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Video gets patients more involved in hand hygiene
Patients, physicians report more questions asked
A hand hygiene video developed by the Centers for Disease Control and Prevention (CDC) that asks patients to become partners in ensuring compliance by remindings caregivers to wash their hands prior to any treatment was shown to be effective in increasing the frequency with which patients questioned their providers about hand washing.
The video, called "Hand Hygiene Saves Lives," was tested in common areas and patient rooms at 17 Catholic Health Partners hospitals; the research was coordinated by the Premier Healthcare alliance. The video encourages patients, family, and visitors to play a role in their own care by helping health care professionals remember to clean their hands before and after touching patients. After the video was shown, patients were twice as likely to report reminding nurses to wash their hands, and doctors were twice as likely to report being asked by patients to wash their hands.
In addition, after watching the video, the majority of patients:
"We know that hand washing is less than optimal; on average, providers wash their hands 50% of the time," notes Gina Pugliese, vice president of the Premier Safety Institute. "People say they wash more than they really do, and we support anything that can appeal to them and help them remember."
Different types of appeals can be made, she continues. "You can appeal to the left brain with facts, or the right brain with emotions — whether you use posters, stickers, patient reminders, peer pressure from colleagues, or the convenience of hand hygiene containers," says Pugliese. "A video is one more tool to help empower patients to feel comfortable about reminding the provider to wash their hands. This is one more way to empower them to feel it is OK to remind the caregiver." In addition, she says, "The majority of doctors and nurses felt comfortable being asked, and it did not bother them at all."
The intervention, she explains, was implemented over a period of a several months. "There was a month where the patients were pre-tested to get their opinions — what they thought of hand washing, how comfortable they would be about asking the caregiver if they had washed their hands, and so forth," Pugliese shares. "The next month we watched them in the treatment rooms via closed-circuit TV. The month after that we asked if there had been any change."
Interventions such as these can be even more successful if the proper foundation has been laid, says Ann Marie Pettis, RN, BSN, CIC, director of infection prevention at the University of Rochester Medical Center. "We ran campaigns prior to the video," she says. "Several years ago, we had providers wear a button saying 'Ask me if I washed my hands.' We did hand wash observation and documented how much of the unit was using the hand washing dispensers and it spiked, so we were already messaging that clearly to our providers. When the video came out, it reinforced the message."
The video, she continues, "is short, which is important, and it actually shows the clinical setting, which makes it more effective." The most unique part of the campaign, she says, "was the idea the patient or family was being encouraged to advocate for compliance on the part of providers. The whole idea is that we're all in this together, and it's OK to ask the provider if they are not seen doing what they are supposed to be doing."
Pettis says there was some "initial timidity" on the part of patients and family to question providers when the original campaign was launched, "but there's been some cultural shift and now, three years later, we don't see quite as much," she notes. "In general, the older patients are a little more uncomfortable than the younger ones — to them it's not unusual to expect to be part of the health care team themselves."
She says she now shows the video as part of the admission procedure. "What we plan to do soon is start a survey with patients asking them four very simple questions: 'Did you see your health care professional sanitize their hands before touching you? After touching you? If you did not see them wash, did you feel comfortable reminding them? If you didn't, please share why not.' Then we end with 'Thank you for helping us protect you from infection!'"
[For additional information, contact:
Gina Pugliese, vice president of the Premier Safety Institute. Phone: (704) 733-5874.]