Recommendation For Hand Hygiene Reminder System

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).

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.

Atul Gawande explains the single biggest problem facing hospitals in the spread of infection in his novel, Better. This is expressed in his conversation with the infection control team, where it is said that “their greatest difficulty is getting clinicians like me to do the one thing that consistently halts the spread of infection: wash our hands. (Gawande, 2007, 14)” He notes that diligence, one of his three core requirements for success in medicine, plays a huge role in enforcing a policy like handwashing. While everyone knows hand washing is important, especially in a hospital, letting health care professionals ignore the practice and make their own decisions about its criticality harms the whole population.

The main of focus of the quality improvement program is always patient’s safety, needs, quality care and expectations. Even though the healthcare system is very critical as it involves the lives of other, there are some errors that can lead to undesirable consequences. One of the most common error that risks the lives of thousands of people including both patients and healthcare employees is the hand hygiene. Healthcare personnel are the leading source for the spread of Hospital acquired Infections. Every year about one million people die from hospital acquired infections in United States.

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.

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)

Stethoscope is one of the most commonly used medical devices on a clinical setting, the environment of which is often represented a potential vector for hospital acquired infections. Scholars highlights that the sterilization of invasive equipments and the disinfection of any kind of devices before the interventions are generally ignored (Kilic et al., 2011). Among those devices, stethoscope is the widely-used equipment with the most possibility of contamination of transmitted organism. Researchers emphasize that the increasing proliferation of infection required diligent hygiene of both hands and instruments between patients to reduce hospital acquired infections (Shaw and Cooper, 2014). Therefore, a survey is being conducted with a brief nurse-directed questionnaire to review perceived reasons for stethoscope antisepsis non-compliance and stethoscope antisepsis compliance. The purpose of this project is to improve compliance with stethoscope care before and after patient contact on the Acute Medical and Progressive Care Unit (D6/5) at University Hospital in Madison, Wisconsin. The following

Action: After making these findings, she collaborated with the infection control staff, her manager, and her team to formulate a plan to solve this problem. At every huddle, she reminded staff the importance of washing their hands. She designed signage to remind staff, patients, and visitors to perform hand hygiene and to empower patients and family members to ask staff members if they have washed their hands. These signs were placed on all 25 patient room entrances and are a visible reminder to everyone who enters. She also educated staff to collaborate with the housekeeping staff to maintain functioning hand hygiene equipment. When performing as charge nurse, she audits all patient charts to confirm that each patient has had their nares swabbed to maintain compliance and assigns patients accordingly to beds based on their multiple drug resistant organism history. Outcome: Through random audits, she found that hand hygiene performance increased to 100%, and the staff is educating patients, family members, and other healthcare professionals in other disciplines about the hand hygiene compliance initiative. The C Diff transmission rate as of December 2015 was 39.45% - the C Diff transmission rate for first quarter FY16 was 18.48%, this shows a 50% reduction in C Diff transmission on her unit. The MRSA transmission rate as of December 2015 was 7.97% - MRSA transmission rate for first quarter FY16 was 3.7% which also shows a 50% reduction in MRSA transmission. Sustainability: She continues this to perform random audits, reinforcing education as needed and continues surveillance while performing duties on 7B. She made it the 7B staff’s responsibility to hold each other accountable for performing hand hygiene in order to maintain the safety of the

Hospital-Acquired Infections entail, urinary tract infections, pneumonia and bloodstream infections. In addition to the patients, the Infections tend also to affect the healthcare workers who usually take care of the patients who are the main sources of the of the infectious diseases in the hospitals. The project tends to investigate the best evidence-based practices and approaches used to reduce the rate transmission and spread of the HAIs, such as washing of hands by healthcare workers. The statement of the problem focuses on the best methods and efforts that can be developed and implemented in the hospitals with the objective of preventing the Hospital Acquired Infections contributed by healthcare workers and the patients who come for treatments at the hospitals (CDC, 2016).

Healthcare associated infections have an impact on patients - how? Can be prevented greatly with compliance to hand hygiene protocols (REF).

The World Health Organization (WHO) introduced five moments of hand wash to help reduce the spread of HCAIs. It outlined that healthcare professionals are to wash hands before patient contact, before clean and aseptic procedure, after bodily fluid exposure, after patient contact and after touching patient surroundings. (Lister 2011). In the wards, there are ‘cleanyourhands’ and five moments of hand wash posters on the walls of toilets and doors to remind staff and visitors to always wash their hands after using the toilet and after visiting patients.

The problem of compliance is unknown due to the lack of surveillance and the level awareness. In order to ensure compliance, the implementation of an electronic monitoring system is necessary; rather than having direct supervision, which can lead to the Hawthorne Effect and Observer Bias. Electronic monitoring can be done pre-surgeries by making sure the healthcare professional on duty has met all requirements before undergoing the procedure. It can also be used to detect compliance with hand hygiene. With this intervention, hospital administrators can focus more on the goal of protecting the lives of the patients while reducing HAIs. Each physician will have an identity badge with sensors that will detect compliance. This system can detect compliance by the time of day, the day of the week, work shift, and workload of healthcare workers. The sensors on the badge can ensure that the healthcare workers are performing hand hygiene. These sensors would be able to detect alcohol-based products when their hands are near the ID badge. Along with this video

Provide education just in time — at or near the point of care — with posters or video displays. Provide computer video presentations of proper technique — embed in Intranet, email distributions, or electronic medical record (EMR) Use fluorescent dye-based training methods to demonstrate correct hand hygiene techniques to clinical staff. 2. Design and test a process for stocking supplies. Assign responsibility to check supplies of soap, rub, and gloves, and assess compliance; set up system to report needed restocking Evaluate soap and alcohol dispensers before purchase to check usability; use front-line staff in evaluation. Make compliance convenient, for example, provide pocket sized bottles of alcohol gel 3. Create a culture that supports reliable hand hygiene. Enlist opinion leaders as role models: Leaders discuss and demonstrate proper technique. Coach opinion leaders to make mutual monitoring an accepted behavior norm. 4. Use reminders at the point of care Enlist patient and caregiver cooperation in providing reminders: Inform every patient that hand washing is expected and encourage them to observe and question staff; start an “OK to Ask” campaign (i.e., patient education encouraging them to ask about hand hygiene before care is provided); place an announcement by the chief executive on the

The need to wash hands has been proven to be beneficial in decreasing Hospital Acquired Infections (HAI) since the time of our foundress, Florence Nightingale was practicing. Though this is widely understood to be beneficial, healthcare providers have consistently scored poorly on studies regarding compliance to hand washing with a rate of 39% on average. In the United States, the healthcare industry has felt an economic burden due to HAI’s which account for the largest rate of morbidity and mortality. HAI prevention is possible with the practice of hand hygiene which is the single most important task healthcare providers can offer. Diegel-Vacek & Ryan, (2016).

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.