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Hand Hygiene Toolkit Training Presentation

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Good hand hygiene saves lives and reduces the strain on our healthcare system. 1 It takes less than one minute to properly wash hands using soap and water and less ... – PowerPoint PPT presentation

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Title: Hand Hygiene Toolkit Training Presentation


1
Hand Hygiene ToolkitTraining Presentation
2
Introduction
  • Do you want your hands to offer hope and healing?
  • Or do you want your hands to help spread hospital
    acquired infections?
  • Its as simple as that and
  • Its up to us to help make Canadas Healthcare
    System a safer place for all of us!

3
Overview
  • Canadian Patient Safety Institute established in
    2005
  • In 2007 Canada joined the WHOs Global Patient
    Safety Challenge
  • Launched the STOP! Clean Your Hands Campaign
  • 2009 Developed Human Factors Toolkit.
  • 2009/10 Launched a review, update redesign and
    integration to Safer Healthcare Now!

4
Goals
  • To promote the importance of hand hygiene in
    reducing the occurrence of healthcare associated
    infections (HCAI) in Canada.
  • To educate healthcare workers, patients, and
    families about the importance of practicing
    optimal hand hygiene.
  • To support organizations in making the delivery
    of healthcare safer for everyone!

5
Objectives
  • To support the needs of healthcare organizations
    for capacity building, leadership development
    and/or the production of tools to help promote
    hand hygiene.
  • To assist organizations in understanding how to
    meet Accreditation Canadas Required
    Organizational Practices specific to hand
    hygiene.
  • To engage participants across the continuum of
    care in understanding and practicing optimal hand
    hygiene

6
Available Materials
  • A website designed to reach out to a broader
    audience and to disseminate information as
    rapidly as possible. (www.handhygiene.ca)
  • Fact sheets demonstrate the need for better hand
    hygiene, optimal techniques, and other related
    supportive materials.
  • Variety of tools online learning module, audit
    training, various types of assessment tools, a
    patient/family guide, and additional patient and
    family tools and information.
  • A nationally consistent audit tool
  • Helps establish baseline performance on hand
    hygiene compliance
  • Helps to monitor and report on improvements over
    time

7
System change Alcohol-based hand-rubs at point
of care
  • An evidence based approach, made up of
  • 5 core components, to improve hand hygiene in
    health-care settings

Training and education of staff

Observation of hand hygiene and feedback to staff

Reminders in the workplace

Establishment of a safety climate Individual
active participation and institutional support
8
Healthcare Associated Infections (HCAI)
  • An infection occurring in a patient during the
    process of care in a hospital or other health
    care facility which was not present or incubating
    at the time of admission. This includes
    infections acquired in the hospital but appearing
    after discharge, and also occupational infections
    among staff of the facility.
  • Ducel G et al. Prevention of hospital-acquired
    infections. A practical guide. WHO 2002

9
The Burden of HCAIs
  • More than 220,000 patients acquire healthcare
    associated infections (HCAIs) in Canada every
    year resulting in 8,000 12,000 deaths.1
  • At any time, over 1.4 million people worldwide
    are suffering from infections acquired in
    hospital.2
  • Up to 50 of HCAIs could have been prevented.3,4
  • Zoutman, D., Ford, B.D., Bryce, E., Gourdeau,
    M., Hébert, G., Henderson, E., and Paton, S.
    Canadian Hospital Epidemiology Committee,
    Canadian Nosocomial Infection Surveillance
    Program and Health Canada.
  • Zoutman et. al, The state of infection
    surveillance and control at Canadian acute care
    hospitals, American Journal of Infection
    Control, 200331 , 266-275.
  • WHO Information Sheet 1 Clean care is Safer
    Care Challenge
  • Pittet D, Hugonnet S, Harbarth S, Mourouga P,
    Sauvan V, Touveneau S, Perneger TV. Effectiveness
    of a hospital-wide programme to improve
    compliance with hand hygiene. Infection Control
    Programme. Lancet 2000 Oct 14356(9238)1307-12.
  • Patient Safety and Hand Hygiene Matter ! CPSW
    Week 2006 brochure

