Focus 31
PATIENT SAFETY/RESEARCH/INFECTION CONTROL
Hygiene
Continued from page 30 Thanks to funding from the Children’s Health Foundation, paediatric inpatient and day unit patients aged four to nine are now learning about hand hygiene, checking their handwashing skills with Glitterbug’s ultraviolet light technology, and taking home the Canadian Institute of Child Health’s colouring book “William: Won’t You Wash Your Hands?”.
By educating this population and their families, we are giving them the tools they need to help keep themselves healthy "The introduction of “William: Won’t You Wash Your Hands?” offers parents the opportunity to educate their little ones, imprinting good hand hygiene techniques for home and hospital, as well as providing a good review of hand hygiene techniques for parents, the child’s siblings, family, and friends,” said Val Rousom, Director of Children’s Care, Children’s Hospital, before joining Children’s Health Foundation President and CEO Susan Crowley in demonstrating the Glitterbugs. “This campaign provides an enjoyable learning experience for families where Children’s Hospital staff are working with patients and families. This inclusive approach to hand hygiene is expected to improve the patient experience as well as increase quality and safety for our wee patients and their families." According to Health Canada, "Washing your hands correctly (or using an alcohol-based hand rub) is the most effective thing you can do to protect yourself against a number of infectious diseases. Not only will it help keep you healthy, it will help prevent the spread of infectious diseases to others." The new paediatric hand hygiene program was developed by Lisa Kroesbergen, an Infection Control Practitioner who said young children, those with chronic illnesses and those who are immunocompromised are all at heightened risk of becoming ritically ill from infections that may be preventable through good hand hygiene. “By educating this population and their families, we are giving them the tools they need to help keep themselves healthy,” Kroesbergen told the crowd. “We are also influencing a generation to practice proper hand washing as a standard behavior." “Children’s Health Foundation is very proud to support the paediatric hand washing initiative in collaboration with Children’s Hospital,” said Crowley. “While it seems simple, this initiative is vitally important in demonstrating proper hand hygiene to our H young patients.” ■ Scot Magnish is a Communications Consultant at London Health Sciences Centre. www.hospitalnews.com
Sandra Callery and Dr. Mary Vearncombe of Sunnybrook’s Infection Prevention and Control team, review Hand Hygiene data.
Hand Hygiene Matters: Key internal supports and strategies help Sunnybrook achieve high compliance. By Natalie Chung-Sayers
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eeing is believing. Germs can’t readily be seen on hands and surfaces but when Hand Hygiene is not top-ofmind, hospitals have undoubtedly seen related outbreaks. “Our goal is to help make the seemingly invisible, proactively ‘visible’ for staff and physicians so that performing proper Hand Hygiene remains a central and consistent part of everyday practice,” says Dr. Mary Vearncombe, Medical Director, Infection Prevention and Control (IP&C), Sunnybrook Health Sciences Centre. Sunnybrook is one of the early adopters of the “Four Moments of Hand Hygiene” based on Ontario’s Just Clean Your Hands (JCYH) initiative that began in late 2007. The hospital is now 91 per cent Hand Hygiene compliant, or more than double its rate at the start of this provincial initiative. Says President and CEO, Dr. Barry McLellan, “Hand Hygiene is a priority at Sunnybrook. Our Infection Prevention and Control team has done a tremendous job in propelling this priority across the organization. Our high rates of good practice are testament to staff and physicians across all disciplines who have literally had a hand in our achievement thus far.” Hand Hygiene compliance is part of Sunnybrook’s Quality Improvement Plan for 2013/2014, and a Ministry Publicly Reported Safety Indicator for all hospitals. To facilitate success, Infection Prevention and Control together with Quality and Patient Safety, employ strategies Dr. Vearncombe refers to as “a multi-modal, multidisciplinary approach” in line with the Ontario Just Clean Your Hands toolkit. JCYH recommended strategies include senior management support and program leadership, environmental changes, moni-
toring and observation, engaging champion and opinion leaders, and education for health care providers. “Our Hand Hygiene education activities are targeted across all groups and are a frequent and integrated component within, for example, orientation, in-service sessions, on-line modules, and training for students including nurses and physicians,” says Sandra Callery, Director, Infection Prevention and Control, Sunnybrook.
Our high rates of good practice are a testament to staff and physicians across all disciplines who literally had a hand in our achievement thus far Internal awareness campaigns are another education component. Staff mentors are highlighted, discussing the importance of Hand Hygiene in their specific roles. Another campaign directed to staff physicians, residents, fellows and medical students, features physician champions with their quotes and published evidence related to the efficacy of Hand Hygiene compliance. All activities are supported with infrastructure and resources to ensure point-ofcare placement of alcohol-based hand rub product, and individualized assessments of patient care units and work areas in collaboration with staff. Human factors analysis is also used to better understand workflow, patient type, and types of healthcare professionals within each area. Another part of the proactively visible strategy, says Dr. Vearncombe, involves recognizing good Hand Hygiene ‘in the moment’. This reinforces what she calls ‘positive deviance’. While on the units,
staff and physicians are routinely audited by Hand Hygiene nurse observers (originally funded through late-career or modified work programs). “The approach is educational, nonpunitive,” Dr. Vearncombe notes. Observers give immediate and personalized feedback using a report card that highlights areas of good technique and suggested improvements. For demonstrating excellent Hand Hygiene compliance, staff and physicians at Sunnybrook get uniquely ‘Caught Clean-Handed’ with special recognition stickers. To gather data consistently, observers use a validated JCYH tool formatted as an input program for laptops. This allows IP&C to provide timely analysis and feedback to units, programs and Sunnybrook senior leadership. IP&C also generates quarterly reports for leadership and the Sunnybrook Board’s Quality Committee. The IP&C team also conducts Hand Hygiene compliance research and regular literature reviews for the latest strategies. In a 2009 study of an outbreak at Sunnbrook, the team found Hand Hygiene compliance inversely related to infection attack rates, reporting units with higher Hand Hygiene compliance had lower numbers of cases. “Hand Hygiene matters,” says Dr. Vearncombe, extending Sunnybrook’s tagline of ‘When It Matters Most’. “At Sunnybrook, Hand Hygiene compliance has become more tangible, achievable and acknowledged, as critically supported by our senior leaders and with the resources and infrastructure to make H it all work.” ■ Natalie Chung-Sayers is a Communications Advisor at Sunnybrook Health Sciences Centre. SEPTEMBER 2013 HOSPITAL NEWS