Page 7 - IQ February 2018

infec on on rate dropped nearly 100% and and this marked both the the the discovery of of hand hygiene to control the the the spread of of of disease - - and and and less ceremoniously the the the crea on on on of of handwashing non-compliance Semmelweis’ proposal for handwashing was was soundly rejected by the the medical community The idea they could could be be causing infec ons o o o o o o o o o o ended doctors who refused to to to entertain the the possibility that could could be be be doing harm to to to their pa ents Nobody subscribed to to his ideas which eroded Semmelweis’ mental competence eventually landing him in in in an an an asylum where he he died of an an infec on And 171 years later handwashing compliance remains dismal while the CDC is is inves ng ng in in in in in assets to to to help very intelligent doctors and nurses comply with something we tell tell children they they need to to to do do And informed pa ents like Emily are asking how they they can get their clinicians on on board with the the the urgency and vigilance around preven ng infec on on that all of us carry - for ourselves So why hasn’t healthcare mastered the rst step of pa ent care? We’ve reached that that important ques on and and problem that that AVA is trying to answer and and solve Among the reasons why we’re s s s s s s s s s ll struggling nearly two centuries a a a er
Semmelweis failed:
1 Denial Nobody thinks they are germy It’s everyone else 2 Mundane Done properly clinicians would wash their hands dozens of mes every shi 3 Skin Irrita on to an an an an sep cs and and repeated cleaning 4 Alarm fa gue Eventually all all the signs and and beeps and and pleas become ambient hospital noise 5 We hate being told what to to do Nobody likes a a a a a a taskmaster and besides - no one thinks they’re the the problem Unfortunately germs don’t care what we think - they’re going to to to be cunning and deadly either way The solu on on to to to to stopping their transmission in in in in in 2018 is no di erent to to to what it was in in 1847 Our issues with handwashing aren’t epidemiological They’re almost purely psychological Hospitals o o o o o o en use “secret shoppers” to survey clinicians during the the course of healthcare delivery to avoid broaching the the compliance conversa on on directly They use use cameras which eventually fail because we get camera camera camera fa fa gue and stop watching which converts the the camera camera into another piece of furniture where bugs can ourish They’ll use a a a a a a a a a “bad cop” whose job is is is is to to to have that that tough conversa on on but 171 years of history show that that isn’t changing the culture If our issues are psychological then we should try to address them by using the the the the the most invested party involved in in in in the the the the procedure That would be the the the the pa pa ent AVA has developed a a a a a a a a a new program for for hospitals to to empower and depu ze pa ents to to watch for for compliance gaps based on their own hospital policies and and protocol It is is as as as primi ve as as as it it is is powerful guiding pa ents to to understand what what they should expect and and what normal looks like A A very small sampling of our Pa ent Advocacy Program (which literally begins and and ends with hand hygiene):
• Anyone who enters your room must wash their hands before proceeding • If you’re ge ge ng ng ng an an an IV ge ge ng ng ng poked a a a a a a bunch of mes is is not not normal and shouldn’t happen • If you’re ge ng an an IV that procedure is is not not supposed to be extremely painful • Anyone who leaves your room must wash their hands when they exit • You have the the the the right to to stop the the the the procedure if you feel proper asep c c c technique is not being followed CONTINUED ON ON PAGE 12
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