10
The Case for Hand Hygiene
  • Hand hygiene is one of the most effective
    measures to reduce the occurrence of HCAI.
  • Good hand hygiene saves lives and reduces the
    strain on our healthcare system. 1
  • It takes less than one minute to properly wash
    hands using soap and water and less than 30
    seconds to properly clean hands with
    alcohol-based hand-rub. Both methods are
    effective.
  • 1 Roth, Virginia, MD, FRCPC Hands that harm,
    hands that heal November 2006 PowerPoint
    presentation, slide 31

11
The Case for Hand Hygiene Cont.
  • As a healthcare worker you should know ...
  • You are also susceptible to carrying around
    infectious organisms
  • 80 of staff who dressed MRSA wounds carried the
    organism on their hands for 3 hours afterward
  • 60 of the hands of staff, within ½ hour of
    contact with patients with Clostridium difficile
    were contaminated without even touching the
    patient
  • Meanwhile, washing with soap and water in these
    cases virtually eradicated these organisms!
  • Stone, S.P. JR Soc Medicine 2001 94(6) 278-281.
    Cited in Mitka, M. JAMA 2009 302(17) reprinted.

12
Where Were Your Hands?
  • Any time within 3 hours of completing a dressing
    change on a patient with MRSA or within ½ hour of
    making any contact in the room of a patient with
    C. difficile?
  • Did you eat?
  • Did you have coffee?
  • Did you cough, rub your nose or eyes?
  • Did you approach and make contact with another
    patient or a family member?
  • Before you touch anything or anyone...
  • STOP! Clean Your Hands!

13
Obstacles to Hand Hygiene
  • Too busy
  • It is essential that you make time
  • Skin irritation
  • Use lotions hand rub appropriately
  • Glove use
  • is not a substitute for hand hygiene
  • Not top of mind
  • needs to become as spontaneous as using aseptic
    technique and all other safety strategies.

14
So, Why Clean your hands?
  • 1) to protect the patient against harmful
    pathogens carried on your hands or present on
    his/her own skin
  • 2) to protect yourself and the healthcare
    environment from harmful pathogens

15
Key Concepts
  • Hand hygiene must be performed at the point of
    care.
  • During healthcare delivery, there are four
    moments when it is essential that you perform
    hand hygiene.
  • Handrub is often preferable to handwashing.
  • If isolation precautions are in place, always
    adhere to the hand hygiene activities described
    in those precautions.
  • It is essential that everyone perform hand
    hygiene using the appropriate technique and time
    duration in order for it to be effective.

16
Point of Care
  • The place where three elements align
  • The patient
  • The healthcare worker
  • The care of the patient involving any contact
    with the patient or the patients zone.
  • A hand hygiene product should be as close as
    possible to the point of care.
  • WHO Hand Hygiene Guidelines, August 2009

17
Four Times to Clean
  • FOUR Moments of hand hygiene during healthcare
    have been identified and are crucial to
    preventing hand transmission of infections.
  • Before initial patient/patient environment
    contact
  • Before aseptic procedure
  • After body fluid exposure risk
  • After patient/patient environment contact
  • This was adapted from the WHOs 5 Moments of Hand
    Hygiene (Ontario Ministry of Health and Long Term
    Care).

18
(No Transcript)
19
Time
  • Optimal hand hygiene using an alcohol-based hand
    rub takes 20-30 seconds
  • Optimal hand hygiene using soap and water takes
    40-60 seconds
  • Both are effective methods

20
Alcohol Based Hand Rub
  • Apply a palm full of rub and cover all surfaces
    of the hand rub together until the hands are dry.

21
How to Hand Rub
To effectively reduce the growth of germs on
hands, handrubbing must be performed by
following all steps illustrated on the
left. This takes only 20-30 secs!
22
Soap Water
  • Wet the hands first and apply enough soap to
    cover all surfaces of the hands. Make sure the
    hands are dry and the towels are not used
    repeatedly or by multiple people.
  • Thorough drying of hands after hand washing has
    important protective benefits and helps to
    eliminate more pathogens from your hands.

