APIC Day 4 Blog... Hand Hygiene Culture, WHO Hygiene Framework and Infection Control Six Sigma

posted Jun 6, 2012, 9:54 PM by Todd Fox   [ updated Sep 23, 2016, 3:26 PM ]
It was sad to see all the Infection Preventionists and vendors leave APIC and the great city of San Antonio... but it will be good to see everyone in 2013 in Florida!  The information overload and hours of the APIC show can take a toll on infection professionals but the experience cannot be replaced.  Without an exception, everyone that visited the OUTFOX booth talked so highly about all of the sessions. 

Enjoy a show discount for Glo Germ items

If you have not attended APIC or took the year off, plan to attend in 2013!  There is so much great information shared and ideas given from successful administrators all over the world.  We hear a lot about competition in other industries, but it seems that collaboration is alive and well for the infection control industry.  So many infection control professionals are eager to share their experience, tips and materials to help your health care facility succeed.

As noted in previous days, the classes were great- here are a few recaps of sessions attended by OUTFOX Prevention representatives.  Enjoy!    

Session 3000: Hand Hygiene Update

Presenter: Elaine Larson, PhD, FAAN, RN, CIC
Although hand hygiene has been overwhelmingly covered over the last few years, it was interesting to have a presentation about the overall impact the increased focus has had.  According to the studies referenced, increased hand hygiene focus has really made a difference with nursing teams.  Where has it lacked?  Other influencers and related parties to the health care organization (doctors, therapists, patients, patient families, etc.) have had lower or consistent compliance numbers. 

What is the greatest factor of a successful hand hygiene campaign?  Most facilities saw the greatest compliance increases when the CULTURE of the unit was congruent with exceptional hand hygiene standards.  Meaning, if team members feel responsibility to the unit to maintain good hand hygiene then they will perform more hand hygiene more often!  Elaine made sure to point out that is was more effective to judge the team and not point out specific individuals if numbers decrease.

So, what is keeping compliance numbers down?  Over the years, it has been determined that elective hand hygiene is not instinctively triggered (based on what they are taught at a young age) as much as it was previously assumed.  Your health care workers may think they are 100% compliant because they don't know exactly when and where all the time- they are left guessing!
Why are they left guessing?  The following observations were noted as common reasons for low hand hygiene compliance:
Lack of awareness
Lack of familiarity
Lack of self efficacy
Lack of outcome expectancy
Inertia of previous practice (stuck in old ways)

One way to continually teach hand hygiene was recommended- The 5 Moments of Hand Hygiene.  Most of you should be familiar with this system, but here is the list anyway:
1. Before Patient Contact
2. Before Aseptic Task
3. After Body Fluid Exposure Risk
4. After Patient Contact
5. After Contact with Patient Surroundings

Also discussed was the WHO Hand Hygiene Framework.
The Framework is an evaluation tool in a questionnaire form.  It was recommended that each Infection Preventionist conduct the Framework Questionnaire and determine the level that their facility resides in.  The questions asked total a score that determines which of following 4 categories the facility fits into: deficient, low, intermediate/average and advanced.
The 5 factor categories for the questions asked to determine the score of your facility include: system change, training and education, evaluation and feedback, institutional safety, reminders (posters, signs, etc)

Interesting facts during the presentation:
Adamant glove wearers are less likely to practice good hand hygiene
16% of the time gloves are donned- they were not appropriate to be used
21% of the time that gloves were needed- they were not donned
Most new nurses in units get the geographic area's infections within 2 months of new job/area

Also look up: Joint Commission's Targeted Solutions Tool (TST)

Workshop- Session 3101: Using Performance Improvement Tools to Drive Infection Prevention

Presenters: Mustafa Abdulali, MBA; Denise Murphy, RN, BSN, MPH, CIC
The circle of performance improvement that should be considered for each process includes these four steps:
1. Engage
2. Educate
3. Execute
4. Evaluate

Six Sigma has been a popular topic in business manufacturing for quite a while but has yet to become a main stream topic in infection control.  Many facilities use the principles and have adopted some of the lingo, but it still has a ways to go to make a larger impact in health care settings. 

Some of the topics that would be helpful to investigate related to Six Sigma for health care settings include:
-The differences between pure waste and necessary waste
-Processes and procedures done right the first time save money and time
-Analyze your facility processes by mapping- Map what is happening NOT what is supposed to be happening
-Investigate FLOW (Flow is a key word for process improvement)
-The following impedes flow: wastes, uncertainty, lack of transparency, batching
-8 wastes: Motion, inventory waiting, rework/defects , inspection, overproduction, neglect of human talent, transportation

Other relevant topics discussed at APIC 2012:
Ambulatory surgery centers are storming on the scene!  Ambulatory centers are able to do more than thought possible 10 years ago. With the continued growth of these centers, it means that infection control needs to keep up with their development! 

Thanks for reading!  Please contact us with questions and stay tuned for other infection control blog posts.

OUTFOX information is copyrighted but can be used if a link and reference to www.OUTFOXprevention.com is used.  Thanks for helping OUTFOX infection so we can all avoid illness and disease more often!