Tag Archives: hand hygiene

Aug 3, 2017

Health care hygiene compliance: Not just for hands anymore?

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It’s time to add ‘and stethoscope hygiene’ to ‘practice hand hygiene’ signs

Stethoscope blog

Changing habits is hard. We can see the data, understand the science and even participate in a training session, yet we go back to doing it like we always did.

That is precisely what researchers observed and documented in a recently published quality improvement project on stethoscope hygiene. In the July issue of the American Journal of Infection Control from the Association for Professionals in Infection Control and Epidemiology (APIC), researchers found that healthcare providers rarely perform stethoscope hygiene between patient encounters, despite its importance for infection prevention. The authors call for the inclusion of stethoscope hygiene in all hand hygiene initiatives.

Infection prevention is a complex undertaking, and stethoscope hygiene is an important component. Here are a few simple tips from 3M™ Littmann® stethoscopes along with some hand hygiene essentials.

Stethoscope blog chart

Barriers to change may exist at several levels. Maybe there is a level of disbelief that stethoscopes get as contaminated as hands, despite what research shows. Maybe wiping stethoscopes is perceived as inconvenient or there’s concern that sanitizers and wipes will damage the stethoscope (Tip: All Littmann stethoscopes feature next-generation tubing with improved resistance to alcohol). Whatever the obstacles, let’s challenge ourselves to identify and overcome them. It’s essential to patient safety.

At 3M, we are committed to a future without preventable infections. As with hand hygiene, cleaning stethoscopes between patients should be expected in all health care settings and supported by leadership and clinicians alike. The future of infection prevention and superior patient care will be built upon a culture of compliance. Be a stethoscope hygiene champion in your facility!

 

May 13, 2016

Redefining Healthcare Sustainability at CleanMed 2016

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Redefining Healthcare Sustainability at CleanMed 2016

At 3M, we are committed to improving our business, our planet, and every life. That’s one reason health care professionals rely on us to provide products they can depend on; products that will help improve lives in a rapidly changing environment.

For us, improving lives also means developing environmentally friendly health care products without sacrificing product quality or performance. On May 17-19, 3M will be in booth 201 at the CleanMed 2016 conference in Dallas, Texas to share our dedication to sustainability with other green-leaders in the health care industry.

Presented by Practice Greenhealth and Health Care Without Harm, this year’s event will be CleanMed’s 17th conference organized to showcase sustainable health care products in use within the health care industry. In 2015, 3M was honored with the Practice Greenhealth “Champion for Change” award for expanding sustainable practices.

Below are some examples of 3M Health Care sustainability products that we’ll be taking with us to CleanMed 2016, which aim to benefit both patients and the environment:

3M innovations reduce waste

Specific Packaging is required to protect medical materials and, in some cases, to keep a product sterile. This packaging is important, but can also result in a lot of waste and increased health care costs. 3M™ Tegaderm™ Dressings are now packed using an innovative nested design that reduces pouch material by 30% compared to a rectangular pouch.

3M innovations increase antibiotic stewardship

3M™ Skin and Nasal Antiseptic helps reduce the risk of surgical site infections when part of a comprehensive preoperative protocol.1-5 3M™ Skin and Nasal Antiseptic has not been shown to lead to resistance, supporting your antibiotic stewardship efforts.6

3M innovations conserve water

3M offers a wide variety of Green Seal certified cleaning chemicals that help reduce the amount of water needed, while also improving indoor air quality. Portable and reusable dispensers reduce environmental impact, and easy mixing minimizes chemical waste.

The 3M™ Easy Scrub Flat Mop is a solution for cleaning floors that reduces water and chemical waste by 80%, and cuts cleaning time in half when compared to a traditional mop and a bucket.

3M™ Avagard™ (Chlorhexidine Gluconate 1% Solution and Ethyl Alcohol 61% w/w) Surgical and Healthcare Personnel Hand Antiseptic with Moisturizers is the first and only FDA NDA-approved waterless, brushless surgical hand antiseptic that uses alcohol for rapid kill and Chlorohexidine Gluconate for persistent, cumulative activity, which is preferred by AORN. The formulation eliminates the need for water, helping hospitals further avoid waste.

3M innovations are made with safer chemicals

Made without natural rubber latex or phthalate plasticizers, 3M™ Littmann® Stethoscopes have reliable and clear acoustic performance and resilient next-generation tubing that retains its shape and flexibility even after folding tightly into a pocket. The new tubing provides longer stethoscope life due to improved resistance to skin oils and alcohol.

