Exploring Hand Hygiene Knowledge and Practice

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Exploring Hand Hygiene Knowledge and Practice




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Presentations text content in Exploring Hand Hygiene Knowledge and Practice

Slide1

Exploring Hand HygieneKnowledge and Practice

Training Module #1 for the CAUTI LTC Core Team

Slide2

2Learning Objectives

After completing this training, the facility core team members will be able to:Explain why hand hygiene is so important to prevent the spread of infections

Reinforce

when and how to perform hand

hygiene

Recognize challenges to hand hygiene in their facility, and identify possible solutions

Discuss ways to monitor hand hygiene adherence and develop feedback reports

Slide3

Front-line Staff Training Recap

Hand hygiene is one of the most important ways to prevent the spread of infectionsGerms, especially gram-negative bacteria, are frequently found on health care worker hands following routine resident care

WHO 4 moments are a simple framework to remember

when

staff should perform hand hygiene during any resident interaction

Guideline for Hand Hygiene in Health-care Settings. MMWR 2002; vol. 51, no.

RR-16

Mody et al Infect Control

Hosp

Epidemiol; 2003:24:165-171 Guide on Hand Hygiene in Outpatient and Home-based Care and Long-term Care Facilities. Just Clean Your Hands Educational Resources: http://www.publichealthontario.ca/en/BrowseByTopic/InfectiousDiseases/JustCleanYourHands/Pages/JCYH-ltch-Education-and-training.aspx

3

Slide4

Hand Hygiene Technique4

http://www.who.int/gpsc/en/

http

://

www.cdc.gov/handhygiene/Resources.html#HCP

Slide5

Front-line Staff Training Recap

Alcohol-based hand products are preferred for hand hygiene during almost all routine patient care activitiesExceptions: When hands are visibly soiled

After care

of a resident with known or suspected infectious diarrhea

Clarify hand hygiene expectations during care of a resident with

C. diff

ABHRs are appropriate on entry to room; use gloves appropriately to prevent hand contamination; wash with soap and water upon glove removal and exiting room

Guideline for Hand Hygiene in Health-care Settings. MMWR 2002; vol. 51, no.

RR-16

Oughton MT et al. J Infect Hosp Epidemiol 2009;30(10):939–944. Dubberke E et al. SHEA/IDSA Practice Recommendation. J Infect Hosp Epidemiol 2014;35(6):628-645

5

Good

Better

Best

Plain

soap

Antimicrobial soap

Alcohol-based hand rub

Slide6

Front-line Staff Training Recap

Gloves play a key role in preventing hand contamination – but do NOT replace hand hygienePerform hand hygiene and wear gloves immediately before:Placing or removing an indwelling catheterAccessing the drainage system to empty the drainage bag or collecting a urine

sample

Remove gloves and

perform hand hygiene

immediately after:

Handling an indwelling catheter

Accessing the drainage system to empty the drainage bag or collecting a urine

sample6

Slide7

Health Care Worker Challengeswith Hand HygieneBelief that hand hygiene guidelines aren’t applicable

30% wouldn’t change current practices; 20% said guidelines were impracticalLack of access to appropriate hand hygiene supplies

16.2% lack of available sink; 27.5% lack of alcohol-based hand rub

No

hand hygiene

because of glove

use

23% nurses, 17% CNAs, 26% other HCWs

Forgot

about hand hygiene because of workload35% of nurses, 22% CNAs, 44% other HCWsLack of access to hand hygiene feedback and/or education55% never to rarely received personal feedback on HH practicesOther HCWs less often received periodic education on HH (86.8% vs. 92

% of nurses and CNAs, p=0.03)

Ashraf MS et al. ICHE 2010; 31(7):

758-762

7

Slide8

Addressing Barriers to Hand Hygiene8

Let’s Chat!What challenges do you experience performing hand hygiene in your facility?What solutions do you propose to address these challenges in your facility?

How can you support a culture of safety around hand hygiene

?

Slide9

Hand Hygiene Adherence Monitoring Options

MethodPros

Cons

Direct observation of hand hygiene technique

Educational moment

Does not measure adherence during patient care

Direct observation of hand hygiene adherence

Captures

information on product, technique

Data summarized by staff type, shift, unit

Educational moment

Time and resource intensiveCan influence performance

Measurement of volume of AHBR or soap used

Easy

to track consistently

Consumption

may not correlate with appropriate use

Could be biased by purchasing patterns

Survey/self-report of hand hygiene adherence

Captures

perceptions and barriers

Rates

often inflated

9

Slide10

Feedback and Disseminationof Hand Hygiene RatesProviding feedback on hand hygiene adherence to front-line staff

is key to raising awareness and maintaining high compliance ratesConsider opportunities for “just in time” education when incorrect practices are observed

10

Slide11

Interactive ActivitiesDemonstration of hand hygiene techniqueCulture staff hands before and after hand hygieneDemonstration of germ transfer

Use glow powder on commonly touched objects to see how and where “germs” travel11

Before After

Slide12

Hand Hygiene VideosWHO - SAVE LIVES: Clean Your HandsHand Hygiene Video New England Journal of Medicine

Hand Hygiene Training Films and Slides O les mains Hand Hygiene Dance CDC—Hand Hygiene Interactive Education Video

Public Health Ontario—Just Clean Your Hands

NPSA Wi-Five Hand Hygiene Video Game

12

Slide13

Hand Hygiene PostersCreate your own!Have staff role model positive behaviorsOther Resources:

CDC and WHO Hand Hygiene ResourcesAdditional postersPublic Health Ontario – Just Clean Your Hands

13

http://

www.cdc.gov/handhygiene/Resources.html#HCP

Slide14

Take the Pledge…14

Slide15

Stay Updated with Useful Resources15

Take the PledgeWorld Health Organization How to Handrub PosterWorld Health Organization How to Handwash Poster

Slide16


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