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Talk
to the
Hand
Straightforward dialogue
about hand hygiene compliance.
MMI McGuckin Methods International - hhreports.com - Vol. 2 No. 2
For a printable PDF version
of this newsletter,
click here to
download. (400 KB)
Contents:
1. JC's CMHH
2. WHO Global Challenge
3. New Patient Empowerment Brochure: "One Patient, One
HCW, One Question"
4. Patient Empowerment and Hand Hygiene Measurement Plan
Part I
5. Patient Involvement and Patient Safety
6. Partnership Feature: Ecolab
"They
expect so much, and we have so little resources and
time!"
Stevenson, New
Yorker
HOW
TRUE! (No offense, but from personal experience, I
often felt like the gorilla when trying to get the
message across to administrators, CDC, JC, IDI, State
Reporting, etc!)
1. Joint Commission - Consensus Measurement in Hand
Hygiene (CMHH)
In 2006, I brought to your attention the JC's CMHH
project, and encouraged many of you to complete the
survey. The goal of this project is to develop an
educational monograph that will articulate promising
methods for measuring hand hygiene that have met three
basic attributes.
1. The method is clearly described with detailed collection and reporting
instructions and definitions.
2. The method has
been used in practice and shown to be feasible.
3. The accuracy and
reliability of the method have been evaluated.
RESULTS: Over 200 methods were submitted
representing 16 countries. Of the 200, a little over
100 met the criteria and were sent to the panel for
review and scoring.
Approximately 37 promising methods were identified and
the submitters notified in July 2007.
Our product measurement method was selected, we received
the following letter, and have submitted the additional
information. We will be notified in Nov. /Dec. if our
method will be included with the monograph.
Dear Dr. McGuckin,
We appreciate your completion of The Joint
Commission's CMHH project's survey and sending us your signed
submitter's agreement, the copy of your measurement tool, and a copy
of the data as you display it. The Expert Advisory Panel for the
CMHH project has reviewed your submission and requests some
additional information from you. Please see the attached form for
the additional information the panel has requested and return the
form with your information to me by e-mail, mail or fax by July 27,
2007. The panel will reevaluate your submission with the additional
information you provide. Please contact me at (630) 792-5616 or
lkusek@jointcommission.org
with any questions.
Thank you in advance for your
continued interest in our project and for sending us the additional
information requested.
Sincerely,
Linda Kusek, RN, BSN, MPH
Associate Project Director
Division of Quality Measurement and
Research
NOTE: Please keep in mind the following
information provided by the JC. No endorsements are
required to use any of the methods and procedures in the
monograph. It is a resource for the ICP and his/her
team.
2. WHO Global Challenge
During the past six months, I have been collaborating
with Julie Storr, Project Manger for WHO Global
Challenge and Dr. Pittet on patient empowerment as it
relates to hand hygiene. The goal is to develop a model
for patient empowerment. In order to achieve this goal,
we conducted a survey to determine attitudes and
practices in various countries on the issue of patient's
being able to ask HCWs about hand hygiene. We are now
in Phase II of the survey, but our findings for Phase I
clearly showed that HCWs must be the driving force
behind patient empowerment.
NPSF 13 addresses this point and clearly notes that the
empowerment of patients must be active and encouraged.
In 2006, we reported our findings (McGuckin, et. al.
_Consumer Attitudes About Health Care-Acquired
Infections and Hand Hygiene, Amer J Med Qual
2006;21:342-346) that 80% of consumers said they would
ask their HCW to wash/sanitize their hands if their HCW
asked them.
Our preliminary results from Phase I of the WHO Global
survey had similar results. The following graph will
show you how compliance to asking HCWs changes when the
HCW encourages the patient. Note: This should be
excellent evidence for colleagues out there that are
hesitant about empowering patients.
% axis
RED: If your doctor, nurse or other person providing
healthcare to you, DID NOT ASK or invite you to remind
them to wash/sanitize their hands before examining you,
would you feel comfortable asking them to wash/sanitize
their hands?
BLUE: If your doctor, nurse or
other person providing healthcare to you ASKED or
invited you to remind them to wash/sanitize their hands
before examining you, would you feel able to do this?
GREEN: If you saw your doctor or
nurse taking care of the patient next to you and then
coming to you without washing or sanitizing their hands,
would you ask them to do so?
3. New Patient Empowerment Brochure
 In
1997, when I developed and authored Partners In Your
Care, it was a first attempt to get patients involved.
