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

Clean Care Conversations Webinar STOP! Clean Your Hands Day May 6, 2019 patientsafetyinstitute.ca securitedespatients.ca

Your moderator, host and presenters Carmen Stephens Dr. Greg German Jason Tetro Christopher Thrall Patient Partner with Prince Edward (moderator) Communications Patients for Patient Island's Medical visiting scientist at Officer at CPSI Safety Canada & Microbiologist, the University of (host), has served involved as a Patient Infectious Diseases Guelph & worked in in communications & Family Advisor Physician, & infection prevention roles for the past with the Infection Control and control for the 15 years Saskatchewan Consultant last 15 years @Patient_Safety Health Authority for @DrGregGerman @JATetro 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 43 rd Annual Conference, June 11‐13 th , Charlotte, North Carolina

The Big Picture Curing: Dirty, disengage, dangerous hands

What is dirty? 1700 14,000 2,000,000 120,000 2300 1100 174 32 CLEAN IS 5 or less germs growing on an object about the size a dime Contaminated / colonized is 5 to 10 Very contaminated “Dirty” is 10 or more 1500 1800 Stethoscopes: 54% not clean. 18% dirty 1 Medical Students Hands: 83% Not clean. 37% dirty After Cleaning: only 2.1% dirty Source: http://www.travelmath.com/feature/airline‐hygiene‐exposed/ (National Science Foundation USA) 1 ICHE 1999 20:626 2 ICHE 2010 31:1194

Health Care Worker disengagement More Contact Time: DISENGAGED Check temperature  More likely to be examined  More likely to have more questions asked or answered ENGAGED Hospital Physicians: Avoiding: “The 5 minute U‐turn at the head of the patient’s bed” Clinic Physicians: Avoiding: Looking a the computer or phone more than at the patient. Source: https://blog.thesocialcoin.com/en/what‐disengaged‐employees‐look‐like/ Source: https://www.timeshighereducation.com/student/subjects/what‐can‐you‐do‐nursing‐degree

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. 1 Huis IJNS 2013

But we are at 100% Covert researchers found that hand hygiene was 8% to 29% percent over reported due to the “Hawthorne Effect” Werzen AJIC 2019

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 washing with soap and water and then house, consider long acting use alcohol based hand rub just after . Wear Gloves/Mitts to protect from winter large bottle of moisturizer Use facility provided moisturizer at start refill non‐facility dispensers or personal of shift and PRN. supply containers. Seek occupational health / medical a barrier cream unless coordinated by assistance if pain, itchiness, or oozing occupational health. occurs. Trust that Alcohol based hand rub is less jar or putty moisturizers (see below) drying for your hands than soap and water

#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