Bird Flu Hits Florida Trailer Park

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Bird Flu Hits Florida Trailer Park
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Colorado Patient Safety Coalition Hand Hygiene

• Laurie Griffith, BSN, MPH, CIC
• Manager of Infection Control
• Denver Health

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Terminology

• Hand washing soap and water
• Hand sanitizers waterless alcohol-based
• Hand hygiene cleaning ones hands
• Disinfect environmental surfaces
• Sanitize skin
• Infectious disease treating ones disease
• Infection control preventing transmission
  between people

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Hand hygiene is the simplest and most effective,
proven method to reduce the incidence of
healthcare associated infections.

• - The Centers for Disease Control (CDC)

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Patient Safety

• Prevent Healthcare Associated Infections
• Environmental Contamination
• Transient Flora
• Patient to Patient
• Oneself

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Many personnel dont realize when they have germs
on their hands

• Healthcare providers can get 1000s of bacteria on
  their hands by doing simple tasks, like
• pulling patients up in bed
• taking a blood pressure
• touching a patients hand
• rolling patients over in bed
• touching the patients gown or bed sheets
• touching equipment like bedside rails, over-bed
  tables, IV pumps

Culture plate showing growth of bacteria 24 hours
after a nurse placed her hand on the plate
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The literature suggests that in the acute care
setting there may be up to 45 occasions for HH
per hour per patient

• Vandenbroucke-Grauls C., 2000
• Gould D, 2004

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How many hand hygiene opportunities are there in
the hospital each day??

• Nurses
• Nurse Aides
• Phlebotomist
• Respiratory Therapist
• Physical Therapist
• Radiology Technologist
• Social Worker
• Transporters
• Dietary

• Physician
• Cardiologist
• Pulmonologist
• Internal Medicine
• Surgeon
• Fellow
• Residents
• Med Students

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How many hand hygiene opportunities are there in
the hospital each day??

• Blood draw at 5 am
• Chest X-ray 6 am
• Nuclear Medicine 9 am
• Physical Therapy 10 am
• Bronchoscopy 1 pm

• Turn every 2 hrs
• Vital signs every 4 hrs
• Nebulizer tx every 4 hrs
• Toileting every 6 hrs
• Ambulate every 8 hrs
• 3 meals / day snack

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Products

• Soap
• Waterless, alcohol-based hand sanitizers
• Foam
• Gel
• Hand wipes
• Lotion

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Federal Register

• Carpet
• Width of hallway
• Storage
• Fire Sprinklers
• Electrical Sources
• Oxygen

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JCAHO International Patient Safety Goals as
accreditation requirements for 2007

• Goal 7 Reduce the risk of health care-associated
  infections.
• 7A Comply with current Centers for Disease
  Control and Prevention (CDC) hand hygiene
  guidelines.

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Surveillance

• No standard
• Observation
• Johns Hopkins
• Computer voice prompting
• Before the study 19
• During the study 27
• After the study 24

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Even this didn't work!
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SHEA 2006 Abstract (KY)

• Improving Hand Hygiene Compliance
• Rates were 0 - 20
• MRSA outbreak
• Corrective measures
• Verbal correction
• Mandatory computer modular training
• Verbal warning
• Written warning
• HR disciplinary action / dismissal
• Rates improved to 85 - 95

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Ask me if Ive washed my hands

• Des Moines Register March 2005

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Compliance

• Location
• Product selection
• Surveillance
• Before
• After

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Hospital Campaign

• Surveillance
• Overall
• Before After
• Department
• Profession
• Shift
• Availability
• Installed over 400 canisters
• Options
• Foam
• Large gel containers
• Hand-held gel bottles
• Education

• Foam Slogans
• Coupons
• Share data
• Post it!
• Compare it!
• Kudos for improvement!
• Screensavers
• Photos of CEO and Med staff washing their hands
• Articles in hospital newsletter

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Misconceptions about hand hygiene

• If I wear gloves, I dont need to wash my hands
• Waterless hand sanitizers have alcohol in them,
  thus they will dry my skin
• Washing hands between patients is sufficient
• We should worry more about the dirty keyboards
  and how to disinfect them!
• Were too busy saving lives to wash our hands!

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Questions??
Laurie.Griffith_at_dhha.org 303-436-6484