Hand Hygiene

Hospital Borne Infections and Careful Hand Washing Tactics

By Mariana Ashley

There are several bacteria and fungi that have learned to thrive in our hospitals. Hospital-acquired infections (HAI) are infections that have found a way to better develop and prosper in a hospital setting. These infections are particularly worrisome for health care professionals and patients because they are strong in such vulnerable places of our existence. Many of these bacteria and fungi have developed resistances to antibiotics that were at one point effective on them. Gaining resistance to some of the most commonly useful and effective drugs helps these would be minor infections become a real worry for doctors and patients. 

Part of what makes HAIs such a difficulty is that patients who are in the hospital are typically already in a state of weakened immunity. So, individuals who could normally fight off these infections cannot within the hospital. Many of the bacteria and fungi spores that cause these infections are present on nearly all surfaces throughout a hospital. For this reason, one of the most common ways to transmit these bacteria or fungi to an individual is through poor hand washing. Doctors and nurses who are able to fight off the infections caused by these microorganisms will transmit them to more vulnerable patients through wound care, contaminated instruments, invasive instruments, and more. These two infections are among the most common hospital-acquired infections in hospitals today, each of which can be better prevented with thorough hand washing techniques. 

Methicillin Resistant Staphylococcus Aureus (MRSA)

As a form of staph infection, MRSA is one of the more common infections among hospital patients and is also one of the most varied. MRSA comes in many forms and is resistant to any penicillin antibiotic. MRSA most typically presents as a painful skin infection, causing irritated red bumps that look like pimples or bug bites. Other common symptoms associated with MRSA at this stage are fever and other rashes on the skin. These bumps will eventually engulf with white blood cells and the bacteria will attack other parts of the sufferer's immune system. If the infection becomes harsh enough, painful abscesses will have to be cut out of a patient's skin. Healthy individuals can be carrying the MRSA bacteria on them and remain asymptomatic. This makes it very difficult to control. With careful hand washing and anti-microbial practices, MRSA can be more easily managed and prevented. It is still believed that poor hygiene habits of health care professionals are the primary setback for reducing the spread of MRSA.

 Clostridium Difficile (C. Diff)

C. Diff is a bacterium that causes severe intestinal distress and disease within sufferers. This bacterium takes over the intestinal tract of a patient when a course of antibiotics has already eliminated all of the natural bacteria in the gut that would normally fight off the C. Diff strains. C. Diff can result in several very severe infections and illnesses, including colitis, bloating, and potentially life threatening toxic megacolon. While the primary cause of this infection is the improper prescribing of antimicrobials, infection control measures such as careful hand washing and area sanitation can drastically hinder the spread of this illness. C. Diff spores are present on almost any surface throughout the hospital. For this reason, it is essential that doctors, nurses, and visitors use gloves and carefully wash their hands with soap and water to eliminate the transmission of these spores to a more vulnerable host.

 By-line:

Mariana Ashley is a freelance writer who particularly enjoys writing about online colleges. She loves receiving reader feedback, which can be directed to mariana.ashley031@gmail.com.

The future of hand hygiene?

Hand washing  The New York Times recently covered a new invention for cleaning hands: inserting hands into boxes delivering room temperature plasma. According to the article, this plasma is the same the lights neon signs and TV screens.  Imagine if health care workers could sanitize their hands in four seconds instead of the time it takes to sing Happy Birthday.  Given that the Centers for Disease Control and Prevention estimates that clinicians only adhere to hand hygiene protocols 40% of the time, anything to improve practices in this area would be welcome.

But what is it that keeps health care professionals from sanitizing their hands?  Is it the length of time that it takes to do it?  Is it interrupting long-established work flow habits for any length of time?  We need more research to understand all of the impediments. However, we do know that getting people to establish good habits (even stopping for a 4-second hand cleaning) takes lots of work and constant feedback.  Unfortunately, even new inventions like these plasma cleaners can't change human nature.

Nurses and women come up cleaner in hand washing studies -- by Robin Walters, R.N., B.S.N.

As part of our guest contributor program, we thank Robin Walters R.N., B.S.N, for her article below that illuminates some interesting differences in the hand hygiene behavior of men and women--both in healthcare settings and outside of them. The results may surprise you...

In order to improve hand washing behavior, it helps to know who needs to improve. Recent studies indicate that men and physicians (73% of whom in the U.S. are male) need to wash up more often.

For a study published in the June 2008 Infection Control & Hospital Epidemiology, observers documented the hand hygiene behavior of workers at the University of Toledo Medical Center for roughly five months. The results? Nurses complied with hand washing at a rate of 91.3%, while medical attending physicians (the lowest performers) registered at 72.4%.

 A 2007 study sponsored by the American Society for Microbiology and The Soap and Detergent Association (SDA) also suggests that campaigns to improve hand washing need to focus more on men. Observers recorded the hand washing behavior of adults who used public restrooms at six large sites in four major U.S. cities, and overall, 88% of the women and 66% of the men washed up.

The confessions of moms and dads further support a gender divide in hand hygiene. As part of the 2007 Clean Hands Report Card, the SDA surveyed by telephone parents of school-age children and found that 97% of the mothers vs. 89% of the fathers reported always washing their hands after using the bathroom. Although results of observational studies strongly suggest a gap between reported and actual hand washing behavior, the difference between what moms and dads own up to remains significant.

