaine Larson, RN, PhD, CIC, FAAN
Associate Dean for Research and Anna C. Maxwell Professor of Nursing Research
Columbia University School of Nursing
Editor, American Journal of Infection Control

Over the past few decades, especially since the ‘antibiotic era’ and the advent of increasingly technologic and sophisticated interventions, there has been less and less attention paid to simple hygiene measures in the curriculum of healthcare professionals.  In fact, I recall in the 1980s reading that the age of infections was coming to an end because we had conquered germs.  Confident that the ‘battle against germs’ was won, hand hygiene, isolation practices, and personal protective equipment took a back seat to fancier therapies.  Educators of physicians and nurses seemed to assume either that everybody knows how to wash their hands (or perhaps that it wasn’t really that important?).  Hence, because many effective barrier practices are also rather simple, they have received little, if any, attention in healthcare curricula.

In the September issue of The American Journal of Infection Control, Gould and Drey reported on student nurses’ experiences with infection prevention and control during their clinical placement.  Almost 500 students from England, Wales, Scotland, and Northern Ireland responded to a survey placed on the website of The Royal College of Nursing.  More than three-fourths reported that they had seen clinicians failing to perform hand hygiene before patient contact, and more than half reported deficiencies in other infection prevention practices such as ‘sharps’ disposal, changing personal protective equipment between patients, or failure to apply isolation precautions.

Even though the study was biased by a low response rate and by the fact that nursing students who respond to such surveys may have characteristics and attitudes different than those who do not respond, the findings are very consistent with what others have reported from both nursing and medical students.  That is, when students observe infection prevention practices, they can and do identify frequent breeches in themselves and others. 

So what do these findings mean for educators and for clinicians working with ‘newbies’?  Clearly, the problem does not seem to be lack of knowledge, since students can identify deficiencies.  But we know that infection prevention practices and habits don’t just happen, even when people know what to do!  Having students be observant of practice increases their mindfulness and can help translate the ‘book learning’ into actual practice.  Such ‘mindfulness’ ultimately is what will be required of all staff members to build the kind of safety and patient-oriented culture for which we are striving.  So, we need to support students and staff to increase their mindfulness and take ownership of their own infection prevention practices.

Watching Hands: Georgia-Pacific Professional and the CDC Foundation take an artistic approach to promote hand washing

Categories: Hand Hygiene

 Art of Washing Hands

Art of Washing Hands

Guest Author – Bill Sleeper
Georgia-Pacific Professional

Each year, more than 200,000 people are hospitalized with the flu and 36,000 die from complications of the virus, according to the CDC. While it may seem like a mundane daily task, washing your hands is the single most effective way to prevent the spread of disease.

As a leading provider of hygienic washroom solutions, Georgia-Pacific Professional is committed to educating citizens about proper hand hygiene practices. Our ongoing efforts are showcased through a variety of campaigns, activities and initiatives that teach and remind people of all ages about the importance of hand washing and drying. Entering its third year, our Art of Washing Hands program features a karate-themed Mo – Georgia-Pacific Professional’s VP of Hygiene and Chairman of Cool – to educate kids about the importance of hand hygiene in a fun, interactive way. Last year we launched Spread Wellness, a campaign aimed at teaching people proper hand washing techniques and encouraging them to share these practices wherever they go.

Hand Hygiene CAN Save a Patient’s Life

Categories: Hand Hygiene, Healthcare-associated infections

Armando and Victoria Nahum

Armando and Victoria Nahum

Author – Victoria Nahum
Co-Founder and Director
Safe Care Campaign (Atlanta, Georgia)

My name is Victoria Nahum. Almost 5 years ago, my husband Armando and I learned the hardest lesson of our lives. We learned that losing our 27 year old son Joshua to a healthcare-associated infection didn’t have to happen; even worse, his untimely death may have been prevented by some simple steps we wish we would have known back then. [Read Josh’s story.]

Perhaps the bitter knowledge that he did not die of his original diagnosis (injuries from a skydiving accident), but died instead of what health experts tell us was most likely preventable (a Gram-negative infection he caught during his care) is the hardest thing we live with every day.

In 2006, when Josh was first admitted to the hospital his father and I read and obeyed the sign on the door that simply said, “All visitors must wash their hands before entering the ICU.”

Taking GRIME out of South Carolina

Categories: Hand Hygiene, Healthcare-associated infections, State HAI Prevention

Dixie Roberts, APRN, C, MPH

Dixie Roberts, APRN, C, MPH

Author – Dixie Roberts, APRN, C, MPH
Healthcare Associated Infections Coordinator
South Carolina Department of Health and Environmental Control

“He who doesn’t prevent grime when he can, encourages it”

In 2007, with the knowledge that hand hygiene compliance is directly related to hospital acquired infections (HAIs), the South Carolina Hospital Association (SCHA) launched the first statewide hand hygiene campaign in alignment with the World Health Organization’s (WHO) international hand hygiene campaign. DHEC, AARP, Mothers Against Medical Error and APIC- Palmetto Chapter soon joined the effort.

This campaign had to be engaging in order to be successful. We selected the theme “Grime Scene Investigators: South Carolina” (GSI:SC), a parody on the popular television series CSI. Enthused about our initiative, the South Carolina Chapter of HOSA and the South Carolina Department of Education joined our effort.

In July 2009 a “summons” was sent to hospital infection prevention and marketing departments and public health regions calling them for training in Grime Scene Investigation. Each hospital received a GSI:SC kit with everything needed to set up a “grime scene” to create awareness while educating people on proper hand hygiene and its importance. Every SCHA member facility and public health region demonstrated their support of the campaign by designating a point of contact.

Hand Hygiene: Back to Basics in Infection Prevention

Categories: Hand Hygiene, Healthcare-associated infections

Katherine Ellingson, PhD

Katherine Ellingson, PhD

Author – Kate Ellingson, Ph.D.
CDC Epidemiologist
CDC’s Division of Healthcare Quality Promotiona

Hand hygiene is a simple practice that has been at the core of infection prevention for over 150 years. Yet getting healthcare personnel to follow recommended hand hygiene practices in today’s complex and demanding healthcare environment continues to be a monumental challenge. Even in the developed world, adherence is estimated to be less than 50%, meaning healthcare personnel practice hand hygiene fewer than half of the times that they should.

In the past year, the visibility of novel strategies to improve hand hygiene in healthcare has increased — from technologies that can monitor and report hand hygiene performance in real time, to smartphone applications that streamline hand hygiene data collection by human observers, to financial incentive schemes that pay or fine healthcare personnel based on hand hygiene performance.  We at CDC are very interested and engaged in understanding how these strategies work, what their strengths and limitations are, and how feasible and affordable their implementation is. Creative or high-tech solutions must work in parallel with the fundamental building blocks of hand hygiene improvement: education, grassroots promotion, and leadership.

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