However, over the last few years as a result of my
consumer survey and the WHO challenge, I realized that
the content of Partners In Your Care no longer addressed
the needs or components of patient empowerment and NPSG
13. It was a good starting point, but it is now time to
move to the next phase of empowerment. Therefore, with
the help of colleagues and consumers, we have developed
and authored an empowerment brochure that bridges the
patient and HCW as:
Partners
in Care: All for
One©
One
Patient
One
HCW
One
Question:
Did you Wash/Sanitize your Hands?
To see a sample brochure, click on the picture at right
(PDF document) - - >
4. Patient Empowerment and Hand Hygiene Measurement
Plan Part I
Patient Empowerment – The
Evidence
This will be a two part review of what I consider the
two essential components of a hand hygiene compliance
program: Patient Empowerment and Hand Hygiene
Measurement.
 29%
Patients believed they should not be involved in hand
hygiene.
71% Patients believed they should
be involved!
Source: National Patient
Safety Agency
We know patients want to be
involved so what is the evidence that involving patients
can increase hand hygiene compliance?
Between 1997-2007, we published five peer review
articles, using patient empowerment as the intervention
in various health care settings. The table below
summarizes our results for each study. In addition to
the peer review articles, we have several thousand data
points from representing hundred hospitals in US and
Canada that are using patient empowerment as a major
component of their compliance program. Data from these
sites show that hand hygiene compliance can increase and
be sustained when patients are part of the intervention.
Does Empowerment Work for Hand Hygiene Compliance –
Evidence
Acute Care
McGuckin M, et al, Patient
Education Model for Increasing Handwashing Compliance.
Am J Infect Control, Vol 27(4);309-314, 1999
34% increase HH – 6 weeks
Acute Care
McGuckin M, et al,
Evaluation of Patient Empowering Hand Hygiene Programme
in UK The Journal of Hospital Infection 48:222-227 2001
50% increase HH – 6 weeks
Rehab
McGuckin M, et al,
Evaluation of a Patient Education Model for Increasing
Hand Hygiene Compliance in an In-Patient Rehabilitation
Unit.
Am J Infect Control, 32:235-8,2004
56% increase - 6 weeks
LTC
McGuckin M, et al,
Validation of a Comprehensive Infection Control Program
in LTC The Director, Vol 12;1:14-17, 2004
90 less infections in 6 months
ICU
McGuckin M, et al. The
Effect of Random Voice Hand Hygiene Messages Delivered
By Medical, Nursing and Infection Control Staff On Hand
Hygiene Compliance in Intensive Care. Am J Infect
Control, Vol 34;(10):673-675,2006
100% increase in sanitizer
usage
5. Patient Involvement and WHO Patient Safety Global
Challenge (More Evidence)
As I mentioned earlier, my collaboration with the WHO
has some very positive rewards, one of which is an on
going literature update on patient empowerment. I would
like to share this recent update with our readers as I
believe it gives additional support to patient
empowerment or involvement. The following is a link to a
PDF on our website that will provide you with a patient
safety literature update:
www.hhreports.com/downloads/PSLUSeptemberstandard.pdf
This review is for (Sept. /Oct. 2007) and when you open
this link you will see the search parameters.
Remember, the first step
for empowerment:
Support!
“If there are no
more questions, we’ll have our cookies now.”
6. Partnerships
The goal and mission of MMI - McGuckin Methods
International is to standardize the method, measurement,
and benchmarking of hand hygiene compliance.
We see industry, health care systems and state hospital
associations as excellent partners to help us reach
ICP's across the U.S.
Several partners have taken this opportunity to help us
reach this goal and we will be recognizing different
partners in our newsletter.
 Ecolab
is our first partner and an excellent model for other
companies that have developed educational programs. As
you know, Ecolab has the program It's Okay to Ask, which
provides the ICP with a variety of educational tools for
both the HCW and patient and the message of patient
empowerment. However, they realized with NPSGs 7A AND
13 that there was a need to provide measurement and
benchmarking. After evaluating several options, they
recognized the value in partnering with an established,
evidence based methodology. We are delighted to have
them as a partner and thank them for helping us get the
message to ICPs. If you are interested in receiving
information about their program It’s Okay to Ask and
enrollment in our measurement program, contact
john.bucholze@ecolab.com
= = = = = = = = = = = =
Talk to the Hand is produced by Dr. Maryanne McGuckin of
MMI - McGuckin Methods International as a newsletter for
members and qualified associates of our Hand Hygiene
Reports. More information can be found at
www.hhreports.com. Contact us at data@hhreports.com.
Don’t forget to wash your hands!
© 2007 MMI.
Your comments are
welcome!
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