Gbstetric Performance Assessment

Keeping our hands clean is one of the most effcient and important steps we can do as humans to avoid getting sick or spreading germs to other people. Unwashed hands spread many diseases such as the flue, E. coli, and salmonella. Unfortunately, hand hygiene is still one of today’s most leading causes of infection in health care facilities. The risk of clinicians, patients, and visitors not complying with hand hygiene protocols creates a practice problem for nurses and their patient care. The cause of health care infections, also known as, health care-associated infections (HAIs) are increasing along with the rise of the inability to control or treat infections that are multi-drug resistant. Lack of proper hand hygiene is a major problem in clinical settings sourcing from critical care divisions where the most contaminations are prevalent. This paper will discuss how hand hygiene affects the nursing process and solutions of how to better prevent HAIs within the nursing scope of practice.

CMS will be rewarding the top performing hospitals by increasing to their payment for Medicaid patients. HCAHPS survey is sent out within six weeks of the patients discharged, there is 27 questions relating to communication with the staff, cleanliness, pain management, communication about medicines, discharge information and if they would recommend the hospital. The data is to Premier Incorporated to categorize the date, and then place this information on the website http://.wwwhospitalcompar.hhs.gov and available to the public. Health Quality Alliance and Center of Medicare and Medicaid Systems have awarded over eight million to hospitals who have shown improvements in the care of their patients.

Patient satisfaction: This issue can affect funding, revenue and reimbursement from insurance providers. Patient satisfaction can be affected by nearly any aspect of the hospital experience, surveys are done randomly to gain insight on the patients overall treatment at the facility. Negative feedback can cause assumptions about treatment and quality by the HCO as well as decrease in incoming patients.

CDCs clean hands count campaign aim to improve healthcare provide adherence to hand hygiene recommendations, address, myths and misperceptions about hand hygiene and empower patients to play a role in their care by asking or reminding healthcare providers to clean their hands and the most germs that cause serious infections in healthcare are spread by people’s action, every patient is at risk of getting an infection while they are being treated for something else, hand hygiene is a great way to prevent infections and healthcare providers clean their hands less than half of the time they should, good hand washing is the first line of defense against the spread of many illness.

He feels that we need to enforce the hand washing policy of the hospital to extend to the general public that comes in and out of the ED (Larsen MSN, ARNP, FNP, 2009).

Another problem that goes with the lack of hand-hygiene compliance is the many excuses that healthcare workers use to avoid washing their hands. Hass and Larson summarize (2009) some of the barriers to adherence that healthcare workers use, “a lack of access to hand-washing sinks, insufficient time, skin irritations, and lack of accountability” (Hass & Larson, 2009). Some solutions they explain to combat the barriers are to put more alcohol-based sanitizers where sinks are not around and placing them all over the patient care areas also reduces time and can be a suitable way for proper hand hygiene if the healthcare worker’s hand is not soiled. They also describe, “Involve staff in trying several alcohol-based hand sanitizers before deciding on one, and involve employee health services in creating a plan to manage hand-skin problems among staff. Alcohol-based sanitizers that have lotion in them can be helpful for staff who have very sensitive skin” (Hass & Larson, 2009).

Patients have observed several physicians and nurses not washing their hands before interacting with patients. Hand hygiene is one of the largest tactics to combat nosocomial infections. The hospital should adopt a culture of 100% compliance with hand washing. The first step would be to increase handwashing stations and have more quick-dry alcohol-based antibacterial soap dispensers. Making access easier and decreasing the time taken to wash one’s hands would encourage adherence the policy. Furthermore, each floor should track hand washing and report data of potential nosocomial infections caused by improper handwashing. Keeping patients protected from bacteria is important especially when most are in an immunocompromised

Hospitals and insurance providers alike as well as the Centers for Medicare and Medicaid Services (CMS) are aiming to measure the value of health care (Morris, Jahangir, & Sethi, 2013). Improving patient satisfaction not only enhances the care a patient receives overall but it can have a major impact on a hospital’s reputation and financial results as well (Hall, 2008).

The HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) survey is the first national, standardized, publicly reported review of patients ' perspectives of hospital care. While many hospitals have collected information on patient satisfaction for their own internal use, until HCAHPS there was no national standard for collecting and publicly reporting information about patient experience of care that allowed valid comparisons to be made across hospitals locally, regionally and nationally.

In other to be successful in improving adherence with hand hygiene policies and procedures at the hospital, the system of change strategy will be multimodal and comprise staff education and motivation, the use of performance indicators, and hospital management support (Troy, n.d.). Effective campaigns will bring about lessened contamination rates, antimicrobial resistance spread, and improve patient safety. The multidisciplinary strategy will include: (British Columbia Ministry of Health, 2012)

The five core curriculum components will be evaluated during the execution, and outcome of the designed program to improve HCAHPS scores. All five curriculum sessions encompass the patient’s

Highlighted in the Keogh Review, and the Francis Report - Avoidable harm was inflicted by HCAI - Hand hygiene not routine amoung staff (REF). - Patients were not encouraged or assisted with hand hygiene, leading to risk of infection, staff lack awareness. - Further training needed - Staff and visitors need to comply with guidelines.

Hand hygiene is everybody’s job, including the patients. Linda Pearson (2006) refers to AL Damouk et al (2004) who suggests that inviting patients to become partners in their care maybe an appropriate response to reports of the rising incidence of healthcare associated infections and difficulties with

Recent studies show that at any time, over 1.4 million people worldwide suffer from hospital-acquired infections (Public Health Ontario). In Canada alone, approximately 250 000 patients every year contract infectious micro-organisms from their healthcare providers (Nagel 18). At London Health Sciences Centre (LHSC) we take pride in providing world class care in a safe, comfortable environment for patients. However, between 2008 and 2010 the LHSC still had between 20 and 30 per cent non-compliance to proper hand-washing protocol (Nagel 20). This data is very troubling considering it is following the launch of “Just Clean Your Hands” pilot project. As student nurses and volunteers of the LHSC team we are equally responsible to increase hand-washing compliance.