Hand hygiene is recognized as the best way to prevent the spread of infection. In the busy world of Critical Care at the Health Sciences Centre, the staff has taken matters into their own hands and made hand hygiene a priority.
The Critical Care area at the Health Sciences Centre (HSC) takes care of the sickest and most vulnerable patients in our province. It’s an area where patients require vigilant monitoring, continuous assessment, and quick thinking. Critical Care is comprised of three units: the Coronary Care Unit (CCU), the Medical Surgical Intensive Care Unit (MSICU), and the Cardiovascular Surgery Intensive Care Unit (CVICU).
The staff in all three areas strive to promote best possible patient outcomes. What is the simplest way we do this? By washing our hands!
Infection control is vitally important in the Critical Care environment, according to Rhonda Sheppard, a registered nurse in the MSICU.
“Hand hygiene is simply the easiest and most effective way to prevent infection,” Rhonda added. “In Critical Care, our patients are often immune-compromised, making hand hygiene one of the most important things to ensuring best patient outcomes.”
Faced with peaks and troughs in hand hygiene compliance in the past, leadership and staff at Eastern Health agreed that hand hygiene compliance was a priority. In 2013, Critical Care joined forces with the Infection Prevention and Control Program to initiate hand hygiene self-auditing
Being a pioneer in the self-auditing process, the Critical Care area quickly appreciated the impact that self-auditing has on the rate of employee compliance. Armed with the knowledge, and the ability to assess, monitor and critique current practices – hand hygiene became a big part of the conversation in all areas of Critical Care.
Critical Care at the HSC strives not only to comply – but to be a leader in hand hygiene compliance.
In fact, since the employees began monitoring themselves, compliance rates have risen from 30 per cent to as high as 80 per cent. Strong leadership from the front line – combined with a strong sense of accountability to coworkers, our patients and families – has created a coalition to ensure hand hygiene is a priority.
But we’re not perfect – just yet! Our ongoing challenge is to drive our rates ever higher!
So how do we achieve that? According to Kirk Dawe, nurse practitioner for Critical Care, we need to focus on positive reinforcement and reminders. “We ask our coworkers, patients and family members to hold us accountable – and to remind us to wash our hands when we forget,” Kirk says. “A simple reminder – or a visual signal to each other – can help us make hand hygiene part of our daily routine.”
Respect and professionalism are also key to improving hand hygiene compliance and have been integral in improving rates. A rule of thumb in Critical Care – if you get a reminder to wash your hands, the only acceptable response is “thank-you.”
There are staff who have mastered the practice and they provide support to others in ensuring hand hygiene is included as the first and last step to any aspect of patient care. Our vision is to embed hand hygiene into practice in Critical Care to the point where it takes no special effort to be compliant – it becomes common practice.
Kaylynn Cameron, a hand hygiene champion in the CVICU sums it up with this powerful message on hand hygiene: “Providing safe care to our patients is the motivation that drives hand hygiene. Being a potential vector of infection contradicts providing the safest care.”
In the busy and ever-changing area of Critical Care, the simple task of hand hygiene will continue to be a priority because we know that this ‘simple’ task can greatly improve outcomes for our patients.
We challenge other areas to make this your priority as well.
The power is in your hands.
Protect your patients. Protect yourself! ■
This story was written by Jeannine Herritt, regional program manager in the Medicine Program at Eastern Health, and former Research Coordinator for Critical Care.