3M’s hand hygiene line contains foam and gel products that have earned the USDA biobased product certification, and a soap that is made without triclosan.

3M innovations conserve energy and resources

Every dollar spent on utilities is a dollar not spent on patient care. 3M™ Thinsulate™ Climate Control Window Film enhances existing window insulation by keeping the warmth in during the winter and the cool, conditioned air in during the summer. The 3M™ Climate Control Window Film solution helps facilities reduce their energy consumption, while creating a safe and pleasant environment for patients.

The majority of our 3M™ Steri-Drape™ Fabric Surgical Drapes are now made with plant-based renewable resources and reduce the environmental impact of medical disposables, while maintaining the same standard our customers expect from us:  strikethrough-resistant barrier, strength, adhesion, drapability and low linting, plus improved absorption and ease of application. What’s new:

  • 18% fewer fossil fuel resources used throughout the product life cycle7
  • 10% less CO2 emitted during the product life cycle7
  • 62% of entire fabric made from renewable plant-based material8
  • Nonwoven layer contains 95% renewable plant-based material8,9  

We invite you to stop by booth 201 at the conference to learn about the exciting breakthroughs 3M is making in patient safety and environmental accountability. See a preview of 3M’s sustainable solutions.

 

References

1. Phillips M., et al. Preventing Surgical Site Infections: A Randomized, Open-Label Trial of Nasal Mupirocin Ointment and Nasal Povidone-Iodine Solution. Infect Control Hosp Epidemiol 2014;35(7):826-32

2. Bebko S., et al. Effect of a Preoperative Decontamination Protocol on Surgical Site Infections in Patients Undergoing Elective Orthopedic Surgery with Hardware Implantation. JAMA Surg, Published online March 04, 2015. doi:10.1001/jamasurg.2014.3480

3. Brown L., et al. (2014, June) The Effects of Universal Intranasal Povidone Iodine Antisepsis on Total Joint Replacement Surgical Site Infections. Poster present at the APIC National Conference, Anaheim, CA

4. Waibel M., (2013, June) Revisiting Process Improvement for Total Joint Arthrophlasty Surgical Site Infections. Poster presented at the APIC National Conference, Ft Lauderdale, FL.

5. Hogenmiller J., et al. (2011, June) Preventing Orthopedic Total Joint Replacement Surgical Site Infections through a Comprehensive Best Practice Bundle/Checklist.Poster presented at the APIC National Conference, Baltimore MD.

6. 3M Study 05-011322 *The clinical significance of in vitro data is unknown

7. Life Cycle Assessment per ISO 14040 and ISO 14044 and validated by PE INTERNATIONAL

8. Tested per ASTM D6866 byBeta Analytic Inc.

9. Certification by Vinçotte

May 5, 2016

Remember the importance of hand hygiene

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Hospital hand hygiene

Imagine your Mom gets sick and is admitted to the hospital. A healthcare provider arrives and starts checking her vitals. You notice they’re not wearing gloves and didn’t wash their hands. But you were afraid to ask. A month goes by and Mom takes a turn for the worse.  She’s back in the hospital, this time, she has a new infection. Out of the blue. Where did this come from? Was it from the healthcare provider who didn’t wash their hands? Could something as simple as using soap and water or hand sanitizer have prevented this? I wish I would’ve said something.

As everyone knows, hand hygiene is critical on a daily basis. Once a year on May 5, the World Health Organization (WHO) initiates a global campaign, Save Lives: Clean Your Hands day to engage healthcare facilities on the importance of hand hygiene. The WHO campaign supports the importance of hand hygiene in healthcare and the improvement of hand hygiene globally. Professor Didier Pittet, from WHO, stresses that washing hands saves lives. Watch his Adapt to Adopt video to see some creative ways on how facilities are focusing on hand hygiene improvements.

Are you following WHO’s recommendations for My 5 Moments for Hand Hygiene?

  1. Before touching a patient.
  2. Before clean and aseptic procedures (eg. inserting devices such as catheters).
  3. After contact with body fluids.
  4. After touching a patient.
  5. After touching patient surroundings.

In support of WHO’s campaign, we want to help you drive proper hand hygiene compliance throughout your healthcare facility. Take time to review the on-demand educational opportunities below. The fight against infection is in your hands.

