Joint Commission Update for Infection Control: Joint Commission: Patient safety is in your H.A.N.D.S.
December 1, 2009
Joint Commission Update for Infection Control
Joint Commission: Patient safety is in your H.A.N.D.S.
Habit, Active feedback, No excuses, Data Systems
A hand hygiene project launched at The Joint Commission's Center for Transforming Healthcare cites the following problems and solutions on hand hygiene:
Causes of failure to clean hands
Ineffective placement of dispensers or sinks
Hand hygiene compliance data are not collected or reported accurately or frequently
Lack of accountability and just-in-time coaching
Safety culture does not stress hand hygiene at all levels
Ineffective or insufficient education
Hands full
Wearing gloves interferes with process
Perception that hand hygiene is not needed if wearing gloves
Health care workers forget
Distractions
Examples of how to link specific causes to targeted solutions
Cause: Ineffective placement of dispensers or sinks
Solution: Provide easy access to hand hygiene equipment and dispensers
Cause: Hand hygiene compliance data are not collected or reported accurately or frequently
Solutions:
Data provide a framework for a systematic approach for improvement
Utilize a sound measurement system to determine the real score in real time
Scrutinize and question the data
Measure the specific, high-impact causes of hand hygiene failures in your facility and target solutions to those causes
Cause: Hand Safety culture does not stress hand hygiene at all levels
Solutions:
Make washing hands a habit - as automatic as looking both ways when you cross the street or fastening your seat belt when you get in your car
Commitment of leadership to achieve hand hygiene compliance of 90+ percent
Serve as a role model by practicing proper hand hygiene
Hold everyone accountable and responsible - doctors, nurses, food service staff, housekeepers, chaplains, technicians, therapists
Cause: Hands full
Solution: Create a place for everything: for example, a health care worker with full hands needs a dedicated space where he or she can place items while washing hands
Solutions: Effective hygiene is in our HANDS (Habit, Active Feedback, No One Excused, Data Driven, Systems)
Habit
Always wash in and wash out upon entering/exiting a patient care area and before and after patient care
Make washing hands a habit - as automatic as looking both ways when you cross the street or fastening your seat belt when you get in your car
Active Feedback
Coach and intervene to remind staff to wash hands
Clearly state expectations about when to sanitize hands to all staff members
Communicate frequently - provide visible reminders and ongoing coaching to reinforce effective hand hygiene expectations
Engage staff - real-time performance feedback
Tailor education in proper hand hygiene for specific disciplines
Provide just-in-time training
Use technology-based reminders and real-time feedback
Celebrate improved hand hygiene
No One Excused
Protect the patient and the environment - everyone must wash in and wash out
Make it comfortable to wash hands with soap or use waterless hand sanitizer
Hold everyone accountable and responsible - doctors, nurses, food service staff, housekeepers, chaplains, technicians, therapists
Apply progressive discipline from the top - managers must hold everyone accountable for proper hand washing
Commitment of leadership to achieve hand hygiene compliance of 90+ percent
Identify proper hand hygiene as an organizational priority
Serve as a role model by practicing proper hand hygiene
Data Driven
Data provides a framework for a systematic approach for improvement
Utilize a sound measurement system to determine the real score in real time
Use trained, certified independent observers to monitor appropriateness of hand hygiene
Scrutinize and question the data
Measure the specific, high-impact causes of hand hygiene failures in your facility and target solutions to those causes
Systems
Focus on the system, not just on people
Make it easy; examine work flow of health care workers to ensure ease of washing hands:
Provide easy access of hand hygiene equipment and dispensers
Create a place for everything: for example, a health care worker with full hands needs a dedicated space where he or she can place items while washing hands
Limit entries and exits from a patient's room - make supplies available in room and eliminate false alarms that require staff to leave room to turn alarm off
Identify new technologies to make it easy for staff to remember to wash hands, i.e., radio frequency identification, automatic reminders, real-time scoring