Puppets for Patients:
Goal:
Reduce preventable HAIs through broader engagement of surveillance by patients and family members to improve accountability of healthcare worker’s with proven hand hygiene guidelines. As well, this will make the Infection Control and Patient Safety staff-in-service memorable and awaken those who are sleeping! “Talk to the Hand!”
Introduction:
Very few patients are going to “question” their nurse or physician about hand hygiene, as this is the HCWs who you are relying upon for your care. Creating potential conflict in a vulnerable position is counter intuitive to human behavior. Role playing or acting with puppets is very effective to teach people how to communicate about subjects that are potentially contentious or threatening. “Triangulation” is an effective method to help “break the ice” barrier to convey a message to an “expert, authority figure or elder, etc.”to avoid direct eye contact when asking a potentially threatening question. Then “practice makes perfect” for the individual(s) who are engaged and will result in greater surveillance for hand hygiene compliance, that should be an innate behavior of the HCW.
Is the responsibility on the patient or family member to teach the HCW that immediately before touching them is the moment to wash or sanitize? A basic scientific principle! No, but it will improve the compliance. And yes, the patient or family member has a vested interest in not being “handed” an organism (MRSA, C.diff, VRE, etc.) that may have catastrophic effects on them. Technology has created many more opportunities to fail at hand hygiene compliance, an unintended consequence. Technology is NOT going away as there have been many benefits to Patient Safety and outcomes. So we need to have critical reminders to help the HCWs with “situational awareness” to reduce the HAI incidence. This is where we developed “Puppets for patients” as a great method to engage patients, family and advocates in more of an advocacy role in infection prevention. Reinforcing that they can have a significant role in reducing the risk for an HAI by following through on a few simple “hand behaviors” that require only keen observation, not level of education. By briefly explaining the statistics of the 90,000 preventable deaths from HAIs and the few simple steps to “monitor” and “comment” to the HCW when they do not wash/sanitize immediately before touching the patient, will help empower the patient to “mention it” to the HCW. It also elevates the importance for the patient and family members/visitors Not to “touch” any surface between wash/sanitize and contact with the patient’s hand or other key parts so they do not “give” them any infectious disease inadvertently. Working together WE CAN make a difference!
Reduce HAIs by increasing accountability and situational awareness for the expected behavior for EVERYONE who is involved with the patient in the hospital setting to be closer to 100% compliance with hand hygiene. If more observers (known and unknown) are around (unit clerks, transporters, patients, nurses, physicians, administrators, patients and family members, etc.) watching and commenting on the Hand Awareness (hand hygiene, respiratory etiquette and cross contamination awareness) compliance will improve. Promoting an open and continuous surveillance of hand hygiene compliance will achieve better results than intermittent monitoring. Increasing HCW situational awareness at the “patient point of care” immediately before touching the patient or object the patient will handle will help reduce transfer of unwanted organisms. HAIs are not walking down the hallways, we or some object are carrying them. Henry the Hand Champion Handwasher “Puppets for Patients” helps patients role play and “speak up” to HCWs about hand hygiene compliance. A few questions to reflect upon:
What is your observed rate of handwashing? Sanitiizing?
Who is observing?
Does your staff always differentiate between the benefit of handwashing versus sanitizing?
Where are the areas you believe need improvement in Hand hygiene?
Reduce C.difficile incidence in hospital setting by improving accountability of Hand Awareness and active knowledge for EVERYONE who is involved with the patient about when to wash with soap and water versus sanitizer. By increasing awareness and knowledge about what types of infectious diseases are on the ward, and listing in the nursing stations, there will be greater compliance with the appropriate hand hygiene action (handwashing versus sanitizing). HCWs will be able to assist others in their compliance due to the cultural emphasis on both Hand Awareness and improved communication. When you ask all HCWs, patients and visitors you will be surprised who believe sanitizer kills C.difficile spores.
Has your facility experienced increased C.difficile incidence and severity of complications?
What strategies are you considering for C.diff incidence reduction?
Are you engaging the patients and family effectively?
Are you using any new technologies to ID C.diff earlier?
How to contact:
Will Sawyer MD
513-769-4951
Resources:
Speak Up Campaign
Role HCPs Play in Transmission of MDROs