While watching a recent episode of a medical television series, I was particularly fascinated by the way they showed how droplets from a sneeze spread from the emergency room throughout the hospital. The droplets could be seen as glowing and moving dots! The droplets traveled easily and quickly without anyone noticing them. Just like in real life, we don’t “see” the germs, making it easier than we realize for infection to spread.
This show got me thinking. If only we could see the organisms that can be transmitted between patients, it would probably play a huge role in getting hospital staff to wash their hands as often and as long as they should.
There are several misconceptions about how organisms can be transmitted between patients. For example, staff expect to have germs on their hands after specific actions when they can visibly see a need to wash their hands, such as in the presence of a wound, removing catheters, or when a patient has a respiratory infection and secretion. During simple procedures like taking a patient's pulse, temperature or blood pressure, if staff doesn't see a visible need, they aren't motivated to wash their hands. Unfortunately, organisms can still spread during these actions.
Surface contamination is also a huge contributor when it comes to spreading infection. Germs can thrive on stethoscopes, patient bed rails, curtains, doorknobs and carts and can quickly be passed on by staff touching what looks like a clean surface. Plus they can be transferred to and from electronic devices like tablets, computers and cell phones.
Which brings us back to, since we can’t see the germs, we aren’t automatically compelled to do something about them. Getting a little creative when communicating to staff about hand hygiene might help your organization improve infection prevention efforts. Here are some approaches to consider:
Focus on behavioral change. It’s becoming increasingly evident that improving hand-hygiene compliance is more successful when there’s a behavioral change in the staff. It takes patience, persistence and it requires studying your staff to understand what makes them tick. For some it may just be the grossness of the germs, while others may just be driven by protocol.
Seek to understand what's limiting them from being compliant either by talking to them directly or through a more confidential channel, like a survey. Then, work to remove the barriers as much as you can to help them. Sometimes removing common obstacles such as making sure the staff have easy access to hand-hygiene dispensers (that have enough soap!), providing appropriate hand lotions for those who may develop dermatitis, or even something as simple as providing a spot to set down charts, tablets or phones while washing hands, can be helpful.
Make sure to communicate hand-hygiene expectations and protocols and hold them accountable for their actions. Providing regular and real-time feedback via electronic hand-wash counters helps them measure and monitor their performance. Show them numbers regarding infection rates and how the numbers can be reduced with their help.
Make it rewarding and fun. Include a reward system for staff who comply. Change up the rewards system to keep it interesting because one type of recognition may not necessarily interest everyone. Consider scheduling fun, informal educational sessions as a less stressful environment for learning. Set up an escape room, simulation or game-type scenario to educate the staff about infection prevention. Think about incorporating an ultraviolet hand-washing kit with a product like GloGerm™ to graphically demonstrate how germs are spread. The odorless powder or lotion glows brightly when exposed to the UV light.
Gain leadership buy in. Hospital management and senior clinical staff can play a significant role in facilitating change. Ask your senior level staff to be champions of hand hygiene and infection prevention. When they practice it consistently, team members will notice and be more likely to follow. When staff are proud of a culture of a good compliance they are more likely to own it and follow it. Plus, new staff automatically adapt to it much quicker.
Use technology! The latest hand-hygiene monitoring systems can be instrumental in increasing compliance. Evaluate the best system for your hospital and talk to the supplier to see how they can help. Find critical areas and implement technology-related tracking systems there first and use the results to extend it to other parts of your organization. Leverage your hand-hygiene product suppliers because they often come up with innovative ways to engage caregivers when these systems are deployed.
Remember, it took years before someone would listen to Florence Nightingale to improve hygiene standards, but her persistence and use of evidence-based knowledge versus conventional wisdom started a significant change in the world of hand hygiene. I doubt we’d be where we are today without out-of-the-box thinkers like her. History has a lot to teach us; and with dedication and a little creativity, we can move the needle on infection prevention.
About the author. In her role as senior clinical manager at Vizient, Punitha Velusami uses her extensive health care experience and medical training to integrate the clinical aspects of products and services into the organization’s bid process. She authors educational resource guides that support the adoption of products within the Vizient portfolio, as well as industry, national and global health care initiatives. Dr. Velusami is skilled in all aspects of market research, including design, data collection, management and analytics; and her background includes work on global health care market research projects coordinated in partnership with client executives from the international pharmaceutical and medical device industries.