23
How to Hand Wash
To effectively reduce the growth of pathogens on
hands, handwashing must last 40-60 secs and
should be performed by following all steps
illustrated on the left.
24
Gloves Skin care
  • Gloves do not replace the practice of optimal
    hand hygiene
  • Avoid hand washing immediately before or after
    using an alcohol-based hand rub
  • Avoid hot water
  • Let hands dry completely before donning gloves
  • Use hand lotions and creams
  • Allergies or adverse reactions use alternative
    products
  • No artificial fingernails or extenders
  • Keep natural nails short (0.5 cm)
  • Remove jewelry

25
Resources
  • World Health Organization Guidelines on Hand
    Hygiene in Health Care. First Global Patient
    Safety Challenge, Clean Care is Safer Care.
    August 2009.
  • http//whqlibdoc.who.int/publications/2009/9789241
    597906_eng.pdf
  • WHO Clean Care is Safer Care Tools and
    Resources http//www.who.int/gpsc/5may/tools/en/i
    ndex.html
  • Canadian Patient Safety Institute
    www.handhygiene.ca
  • Community and Hospital Infection Control
    Association Canada. http//www.chica.org/links_h
    andhygiene.htmlSTANDARDS

26
Resources
  • Public Health Agency of Canada, Hand Hygiene
    Recommendations for Remote and Isolated Community
    Settings. http//www.phac-aspc.gc.ca/alert-alerte/
    h1n1/public/handhygiene-eng.php?optionprint
  • Health Canada The Benefits of Handwashing
    http//www.hc-sc.gc.ca/hl-vs/iyh-vsv/diseases-mala
    dies/hands-mains-eng.php
  • Canadian Centre for Occupational Health and
    Safety http//www.ccohs.ca/http//www.ccohs.ca/
  • http//www.ccohs.ca/pandemic/subject/handwashing.h
    tml
  • The Art of Washing Hands http//www.theartofwashi
    nghands.com/index.html

27
Questions?
28
Introduction
  • Do you want your hands to offer hope and healing?
  • Or do you want your hands to help spread hospital
    acquired infections?
  • Its as simple as that and
  • Its up to us to help make Canadas Healthcare
    System a safer place for all of us!

29
Overview
  • Canadian Patient Safety Institute established in
    2005
  • In 2007 Canada joined the WHOs Global Patient
    Safety Challenge
  • Launched the STOP! Clean Your Hands Campaign
  • 2009 Developed Human Factors Tool Kit.
  • 2009/10 Launched a review, update redesign and
    integration to Safer Healthcare Now!

30
Goals
  • To promote the importance of hand hygiene in
    reducing the occurrence of healthcare associated
    infections (HCAI) in Canada.
  • To educate healthcare workers, patients, and
    families about the importance of practicing
    optimal hand hygiene.
  • To support organizations in making the delivery
    of healthcare safer for everyone!

31
Objectives
  • To support the needs of healthcare organizations
    for capacity building, leadership development
    and/or the production of tools to help promote
    hand hygiene.
  • To assist organizations in understanding how to
    meet Accreditation Canadas Required
    Organizational Practices specific to hand
    hygiene.
  • To engage participants across the continuum of
    care in understanding and practicing optimal hand
    hygiene

32
Available Materials
  • A website designed to reach out to a broader
    audience and to disseminate information as
    rapidly as possible. (www.handhygiene.ca)
  • Fact sheets demonstrate the need for better hand
    hygiene, optimal techniques, and other related
    supportive materials.
  • Variety of tools online learning module, audit
    training, various types of assessment tools, a
    patient/family guide, and additional patient and
    family tools and information.
  • A nationally consistent audit tool
  • Helps establish baseline performance on hand
    hygiene compliance
  • Helps to monitor and report on improvements over
    time

