Hygiene and Infection Control

PATIENT SAFETY: IT’S IN YOUR HANDS

Hand hygiene was the theme of the 2006 Canadian Patient Safety Week, an annual initiative sponsored by the Canadian Patient Safety Institute. Their resource centre includes a poster, masthead, information sheet, and Power Point presentation to publicize the importance of clean hands. The site also offers a list of ideas for encouraging hand hygiene and links to hand hygiene initiatives from around the world.

Handwashing may seem like a simple matter, but it is too often neglected by time-strapped healthcare professionals, and even more often neglected by members of the public (some of whom may believe that a quick splash of water is sufficient to remove germs). As the best single measure to stop the spread of disease, hand hygiene deserves the attention it is receiving.

LOCAL INITIATIVES

The College of Registered Nurses Manitoba has a page devoted to handwashing, featuring quotes, hand hygiene tips, a downloadable poster and advertisements, and links to research and other resources. The CRNM has taken its handwashing message into the community with a series of posters such as this one as well as an informative handout.

The Winnipeg Regional Health Authority now offers Routine Practices Education on infection prevention and control. All staff within their region viewed a video, completed a learner package appropriate to their level of care, and participated in demonstrations and return demonstrations of hand hygiene and the donning and removal of protective equipment. For more information, please contact Debbie Panchyshyn at 926-7111 or e-mail dpanchyshyn@wrha.mb.ca.

MORE HANDY RESOURCES

Probably the most amusing resource available is the Scrub Club site, designed by NSF International (formerly the National Sanitation Foundation) to teach children about handwashing through games, activities, songs, and humorous posters.

The Minnesota Department of Health offers abundant print and online resources as part of its handwashing toolkit. Their Comprehensive List of Handwashing Print Materials contains both adult-oriented and child-oriented information sheets and posters on why, when, and how to clean hands. This is supplemented by their Comprehensive List of Web Resources.

The Vancouver Coastal Health Authority has prepared posters about how to clean hands with soap and wateror sanitizer. Healthcare facilities in this region have also employed ultraviolet light hand hygiene inspectors and volunteer spotters to encourage staff to make sure their hands are clean.

Capital Health (Edmonton and area) has designed posters and decals instructing both adults and children on proper handwashing technique. They also implemented water-free hand cleaning stations during a 2004-05 program encouraging people to practice good respiratory etiquette: When you sneeze or cough, blow (cover your nose and mouth with a tissue or, failing that, your upper sleeve), throw (the tissue into a wastebasket), and clean and go (immediately use a disinfectant handrub or, if hands are visibly dirty, old-fashioned soap and water).

Ontario’s Ministry of Health and Long-Term Care offers a page of information on why and how to wash hands, as well as how not to. Another source of information and links is the Clean Hands Save Lives page created by the US Centers for Disease Control and Prevention. Finally, there’s the simple screen saver that influenced physicians at L.A.’s Cedars Sinai Hospital to clean up their act. When traditional interventions failed to bring hand hygiene practices up to accreditation standards, the hospital’s head epidemiologist took cultures of doctors’ hands and photographed the colourful profusion of bacteria that grew there. The resulting picture, now displayed as a screen saver throughout the hospital, was worth a thousand words!

A HAND HYGIENE CAMPAIGN

In 2004, the UK’s National Patient Safety Association (NPSA)launched the cleanyourhands^© campaign, aimed at promoting hand hygiene among hospital staff. The major element of the campaign involves providing alcohol-based disinfectant handrubs at bedsides throughout the hospital. There is also a promotional component, in which a variety of posters and other publicity materials are placed where they can influence staff and patients.

The NPSA’s hand hygiene website offers a wealth of resources, including:

• “Ready, Steady, Go,” a guide to preparing for and implementing a cleanyourhands^© campaign
• numerous additional tools to help hospitals launch the campaign
• the originalpromotional materials, as well as 12 new posters.
• “Flowing With The Go,” a 2006 report which describes lessons learned from the campaign’s first year and offers suggestions for strengthening and sustaining it.

You may also want to view this information sheet for advice on how to choose and use alcohol-based rubs - and when not to.

ADDITIONAL INFECTION CONTROL RESOURCES

Safer Healthcare Now! is promoting six evidence-based interventions, based on those developed by the US Institute for Healthcare Improvement as part of its 100,000 Lives Campaign. Three of them are directly related to infection control:

CLI – Prevention of Central Line-Associated Bloodstream Infection: Prevent potentially fatal catheter-related bloodstream infections by following eight guidelines for the insertion and maintenance of a central line.

SSI – Prevention of Surgical Site Infection: Prevent surgical site infections and deaths from such infections by taking specific precautions before and after surgery.

VAP - Prevention of Ventilator-Associated Pneumonia: Prevent the leading cause of death among hospital-acquired infections by implementing four essential practices. The online resource www.saferhealthcare.org.uk, compiled by the NPSA, Institute for Healthcare Improvement, and British Medical Journal Publishing Group, has a special section on infection control. It includes featured articles as well as links to case studies, research papers, and websites.

See also Research on Infection Control.