hand hygiene
By Robert P . Lee
Hand Hygiene and Surfaces : Are Your Education and Training Efforts Doing Enough to Move the Needle on HAIs ?
We need to raise the bar from minimum standards to evidence based standards in our education / training programs . As they also say in surgical training , “ See one , do one , teach one .”
Could your training and education be doing enough to support your integrated , collaborative approach ? Let ’ s look at your current state first and then we can explore some ideas to consider .
In the military we always say , “ You train as you fight .” In coaching , we say , “ You practice like you play .” We are in a battle with pathogens , the unseen enemy , and don ’ t seem to apply the same principles , techniques and resources necessary to win the battle . What did we witness with COVID-19 ?
In a previous columns we spoke about both vertical and horizontal approaches to addressing hospital-acquired infections ( HAIs ). The vertical approach attempts to identify the pathogen and then to implement treatment for that pathogen . A horizontal approach addresses infection on a more broad , non-specific approach where interventions do not target a specific pathogen . Vertical is more tactical and horizontal is more strategic . Within this article , we will attempt to illuminate an important horizontal approach , education and training , which is so important , but apparently severely under-resourced , in need of re-thinking and requiring your utmost attention .
In a recent survey conducted by our organization , we asked the following questions to hospital personnel :
1 . How important is hand hygiene to patient safety and staff safety ?
2 . Do you know your current hand hygiene compliance ?
3 . Is it based on the WHO or CDC minimum standard ?
4 . What is the difference between OR sterile technique principles and your current technique ?
5 . What training / education did your receive on sterile technique , prior to and during your employment ?
6 . Do you have to demonstrate your current sterile technique in a structured controlled setting such as a simulation center ?
The answers were as follows :
1 . Yes . 99 percent answered and recognized the importance of hand hygiene
2 . No . 95 percent did not know their compliance
3 . No . 97 percent did not know the methodology followed .
4 . No . 95 percent said that they got training in nursing school on operating room technique but that floor nursing didn ’ t apply OR standards
5 . No . 95 percent said no additional training in sterile technique , although occasional training on hand hygiene
6 . No . 98 percent said that their competency never used a simulation center to validate .
So , are we teaching the wrong thing ? Should we be teaching a higher level of performance ? Are we not using our resources to best optimize performance ? Are we holding ourselves accountable and training to a higher standard ?
Did you ever wonder why hand hygiene compliance and sterile technique is typically higher in nurses that come from an OR background ? Let me define “ OR sterile technique ” for the purpose of this column . OR sterile technique is the logical understanding , awareness and practice of movements by personnel to prevent the introduction and movement of pathogens within the OR space . For the purpose of this article , I shall exclude handwashing / scrub protocols for they are different for OR and floor nursing . However , once “ scrubbed in ,” the principles are the same . What are you doing with your hands and what are you touching — whether un-gloved or gloved — are vehicles for the pathogens to become mobile .
We need to raise the bar from minimum standards to evidence based standards in our education / training programs . As they also say in surgical training , “ See one , do one , teach one .”
www . healthcarehygienemagazine . com • april 2023
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