Getting Hand Hygiene to the Next Level Through Value Based Improvement in a Culture of Safety

Hand Antiseptics Formulation and Regulation…What’s Involved in Developing the Products You Use

Surgical Hand Antisepsis

Importance of a Clean Environment in Keeping Hands Clean

Leading the Way: Healthcare Facility Hygiene

Hand Hygiene in the Perioperative Setting-Reviewing the Recommended Practice

Nov 23, 2015

The Chain of Infection: A Patient Journey

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The Chain of Infection

Passing Thru the Gauntlet of Healthcare Associated Infections

Meet Mary J, an incoming patient. She’s been referred to your hospital because of its reputation as a state-of-the art facility and one that has minimized healthcare-associated infections – HAIs. Mary’s OB/GYN insisted that yours is the best hospital for her to have her surgery. What began as a persistent pain in her pelvic region has been diagnosed as ovarian cancer and a complete hysterectomy has been ordered. The life of this otherwise healthy, 46 year old mother and elementary school teacher has taken a dramatic turn. She must put her care in someone else’s hands, something she’s unaccustomed to doing. With her family and her students relying on her, the last thing Mary needs is to come through the procedure successfully but encounter an HAI. HAIs can be harbored in virtually any place Mary will be transiting.  According to a recent HAI prevalence survey1 administered by the CDC, 1 in 25 hospital patients in the US have experienced at least one HAI. Read how ready this facility is to mitigate and minimize the occurrence of HAIs in its commitment to patient safety.

Arrival – Let the Battle Begin

Hands, the most common source of pathogen transmission, are a critical battleground in the fight to reduce healthcare-associated infections so naturally they are at the center of the challenge. One challenge is that in order for any product to be effective, it would also need to be gentle enough to promote repeated and frequent use. In any hospital, an effective antiseptic hand solution should also be latex glove and Chlorhexidine Gluconate compatible. It should also be dye and fragrance-free and available in versatile and convenient point-of-care locations to promote compliance. Because your hospital has initiated a comprehensive hand hygiene policy using awareness training, products and tools that are effective against infection yet gentle on skin, Mary’s admission will be less of a risk. Your hospital has also incorporated appropriate environmental cleaning programs with detailed instructions to ensure consistent cleaning based on industry standards and best practices. Because of this, Mary’s chance to contract HAIs as she passes through the hallways and contacts various equipment is reduced. The OR has been cleaned and disinfected using a variety of cleaning products and tools including chemical management systems that mix disinfectants and other products in exacting quantities. Additionally, the Infection Preventionist and Environmental Services Manager routinely review a hygiene-management-system sampling plan to validate the cleaning process and address problem areas. In all areas where Mary will pass, particular attention is paid to disinfecting high-touch surfaces. Cleanliness is verified using a hygiene management and testing system that provides real-time results. The analysis confirms that environmental cleanliness is at or above the goal benchmark for frequently touched surfaces – where the risk of cross contamination tends to be the highest. In addition to physical testing, data-driven assessment tools also help provide facilities managers with the ability to track the cost of HAIs to their facilities and justify investments in infection prevention programs.

Pre-op – Even up Your Nose?

As Mary is prepped for her procedure, she is impressed and reassured to see that all personnel who come in contact with her sanitize their hands using an instant hand antiseptic. They are obviously well trained and sanitize their hands without a second thought. She changes into a forced-air warming gown which will keep her warm as she waits prior to surgery, as well as maintain a comfortable body temperature throughout her procedure. Her nurse administers the hospital pre-surgical cleansing policy, which includes nasal antiseptic applied to her intranasal cavity and even an oral rinse – no opportunity for an HAI is left to chance. Mary’s nurse explains that this routine will help minimize the bacteria in her nasal and oral passages, bacteria that could easily spread to her surgical wounds or her airway while she is on the breathing machine. Her skin is prepared for surgery using specially developed 2% chlorhexidine gluconate rinse-free cloths that address multidrug resistant organisms on the skin and are another layer of defense against surgical site infections. Mary is then transported into the operating room. Other members of the surgical team begin to arrive into the OR. The surgical assistant puts on a high fluid-resistant surgical mask, disinfects her hands with an antiseptic hand prep and then gowns up. All surgical tools are effectively monitored using chemical and biological indicators. These indicators serve as release criteria in the Central Sterile Supply Dept. (CSSD). CSSD places chemical indicators into each set before sterilization and then are checked prior to use in the OR to verify sterilization conditions have been met. This last step is adopted by the World Health Organization, Safe Surgeries Check List to indicate that sterilization conditions exist inside the set (http://apps.who.int/iris/bitstream/10665/44186/2/9789241598590_eng_Checklist.pdf)

The indicators show a “pass”, which means they have met the parameters for sterilization and the instruments are ready. Just before she goes under anesthesia, as part of the patient monitoring process, pre-wired monitoring electrodes are placed on Mary and connected to her monitors. These electrodes use a gentle, conductive adhesive that is repositionable and won’t tear delicate tissues when removed. Mary’s IV  is inserted and secured using a transparent dressing so her IV can be monitored without removing the dressing and exposing the IV site to additional bacteria. Your hospital realizes the importance and cost saving benefits to using dressings that provide superior wear time, gentle removal, and excellent moisture management in the battle against HAIs.