And, this lean toward women as better washers may be global. At the University of Geneva Hospital, a hand hygiene study appearing in the November 2007 Infection Control & Hospital Epidemiology revealed that “female sex . . . increased the likelihood of compliance with hand hygiene.” With the U.S. R.N. force 92% female, this is good news for patients.

About the author: Robin Walters, R.N., B.S.N., has been privileged to provide care in hospitals, clinics, schools and physician offices, at sites ranging from large urban to remote rural.

Interested in submitting content to PatientSafetyFocus.com? Please go here to learn more.

Patient Safety Awareness Week: a tremendous cause, a terrific opportunity to launch our own!

We are proud to launch PatientSafetyFocus.com right in time for, and as an avid supporter of of, Patient Safety Awareness Week (occurring March 2nd - March 8th, 2008).

What is Patient Safety Awareness Week (PSAW)?
It is a national education and awareness-building campaign, developed by the National Patient Safety Foundation, for improving patient safety at the local level. Hospitals and healthcare organizations across the country are encouraged to plan events to promote patient safety within their own organizations. Educational activities are centered on educating patients on how to become involved in their own health care, as well as working with hospitals to build partnerships with their patient community. More information is available here.

How does this blog support the objectives of the program? We are dedicated to focusing on patient safety information, programs and solutions. In aggregating relevant, recent content on programs, protocols, developments, reports, resources, advocacy efforts and studies, our hope is that PatientSafetyFocus.com provides a platform to increase awareness of the critical issue of preventable medical errors--and through raising awareness, we significantly raise the bar.

How are we pushing for change? To improve patient safety practices and significantly decrease preventable medical errors necessitates communication as much as it does innovation. We hope the blog format also works to build conversation among patient safety advocates, media professionals, hospital administrators, insurers and those persons who have either themselves been affected by preventable medical errors or have loved ones that have.

Join the National Patient Safety Foundation and PatientSafetyFocus.com in increasing awareness of this important issue...after all, be you doctor, patient, insurer or advocate, it's in everyone's best interest to improve patient safety!

Interview with Adam Aronson, developer of HVA (Hospital Video Auditing)

Adam Aronson, CEO of Arrowsight Inc., developer of Hospital Video Auditing (HVA), discusses what inspired him to develop solutions to dramatically improve patient safety and preventable medical errors, what HVA offers and the striking results it's providing.

Q: What prompted you to develop and market HVA?

A: "The short answer is that Arrowsight works to improve practices, performance and compliance in many safety-sensitive industries, such as food processing, food services and manufacturing...so improving the healthcare industry, especially with the very basic, but altogether critical area of hand hygiene compliance, was a natural next step.

But the longer answer hits much closer to home.

First, my father, Dr. Mark Aronson (pictured up top on the right with Adam), has been in healthcare for several decades. While watching hospitals grapple with the issues and growing fatalities associated with Hospital-Acquired Infections (HAIs), he watched me develop my video auditing business and made the connection that the technology and services we offered to improve safety for food processing were all too apt for healthcare facilities.

Due to being focused on growing my company across many sectors, I knew it would only be a matter of time before we developed a practice area in the medical sector. But that timing was placed on a fast-track after both my mother and my sister developed HAIs in separate top-notch hospitals due to what should have been short hospital stays for them both.

My mother, after a car accident which shattered her ankle acquired a preventable infection and one surgery turned into several, along with a permanent limp.  In the same year, my sister, after having her baby, and preparing to be released in a few days with a new bundle of joy, developed Scarlet Fever. Both cases were preventable--and both cases could have been potentially prevented with the assistance that HVA offers hospitals. Now that technology and service is available to all hospitals."

Continue reading "Interview with Adam Aronson, developer of HVA (Hospital Video Auditing)" »

Video Monitoring Saves Lives: Interview with Meghan Dierks, M.D.

16357603_3 In structuring the HVA (Hospital Video Auditing) program at a surgery center in the southeastern United States, Dr. Meghan Dierks, Assistant Professor, Harvard Medical School, has witnessed compliance scores soar from 35% to 90%+...and even more striking, she's seen compliance rates remain there.

Q: In what ways, and to meet which specific goals, is the healthcare facility using HVA?

A:
"We applied the technology to tackle a refractory problem in the healthcare compliance arena--the very basic safety protocol revolving around hand-hygiene and getting physicians to modify their safety behavior. The technology was two-fold: first, it would provide us the ability to collect highly reliable data and we hadn't been able to in the past. And, second, by nature of collecting high-quality data and instilling a feedback loop to relay that data to physicians practicing in that environment we could achieve a behavioral change.

We had two goals, both of which were achieved through the use of HVA. First, we needed to be able to collect highly reliable data over a sustained period of time on hand hygiene behaviors--something that has been difficult to achieve using other strategies. Second, in order to achieve a behavioral change, we needed to be able to use this data to provide continuous performance feedback to the healthcare workers practicing in that environment."

Continue reading "Video Monitoring Saves Lives: Interview with Meghan Dierks, M.D." »

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