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Hand hygiene 2.0: Wash like no one’s watching Observed compliance is great, but what happens behind closed doors? Results from the first half of Asante’s hand-hygiene effort are in, and the numbers are impressive. Compliance at all Asante hospitals has soared to well over 90 percent month after month since the awareness campaign launched in November. In some months, adherence at Asante Three Rivers Medical Center and Asante Ashland Community Hospital reached 100 percent. Figures at Asante Rogue Regional Medical Center, however, fell in February in March – the result of a change of observation protocol.
Asante infection prevention leaders are pleased with the results, but they’re also cautious. Compliance is measured by direct observation – how frequently staff members use hand sanitizer when entering and leaving a patient’s room. Although this is a standard method of measurement across the country, it captures only behavior that can be seen by an auditor. “Direct observation is vulnerable to the Hawthorne effect,” explains David Candelaria, MD, a hospitalist with Asante Ashland Community Hospital, who helped spearhead Asante’s hand-hygiene initiative. “That is, the observation itself changes behavior.” A truer test of Asante’s dedication to hand hygiene happens when caregivers are not being watched. In particular, whether they follow proper hand hygiene for at least five critical points of care: Before patient contact, before an aseptic task, after risk of exposure to body fluids, after patient contact and after contact with the patient’s surroundings.
Fast fact: Good hand hygiene can cut hospital-acquired infections in half. Infection preventionists are looking at ways to monitor hand-cleaning beyond entering and exiting patient rooms, but it still falls to every employee to be conscientious about hand hygiene at all times. “Hand hygiene is essential to prevent hospital-acquired infections, including urinary, bloodstream and surgical-site infections as well as MRSA, C.
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Diff and other potentially deadly microorganisms, ” says James Grebosky, MD, Asante’s chief quality and patient safety officer. “We owe it to our patients to maintain hand hygiene at all critical points of care — especially when no one’s watching.” Who’s Responsible for Preventing Infection?
James Grebosky, MD Chief quality and patient safety officer Asante Of all hospital-associated infections, Clostridium difficile has emerged as the 300-pound bug. The potentially deadly organism, which colonizes in the intestines after antibiotic therapy alters normal gut flora, has surpassed MRSA as the leading germ threat. It can lead to pseudomembranous colitis, toxic megacolon, perforations of the colon, or sepsis. It infects nearly half a million Americans a year and kills more than 15,000. Despite these statistics, one thing is encouraging: C. Difficile infection is relatively easy to prevent.
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By following strict hygiene standards and practicing wise antibiotic stewardship, Asante hospitals want to reduce the number of hospital-acquired cases to zero. Hospital staff and physicians must take several measures to prevent transmitting C. Diff, including: • Following contact enteric isolation practices. Hit by drunk driver settlement. That is, wearing a gown and gloves whenever entering the room of a patient with C.
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