eDocTalk article

Do you practice these three habits to protect your patients?

May 2013

The single most important intervention to prevent the spread of infection is hand hygiene. 

Legacy is beginning a new approach to hand hygiene. Rather than passive observation, the goal is to actively ensure adherence. 

  • We will focus monitoring on entering and leaving a patient room (and clinical areas). Hands must be foamed or washed every time (wash with soap and water if C. difficile or Norovirus).
  • If an observer notes a hand hygiene failure, you will be reminded with either the phrase "foam please" or "wash please."
  • The expected response when you get a hand hygiene prompt is a cheery “thank you!” followed immediately by foaming or washing.

A history of success

Over a decade ago, when Legacy Health changed to foam for hand hygiene our hospital infection rates immediately fell drastically, even when our compliance with hand hygiene was only 20 percent. 

As our compliance improved over the last three years, there was a parallel decrease in health care associated infections by 58 percent across Legacy hospitals (p<0.0001).  Still, we have plateaued with hand hygiene compliance at around 90 percent. Put another way, about 1 in 10 patients does not receive clean hands.

Successful infection control should be practiced every time, including when you think it does not need to be done.  If you spend enough time observing people walking into rooms with no intention of touching something who subsequently do, you will realize it is a myth that you are not going to touch anything. 

Active reminder approach

Legacy Good Samaritan Medical Center tested the “active reminder” approach last August, and, in the first six months, health care associated infections decreased by 2.1 a month during with an estimated savings of $450,000.  About 1 in 6 observations needed prompting for hand hygiene, resulting in hand hygiene rates of 100 percent. 

Here are three habits you can practice to protect your patients:

  1. Foam or wash your hands before entering a patient room and when leaving a patient room.  Use soap and water for patients with suspect or known C. difficile and Norovirus.
  2. If you see that someone is busy and forgets to foam, remind the person to clean their hands before the opportunity is missed by saying "foam please" or "wash please."
  3. If someone reminds you to clean your hands, thank them and then foam or wash as appropriate.

Our objective is to prevent the transmission of organisms from one patient to another, and the best way to achieve this is by cleansing hands upon every entry into and exit from a patient rooms and clinical areas.  Every time. 

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