Hand Hygiene

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Hand Hygiene Implementation of Compliance
Monitoring

• Twyla Anderson, RN, BS, COHNS
• Memorial Medical Center
• Las Cruces, NM

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(No Transcript)
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Here to talk about Hand Hygiene
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Todays Headlines

• Hand gel use not linked to improved infection
  rates, study finds
• Hospitals Dirty Secrets
• Hey doc Wash Your Hands

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Factors to Poor Hand Hygiene Compliance

• Lack of knowledge
• How hands become contaminated
• Lack of understanding of correct technique
• Understaffing
• Overcrowding
• Poor access to Handwashing facilities
• Irritant contact dermatitis

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What about Gloves?

• Proper use
• Contaminated during care
• Remove when contaminated
• Gloved hands can be contaminated from tiny
  punctures in material, during removal
• Gloves an important adjunct, not a replacement
  for proper Hand Hygiene

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Healthcare Environmental Challenges

• Computers, lint dust magnets
• Keyboards, germ magnets
• High touch surfaces
• People traffic
• Roaming equipment
• Staffs personal items
• Cell phones

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Family Compliant

• Nephew admitted on 1/15/08, security bracelet not
  applied until late in the day on 1/16/08
• Family never saw anyone wash their hands before
  coming into the room.
• Worker went from her nephew to another child in
  the same room without washing her hands or
  disinfecting the equipment.
• Several nurses were wearing long, dirty, acrylic
  nails.

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Family Compliant

• The phlebotomy tech on 1/16/08 at 0530 was not
  wearing gloves and would not put them on when
  asked her to so (also wearing acrylic nails).
• They did bring their concerns up to a nurse who
  disregarded them.
• Familys main concern No Hand Washing at all

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Monitoring Surveillance

• Monthly Quality Report
• VAP, BSI, UTI
• POA rate
• Hospital wide HAI rate
• SSI rate
• Surgeon follow up letter return rate
• C-section rate
• MRSA, VRE, CDIFF, ESBL, DRSP with CA HAI rates
• Hand Hygiene Compliance NPSG 7
• BFE BFE rate (BFE/FTE X 1000 pt days)

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Interventions/Training

• Starts with initial orientation
• Infection Control Pocket Guide
• Infection Control Manual
• How to use the Patient Information Packet
• Thumbs Up for Clean Hands
• Communication in Hospital Newsletters
• Know how to find the IC Nurse

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Infection Controls Responsibilities

• Role model
• Educate, target your audience
• Communication/Updates
• Monitoring
• Follow up
• Constructive feedback
• Non threatening interventions
• Share your passion

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IC GOALS for 2008

• More visibility
• Report to departments monthly infection rates
• Educational offerings
• Share information timely
• Share my passion
• Give recognition
• Develop departmental Infection Control/Patient
  Safety Liaisons
• Be a motivator
• Keep Learning

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MMC IC PLEDGE for 2008

• We promise to clean our hands before caring for
  you, please let us know if we have forgotten.

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What are the numbers?

• 1.7 million HAI annually
• 99,000 deaths from HAI
• What other business would still be operating in
  the USA if they harmed or killed this many people
  every year?

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What if our team saw the faces?
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Patient Safety Excellence

• Zero tolerance for infections
• Takes energy
• Takes ambition
• Takes enthusiasm

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Thank you!