33
System change Alcohol-based hand-rubs at point
of care
  • An evidence based approach, made up of
  • 5 core components, to improve hand hygiene in
    health-care settings

Training and education of staff

Observation of hand hygiene and feedback to staff

Reminders in the workplace

Establishment of a safety climate Individual
active participation and institutional support
34
Healthcare Associated Infections (HCAI)
  • An infection occurring in a patient during the
    process of care in a hospital or other health
    care facility which was not present or incubating
    at the time of admission. This includes
    infections acquired in the hospital but appearing
    after discharge, and also occupational infections
    among staff of the facility.
  • Ducel G et al. Prevention of hospital-acquired
    infections. A practical guide. WHO 2002

35
The Burden of HCAIs
  • More than 220,000 patients acquire healthcare
    associated infections (HCAIs) in Canada every
    year resulting in 8,000 12,000 deaths.1
  • At any time, over 1.4 million people worldwide
    are suffering from infections acquired in
    hospital.2
  • Up to 50 of HCAIs could have been prevented.3,4
  • Zoutman, Dick, MD, FRCPC, B. Douglas Ford, MA,
    Elizabeth Bryce, MD, Marie Gourdeau, MD,Ginette
    Hébert, RN, Elizabeth Henderson, PhD, and Shirley
    Paton, MN, Canadian Hospital Epidemiology
    Committee, Canadian Nosocomial Infection
    Surveillance Program and Health Canada. Zoutman
    et. al, The state of infection surveillance and
    control at Canadian acute care hospitals,
    American Journal of Infection Control, 200331 ,
    266-275.
  • WHO Information Sheet 1 Clean care is Safer
    Care Challenge
  • Pittet D, Hugonnet S, Harbarth S, Mourouga P,
    Sauvan V, Touveneau S, Perneger TV. Effectiveness
    of a hospital-wide programme to improve
    compliance with hand hygiene. Infection Control
    Programme. Lancet 2000 Oct 14356(9238)1307-12.
  • Patient Safety and Hand Hygiene Matter ! CPSW
    Week 2006 brochure

36
The Case for Hand Hygiene
  • Hand hygiene is one of the most effective
    measures to reduce the occurrence of HCAI.
  • Good hand hygiene saves lives and reduces the
    strain on our healthcare system. 1
  • It takes less than one minute to properly wash
    hands using soap and water and less than 30
    seconds to properly clean hands with
    alcohol-based hand-rub. Both methods are
    effective.
  • 1 Roth, Virginia, MD, FRCPC Hands that harm,
    hands that heal November 2006 PowerPoint
    presentation, slide 31

37
The Case for Hand Hygiene Cont.
  • As a healthcare worker you should know ...
  • You are also susceptible to carrying around
    infectious organisms
  • 80 of staff who dressed MRSA wounds carried the
    organism on their hands for 3 hours afterward
  • 60 of the hands of staff, within ½ hour of
    contact with patients with Clostridium difficile
    were contaminated without even touching the
    patient
  • Meanwhile, washing with soap and water in these
    cases virtually eradicated these organisms!
  • Stone, S.P. JR Soc Medicine 2001 94(6) 278-281.
    Cited in Mitka, M. JAMA 2009 302(17) reprinted.

38
Where Were Your Hands?
  • Any time within 3 hours of completing a dressing
    change on a patient with MRSA or within ½ hour of
    making any contact in the room of a patient with
    C. difficile?
  • Did you eat?
  • Did you have coffee?
  • Did you cough, rub your nose or eyes?
  • Did you approach and make contact with another
    patient or a family member?
  • Before you touch anything or anyone...
  • STOP! Clean Your Hands!

39
Obstacles to Hand Hygiene
  • Too busy
  • It is essential that you make time
  • Skin irritation
  • Use lotions hand rub appropriately
  • Glove use
  • is not a substitute for hand hygiene
  • Not top of mind
  • needs to become as spontaneous as using aseptic
    technique and all other safety strategies.