In the OR Zone

While Mary’s forced-air warming gown is keeping her warm before surgery, another warming product will be used during her procedure – a full access underbody blanket. (Recent studies found that underbody blankets delivered significantly warmer patients than resistive warming devices or standard warming therapy).2-5 Maintaining normothermia helps reduce the risk of infections as well as the hospital length of stay. Warmed blood and fluids are also beneficial in an effort to maintain normothermia and they will be administered using a leading blood and fluid warming device. Once Mary is anesthetized, her skin previously clipped of hair, done in periop, is prepared for surgery using an iodine povacrylex and isopropyl alcohol surgical solution, which keeps bacteria counts below baseline for at least 48 hours. During this time, the rest of the surgical team disinfects their hands with an antiseptic hand prep. Mary is then draped using a surgical drape that has an antimicrobial incise film to create a sterile surface. This front-line barrier provides a sterile surface all the way to the wound edge, and provides continuous broad-spectrum antimicrobial activity to further reduce the risk of SSIs and HAIs. Before making any incision, the team conducts a “time out” to make sure they are doing the right operation on the right patient, have all of the appropriate instrumentation present and confirm that the correct pre-surgical protocols have been followed. The team also makes introductions and states the roles they have in the surgery, all part of your hospital’s head- to-toe patient safety attitude. Satisfied that all of the proper procedures have been followed, her gynecologic oncologist initiates the operation. After successfully removing her uterus, fallopian tubes, omentum and ovaries, fluid and tissue samples are collected and sent for testing. Mary’s skin incision is then closed using a disposable skin stapler. Closing the incision this way maintains wound edge apposition, allowing for appropriate edema to occur and facilitate proper healing. The final touch is dressing the incision. Your hospital stocks an all-in-one dressing that is highly conformable; one that flexes with movement and swelling and provides a better exchange of moisture vapor and oxygen to reduce skin maceration. The post-surgical dressing of choice protects the wound while absorbing drainage, all of which promotes healing and greater comfort. At last, Mary is transferred to the recovery room and then the ICU.

Post op Success and New Horizons

As the staff ushers Mary though recovery, a new set of pre-wired monitoring electrodes are placed on her and connected to the patient monitor. Oral care is started with an oral rinse (Chlorhexidine Gluconate 0.12%). This process is done every four hours while Mary is in the Post Anesthesia Recover Unit, or PACU. Because the staff at your hospital had the right processes and products in place, from the surgical prep station to the sterilization room to the OR and onto the ICU, they helped reduce the risk of Mary walking away with a healthcare-associated infection. Why subject patients to needless risk of a HAI when risk can be mitigated?

References:

  1. CDC, Healthcare-associated Infections (HAIs), HAI Prevalence Survey, 2011, http://www.cdc.gov/HAI/surveillance/
  2. Tominaga A., Koitabashi T., et al. Efficacy of an underbody forced-air warming blanket for the prevention of intraoperative hypothermia. Anesth. 2007;107:A91.
  3. Insler SR., et al. An evaluation of a full-access underbody forced-air warming system during near-normothermic, on-pump cardiac surgery. Anesth Analg. 2008. 106(3):746-750.
  4. Teodorczyk JE., et al. Effectiveness of an underbody forced-air blanket in preventing postoperative hypothermia after coronary artery bypass graft surgery with normothermic cardiopulmonary bypass.  Critical Care. 2009. 13(1):P71.
  5. Engelen S, et al. A Comparison of under-body forced-air and resistive heating during hypothermic bypass. ASA Abstract. 2010. A075.
  6. World Health Organization, Health care-associated infections FACT SHEET, http://www.who.int/gpsc/country_work/gpsc_ccisc_fact_sheet_en.pdf
Jun 1, 2015

Building Ways to Promote Hand Hygiene

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Hand Hygiene

According to The World Health Organization (WHO), hand hygiene is considered one of the most valuable instruments in preventing the spread of Healthcare Associated Infections (HAIs). Patient participation in improving hand hygiene is already recommended by healthcare authorities; however, it is not clear as to whether this idea is readily accepted by the patients or health care workers. For this reason, a cross-sectional survey was performed using a self-administered, anonymous questionnaire in one of South Korea’s teaching hospitals, which consists of 1,000 beds.

