Clean Care Conversations Webinar STOP! Clean Your Hands Day May 6, - - PowerPoint PPT Presentation

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STOP! Clean Your Hands Day May 6, 2019

Clean Care Conversations Webinar

Your moderator, host and presenters

Christopher Thrall Communications Officer at CPSI (host), has served in communications roles for the past 15 years @Patient_Safety Jason Tetro (moderator) visiting scientist at the University of Guelph & worked in infection prevention and control for the last 15 years @JATetro

• Dr. Greg German

Prince Edward Island's Medical Microbiologist, Infectious Diseases Physician, & Infection Control Consultant @DrGregGerman Carmen Stephens Patient Partner with Patients for Patient Safety Canada & involved as a Patient & Family Advisor with the Saskatchewan Health Authority for seven years

Welcome to our Webinar!

Where have we been, and where do we need to go?

It’s less about getting hand hygiene right every time…

• How do you build a culture where you can encourage and remind your colleagues

to perform hand hygiene?

• Stop focusing on “behavior change” and start focusing on having the right

conversations with each other.

• We must adapt so that healthcare workers expect to be observed and given direct

and immediate feedback until good hand hygiene becomes everyone’s ritual.

Culture eats strategy for breakfast. for breakfast.

Changing Culture

Just-in-Time Coaching One Unit’s Hand Hygiene Journey

Oral abstract presented at APIC 43rd Annual Conference, June 11‐13th, Charlotte, North Carolina

The Big Picture

Curing: Dirty, disengage, dangerous hands

What is dirty?

Source: http://www.travelmath.com/feature/airline‐hygiene‐exposed/ (National Science Foundation USA)

CLEAN IS 5 or less germs growing on an

• bject about the size a dime

Contaminated / colonized is 5 to 10 Very contaminated “Dirty” is 10 or more

2,000,000 120,000 2300 1100 174 32 1700 14,000 1800 1500

Stethoscopes: 54% not clean. 18% dirty1 Medical Students Hands: 83% Not clean. 37% dirty After Cleaning: only 2.1% dirty

1ICHE 1999 20:626 2ICHE 2010 31:1194

Health Care Worker disengagement

Source: https://blog.thesocialcoin.com/en/what‐disengaged‐employees‐look‐like/

Source: https://www.timeshighereducation.com/student/subjects/what‐can‐you‐do‐nursing‐degree

DISENGAGED ENGAGED Hospital Physicians: Avoiding: “The 5 minute U‐turn at the head of the patient’s bed” Clinic Physicians: Avoiding: Looking a the computer

• r phone more than at the

patient. More Contact Time: Check temperature  More likely to be examined  More likely to have more questions asked or answered

Right Technique: Don’t miss the Nails

“Hand Hygiene Dance WHO HUG”

Clean Hands: Right time

• 1. Never less than 15 seconds, better

performance at 25 seconds especially for Hand washing with soap. Consider singing “Happy Birthday”

• 2. Soap vs Rub but not both!

3. 4 moments:

“Clean your hands before and after contact with the patient or patient environment”

Role Models: Somebody is watching you!

THE BAD: Healthcare workers in room with a senior staff person or peer who did not wash hands were 80 % less likely to wash their own hands: Lankford EID 2003 THE GOOD: If the mentor cleaned their hands the student was 70% more likely to clean their hands and was the single most important factor in cleaning. Snow AJIC 2006

Champions:

Randomized control trial1: Social influence and Leadership vs standard of care

• Three hour long sessions with goal setting, identifying barriers, allowing

nurses to address each other in case of undesirable hand hygiene

• Commitment from Mangers
• Modeling by informal leaders

64 % more improvement with team / role model approach which was maintained at follow up.

1Huis IJNS 2013

But we are at 100%

Werzen AJIC 2019

Covert researchers found that hand hygiene was 8% to 29% percent over reported due to the “Hawthorne Effect”

Technology to the Rescue: Can we WIFI it?

Can your hands be too clean?

DO / TRY DON’T USE / AVOID Use your own moisturizer before leaving house, consider long acting washing with soap and water and then use alcohol based hand rub just after . Wear Gloves/Mitts to protect from winter large bottle of moisturizer Use facility provided moisturizer at start

• f shift and PRN.

refill non‐facility dispensers or personal supply containers. Seek occupational health / medical assistance if pain, itchiness, or oozing

• ccurs.

a barrier cream unless coordinated by

• ccupational health.

Trust that Alcohol based hand rub is less drying for your hands than soap and water jar or putty moisturizers (see below)

#STOPCleanYourHandsDay #CleanCareConversations

Learn how to start a clean care conversation

Have a compassionate conversation with your patients about clean care. Work hand in hand with patients, families, and colleagues to create a clean care culture.

Learn how to start a clean care conversation

• 1. Talk about clean care.
• Patients and families can contribute to a clean care

culture.

• Explain why clean care – starting with clean hands –

is important to prevent healthcare‐associated infections.

• Listen to your patients and their family members,

answer their questions, and look for feedback.

Learn how to start a clean care conversation

• 2. Show clean care.
• Clean your hands in front of patients, families and

colleagues.

• Take the opportunity to explain how to do it properly.

Learn how to start a clean care conversation

• 3. Encourage conversations about clean care.
• Talk to your colleagues and encourage them to have

an open dialogue with their patients.

• Ask your patients if they need clean care tools: soap

and water, towels, hand cleaner.

Learn how to start a clean care conversation

#CleanCareConversations Quizzes

#STOPCleanYourHandsDay #CleanCareConversations Do you know how to have a compassionate conversation with your patients about clean care? Take the quiz and see for yourself! HandHygiene.ca