40
So, Why Clean your hands?
  • 1) to protect the patient against harmful
    pathogens carried on your hands or present on
    his/her own skin
  • 2) to protect yourself and the health-care
    environment from harmful pathogens

41
Key Concepts
  • Hand hygiene must be performed at the point of
    care.
  • During healthcare delivery, there are four
    moments when it is essential that you perform
    hand hygiene.
  • Handrub is often preferable to handwashing.
  • If isolation precautions are in place, always
    adhere to the hand hygiene activities described
    in those precautions.
  • It is essential that everyone perform hand
    hygiene using the appropriate technique and time
    duration in order for it to be effective.

42
Point of Care
  • The place where three elements align
  • The patient
  • The healthcare worker
  • The care of the patient involving any contact
    with the patient or the patients zone.
  • A hand hygiene product should be as close as
    possible to the point of care.
  • WHO Hand Hygiene Guidelines, August 2009

43
Four Times to Clean
  • FOUR Moments of hand hygiene during healthcare
    have been identified and are crucial to
    preventing hand transmission of infections.
  • Before initial patient/patient environment
    contact
  • Before aseptic procedure
  • After body fluid exposure risk
  • After patient/patient environment contact
  • This was adapted from the WHOs 5 Moments of Hand
    Hygiene (Ontario Ministry of Health and Long Term
    Care).

44
(No Transcript)
45
Time
  • Optimal hand hygiene using an alcohol-based hand
    rub takes 20-30 seconds
  • Optimal hand hygiene using soap and water takes
    40-60 seconds
  • Both are effective methods

46
Alcohol Based Hand Rub
  • Apply a palm full of rub and cover all surfaces
    of the hand rub together until the hands are dry.

47
How to Hand Rub
To effectively reduce the growth of germs on
hands, handrubbing must be performed by
following all steps illustrated on the
left. This takes only 20-30 secs!
48
Soap Water
  • Wet the hands first and apply enough soap to
    cover all surfaces of the hands. Make sure the
    hands are dry and the towels are not used
    repeatedly or by multiple people.
  • Thorough drying of hands after hand washing has
    important protective benefits and helps to
    eliminate more pathogens from your hands.

49
How to Hand Wash
To effectively reduce the growth of pathogens on
hands, handwashing must last 40-60 secs and
should be performed by following all steps
illustrated on the left.
50
Gloves Skin care
  • Gloves do not replace the practice of optimal
    hand hygiene
  • Avoid hand washing immediately before or after
    using an alcohol-based hand rub
  • Avoid hot water
  • Let hands dry completely before donning gloves
  • Use hand lotions and creams
  • Allergies or adverse reactions use alternative
    products
  • No artificial fingernails or extenders
  • Keep natural nails short (0.5 cm)
  • Remove jewelry

51
Resources
  • World Health Organization Guidelines on Hand
    Hygiene in Health Care. First Global Patient
    Safety Challenge, Clean Care is Safer Care.
    August 2009.
  • http//whqlibdoc.who.int/publications/2009/9789241
    597906_eng.pdf
  • WHO Clean Care is Safer Care Tools and
    Resources http//www.who.int/gpsc/5may/tools/en/i
    ndex.html
  • Canadian Patient Safety Institute
    www.handhygiene.ca
  • Community and Hospital Infection Control
    Association Canada. http//www.chica.org/links_h
    andhygiene.htmlSTANDARDS

52
Resources
  • Public Health Agency of Canada, Hand Hygiene
    Recommendations for Remote and Isolated Community
    Settings. http//www.phac-aspc.gc.ca/alert-alerte/
    h1n1/public/handhygiene-eng.php?optionprint
  • Health Canada The Benefits of Handwashing
    http//www.hc-sc.gc.ca/hl-vs/iyh-vsv/diseases-mala
    dies/hands-mains-eng.php
  • Canadian Centre for Occupational Health and
    Safety http//www.ccohs.ca/http//www.ccohs.ca/
  • http//www.ccohs.ca/pandemic/subject/handwashing.h
    tml
  • The Art of Washing Hands http//www.theartofwashi
    nghands.com/index.html

53
Questions?
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