Clean Care Conversations Webinar - Canadian Patient Safety ... · Clean Care Conversations Webinar. Your moderator, host and presenters Christopher Thrall Communications Officer at

patientsafetyinstitute.ca securitedespatients.ca

STOP! Clean Your Hands Day May 6, 2019

Clean Care Conversations Webinar

Your moderator, host and presenters

Christopher ThrallCommunications 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 GermanPrince Edward Island's Medical Microbiologist, Infectious Diseases Physician, & Infection Control Consultant@DrGregGerman

Carmen StephensPatient 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 strategyfor 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 object about the size a dime

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

2,000,000 120,000 2300 1100 174 321700 14,000

18001500Stethoscopes: 54% not clean. 18% dirty1

Medical Students Hands: 83% Not clean. 37% dirty After Cleaning: only 2.1% dirty

1ICHE 1999 20:6262ICHE 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 or phone more than at the patient.

More Contact Time: Check temperatureMore likely to be examinedMore likely to have more questions asked or answered

Right Technique: Don’t miss the Nails

“Hand Hygiene DanceWHO 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 of shift and PRN.

refill non‐facility dispensers or personal supply containers.

Seek occupational health / medical assistance if pain, itchiness, or oozing

occurs.

a barrier cream unless coordinated by occupational 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.


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.


2. Show clean care.

• Clean your hands in front of patients, families and colleagues.

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


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.


#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

Clean Care Conversations Webinar - Canadian Patient Safety ... · Clean Care Conversations Webinar. Your moderator, host and presenters Christopher Thrall Communications Officer at

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