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Behavior Change in Healthcare to Break Old Habits and Prevent HAIs

Posted on by CDC's Safe Healthcare Blog
Jan Patterson, MD, MS
Jan Patterson, MD, MS

Author: Jan Patterson, MD, MS, FACP, FIDSA, FSHEA, CPE, FACHE
President of the Society for Healthcare Epidemiology of America

Change is never easy and old habits are tough to break. Since preventable healthcare-associated infections (HAIs) affect one in 20 patients, the healthcare community – from the C-Suite to the front line – must come together to change practices that allow HAIs to impact the quality and safety of patient care.

Last week, medical researchers and practitioners from across the world convened in San Diego for IDWeek 2012TM, the first joint annual meeting of the Infectious Diseases Society of America, Society for Healthcare Epidemiology of America, Pediatric Infectious Diseases Society and HIV Medical Association. The meeting covered the progress we’ve made in eliminating HAIs and what more we need to do to confront these issues.  Even with the evidence that backs up core infection control practices, without behavior change, science can only accomplish so much.

Cultivating a Culture of Safe Care 

Creating change in healthcare requires knowledge and practice of quality improvement.  Professionals must know the evidence-based measures and must also understand standard quality improvement tools to implement them. Similar to corporate cultures, healthcare management needs to show support for these measures for them to be embraced and put into daily practice at the bedside. 

This issue takes real leadership among those who make decisions at the top, making a significant commitment to craft policies in eliminating HAIs by listening to feedback from the entire healthcare team from hospital executives to those on the front line, including doctors, nurses, medical assistants, and laboratory technicians.  

There is a need to recognize and reward success. If a unit achieves a low record of HAIs, make them the model to others to strive toward. Recognize their commitment to the mission of safe healthcare and challenge others to follow in their footsteps. 

Prevention Strategies 

No matter the infection type, SHEA recommends five prevention strategies that should be applied across the board, including: 

  • Improve hand hygiene among healthcare professionals;
  • Use of appropriate isolation precautions for patients known to be colonized with dangerous or drug-resistant organisms like Clostridium difficile or MRSA;
  • Ensure adequate cleaning of the environment and equipment;
  • Remove unnecessary catheters and other devices promptly; and
  • Educate healthcare professionals and patients.

 Across the nation, in acute care facilities of every shape and size, it’s evident that involving the whole healthcare team in efforts that combine science and implementation result in success. Providing safer, high-quality care requires that each every member of the team to do their part to promote a culture of safe care.

Posted on by CDC's Safe Healthcare Blog

3 comments on “Behavior Change in Healthcare to Break Old Habits and Prevent HAIs”

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    Handwashing is the best, with soap, not alcohol. All those antibacterial soap dispensers are a waste and help encourage resistance.
    I understand that in Europe all hospital patients are cultured upon entry. That was the key to detecting infections and so Europe does not have the same level of problem we have.
    The difference is that our insurance companies which have a monopoly on health care, did not want to pay the costs of screening. Great system, right? Now the suffering and extra costs of treating MRSA patients alone could have paid for the screening. Tell me I am wrong please.
    Bill Olkowski, see book on Superbug: MRSA.

    Hand hygiene absolutely the biggest issue based on my experience with family members as inpatients. Being the consumer of care has heightened my awareness especially since someone I know was infected with MRSA.
    In ICU and ER environment I repeatedly noted a lack of handwashing and in one case a lack of accessible sinks. Gloves were the answer it seemed for all BUT they were not changed when moving between patients. Patients, caregivers, providers at every level all need to speak up and ask have you washed your hands or used a hand sanitizer?

    While I believe that innovation and quality products are part of the equation for the elimination of HAI’s, without behavior change you cannot implement either. Building best practice behaviors into every procedure is the only way to get optimal outcomes. I would encourage every institution to review:
    How supplies are put together, is it easy for the clinician to do the right thing with them?
    Audit and correct as part of a daily routine.
    Ensure competence from the educator to the staff, don’t just assume it.
    Years ago we started to focus on “core” competencies. I believe that if we focus on the competencies that reduce morbidity and mortality in our clinical environments we have found the “core”.

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