Health care-associated infections occur when people get an infection while seeking medical treatment for another health issue https://health.gov/hcq/prevent-hai.asp. According to the Center for Disease Control (CDC) “1 in 25 patients suffer from a Health care-associated Infection” https://health.gov/hcq/prevent-hai.asp. The World Health Organization (WHO) recognizes this issue as a world issue providing links to factors such as socio-economic status, sanitation, age, and more http://www.who.int/gpsc/country_work/gpsc_ccisc_fact_sheet_en.pdf.
Both the CDC and WHO recognize several factors for the cause of Health care-associated infections. These include but are not limited to:
- The use of Catheters (Urinary, IV, Central and more)
- Over use of antibiotics
- Facility cleanliness (dirty floors, equipment, supplies and more)
According to the Patient Safety Network (PSNet) these infections cost the U. S. and the health care system “billions of dollars annually” https://psnet.ahrq.gov/primers/primer/7/health-care-associated-infections. If you are curious as to the impact of Health care-associated infections in your organization specifically, the Association for Professionals in Infection Control and Epidemiology (APIC) provides tools such as a “cost calculator” in which you can enter your organizations specific data information. This tool can be found at: https://apic.org/Resources/Cost-calculators.
The common theme in prevention of Health care-associated infections is hand washing. Hand washing is recognized as the number one prevention tool. Organizations such as the CDC, WHO, and APIC offer tools for training and education as well as surveillance of hand washing in your organization. The goal would be for every individual health care professional to take ownership and responsibility for the performance of hand hygiene consistently, prior to and after every patient encounter.
As a registered nurse and an assistant professor of nursing I not only teach about hand washing and its importance in infection prevention, but I have observed the inconsistency of it among health care professionals. Hand washing is such an easy thing to do, yet as noted above, the presentation by the CDC that “1 in 25 patients have an infection related to hospital care” is staggering. In 2014 the California Department of Public Health posted a presentation that includes barriers that prevent or deter health care professionals from performing this task consistently https://www.cdph.ca.gov/Programs/CHCQ/HAI/CDPH%20Document%20Library/7_HandHygiene.Approved12.01.17-ADA.pdf. Although the importance of hand washing is receiving more attention these barriers still exist in 2018. Including barriers identified in this presentation, reasons for these barriers include but are not limited to:
- Skin irritating agents leaving hands dry and cracked
- Perceptions of the health care professional
- Lack of knowledge about infection transmission
- False sense of security with the use of gloves
- Time for patient care
- Lack of hand washing enforcement
- Not enough sinks and hand sanitizing stations
- Overuse of hand sanitizer and not enough hand washing with soap and water
How do we address this on-going problem? It is addressed through taking personal responsibility and ownership for the care we provide to patients and recognition that together we make up an organization. Therefore, when we say the organization needs to do more we are actually making a statement that we need to do more. The following is a list of some actions that can be taken to help patients remain safe from Health care-associated infections while in our care:
- Follow the CDC guidelines at: https://www.cdc.gov/healthywater/hygiene/hand/handwashing.html. Always use soap and water unless soap and water is not available. If soap and water is not available use an alcohol based hand sanitizer. Recognize that hand sanitizer does not wash away all germs.
- Work together in your organization to create no-tolerance hand washing policies and enforce them
- Engage patients letting them know that it is helpful for them to provide reminders for health care providers to wash their hands
- Remind each other
- Create a safe environment for reporting unsafe practice
- Create a key words campaign to help the care provider remember to wash their hands. If the provider states “I am now washing my hands for your safety” both the care provider and the patient should expect that it will happen.
I am hopeful that you have enjoyed this “Talk Tuesday” informative discussion and have found at least one take away that you can apply in your practice today. Before leaving my site please take time to follow my blog and enter your email address. For Legal Nurse Services in medical record review, determination of merit, risk management, culture change, public speaking, and more please contact me via Talk Tuesday or visit my website at https://upvisionconsulting.com/. I would love to hear from you!
The Legal Nurse