The survey

Dr. Min-Kyung Kim and several colleagues surveyed patients/families, nurses and physicians as to their perspective on patient participation in hand washing programs. The survey was completed by 334 patients/families, 387 nurses and 152 physicians. The overall response rate was 84 percent, 85 percent and in excess of 60 percent among nurses, physicians and patients/families, respectively.

The survey asked patients and families if they knew the importance of good hand washing practices. It also asked if they planned on or wanted to ask health care professionals about hand hygiene, as well as why they would not want to ask health care workers about it.

Physicians and nurses were asked about their perceptions of hand hygiene, how frequently they washed their hands, reasons they neglected to wash their hands and their view on patient participation in hand washing programs.

The results

While 75 percent of patients/families would like to ask health care workers to cleanse their hands if they neglected to do so themselves, only 31 percent of the nurses and 26 percent of the physicians surveyed supported patient participation (P < .001).

Some health care professionals disagree with patient participation

Concern about the relationship between health care workers and their patients was the most common reason that surveyed health care professionals did not support patient participation (54 percent) in hand hygiene programs.

Other reasons that health care workers disagreed with patient participation include patients’ lack of knowledge, an increased workload, the possibility of legal issues and concerns about their authority being undermined.

Method of patient involvement

In regards to the method of patient involvement, patients and their families favor assessing the health care professionals’ hand washing performance periodically during their stay or after being discharged; whereas, health care workers would rather have patients ask them directly.

Discrepancies in methods used to promote hygiene, not its importance

Dr. Nasia Safdar is a researcher at the University of Wisconsin’s Department of Medicine. She did not assist with the study; however, Dr. Safdar states that patients and providers agree that hand hygiene is essential; the disagreement relates to the best method for promoting it.

In an email, Dr. Safdar tells Reuters Health that “Patient involvement and perceptions, as well as those of providers, are very culturally specific, so findings in one setting are not necessarily generalizable.” She states that she believes patients and physicians would feel comfortable if patients were given the option of reminding staff to practice good hygiene by washing their hands. Dr. Safdar adds that hand washing is critical for preventing infection.

According to the Centers for Disease Control and Prevention Dr. John Jernigan, medical professionals’ adherence to hand hygiene practices is less than optimal. This, in spite of the long-standing evidence that shows hand hygiene helps to prevent healthcare-associated infections (HAIs). To put this into perspective, consider that there are nearly 2 million HAIs and approximately 100,000 deaths associated with HAIs among hospitalized patients every year.

Previous research suggests that patients can actively promote hygiene

Research released in December of 2009 by the Centers for Disease Control and Prevention (CDC), the Premier Healthcare Alliance and Catholic Healthcare Partners (CHP) verifies that patients can play an active role in promoting hand hygiene amongst healthcare professionals.

Ways to promote hand hygiene

The CDC suggests that healthcare facilities take an active role in the promotion of hand hygiene. There are various materials available from the WHO, CDC and Association for Professionals in Infection Control and Epidemiology (APIC) to assist in reminding healthcare professionals and patients to practice hand hygiene on a regular basis. These materials include posters, videos, handouts, brochures, a PowerPoint presentation and even a screensaver.

CDC Posters

Keep Calm and Wash Your Hands

Clean Hands Save Lives

Printable Fact Sheets from the CDC

Videos from the CDC

Wash Your Hands

Hand Hygiene Saves Lives

Posters from the WHO

How to Hand Rub

How to Hand Wash

Your 5 Moments for Hand Hygiene

Handouts from the Association for Professionals in Infection Control and Epidemiology (APIC)

You are an Important Part of Infection Prevention

Posters from APIC

Infection Prevention and You at the Hospital

PowerPoint Presentation for Hospital Staff

There is no doubt that the number of HAIs can be reduced. This can be accomplished by building a better understanding and promoting an environment for healthcare professionals and patients to participate in hand hygiene practices. Promoting an environment that focuses on proper hand washing and hand antiseptic techniques is simple with the abundance of materials available through the CDC, WHO and APIC.