21
It, Let’s Wipe It Away…..” Debra Berube MS RNC CIC Director of Infection Control & Prevention St Vincent Hospital Worcester MA APIC NE October 13, 2011

“No Butts About It, Let’s Wipe It Away…..”

  • Upload
    levana

  • View
    46

  • Download
    0

Embed Size (px)

DESCRIPTION

“No Butts About It, Let’s Wipe It Away…..”. Debra Berube MS RNC CIC Director of Infection Control & Prevention St Vincent Hospital Worcester MA. APIC NE October 13, 2011. Brief Outline. C.Diff rates, historical, current, and goals Contact Plus precautions and its implementation - PowerPoint PPT Presentation

Citation preview

Page 1: “No Butts About  It, Let’s  Wipe It Away…..”

“No Butts About It,Let’s Wipe It

Away…..”

Debra Berube MS RNC CICDirector of Infection Control &

PreventionSt Vincent Hospital

Worcester MA

APIC NE October 13,

2011

Page 2: “No Butts About  It, Let’s  Wipe It Away…..”

• C.Diff rates, historical, current, and goals• Contact Plus precautions and its implementation• Hand Hygiene program

• rates• compliance observations• non-compliance

• Team effort• What’s next

Brief Outline

Page 3: “No Butts About  It, Let’s  Wipe It Away…..”

0.002.004.006.008.00

10.0012.0014.0016.00 2008-2010

2011

SVH: C.Diff ratesPer 10,000 patient

days

Jan 11raw =

5

Feb 11raw =

3

Mar 11raw =

2

Apr 11raw =

4

May 11raw =

1

Jun 11raw =

3

Jul 11raw =

3

Aug 11raw =

2

Sept 11

raw = 1

0.002.004.006.008.00

10.0012.0014.0016.00

7.32

4.822.83

6.28

1.62

4.75 4.473.09

1.65

Page 4: “No Butts About  It, Let’s  Wipe It Away…..”

2008-20099.55 to 6.15 35%

2009-20106.15 to 6.54 1%

2010-20116.54 to 4.12 37%

2008-20119.55 to 4.12 57%

SVH: C. Diff: Rate per 10,000 pt days

2008-2011 (through September)

2008 2009 2010 2011(Jan-Sept)

0.00

2.00

4.00

6.00

8.00

10.00

12.00

9.55

6.15 6.54

4.12

Page 5: “No Butts About  It, Let’s  Wipe It Away…..”

NO FOAM ROOM  

PLEASE WASH HANDSWITH SOAP AND WATER

PRIOR TO LEAVING

• This NO FOAM sign is posted in addition to Contact Precautions sign• Alcohol foam is removed from inside of the patient room• Patient and family education• Terminal clean upon transfer or discharge

Page 6: “No Butts About  It, Let’s  Wipe It Away…..”

Infection Preventionists:

• Maintain daily list of all patients admitted that have MDRO, C.Diff. This list includes all other types of isolation as well.

• Along with staff, maintain appropriate environmental controls

• Daily rounding on all patients in isolation

• Patient education oversight of all patients with MDRO including C.Diff. Daily reminder to nursing staff of patient education needs.

• Patient education brochures: MA DPH, CDC, Krames On-Demand

• Dissemination of monthly data to all nursing areas

Environmental controls

Page 7: “No Butts About  It, Let’s  Wipe It Away…..”

Amount of emphasis on hand hygiene and rates of

HAI C. Diff seem to go hand in hand at our facility.

Hmmm.....That would mean: if hand

hygiene rates increase then HAI C. Diff would decrease.

All other HAI’s will follow....

Page 8: “No Butts About  It, Let’s  Wipe It Away…..”

Hand Hygiene Program• Education upon orientation, annual competencies, as needed• Patients, visitors encouraged to wash hands• Daily update at morning huddle:

• current rate, # observations done, days left in the month

• Movie themed posters:• Field of Germs• Staph Wars• E.G. the Extra-Germestrial• etc.

• Other posters rotated to prevent sign fatigue

Page 9: “No Butts About  It, Let’s  Wipe It Away…..”
Page 10: “No Butts About  It, Let’s  Wipe It Away…..”
Page 11: “No Butts About  It, Let’s  Wipe It Away…..”

The posters :• 20 x 26 inches• professionally printed• for staff and visitors.....

patient empowerment!

• washable• eye-catching!!• fun

Problems:

• poster / sign fatigue• rotate them unit

unit• create new ones• move locations

Page 12: “No Butts About  It, Let’s  Wipe It Away…..”

12 different posters of children and animals, 8

½ x 11 inches, laminated, washable.

Page 13: “No Butts About  It, Let’s  Wipe It Away…..”
Page 14: “No Butts About  It, Let’s  Wipe It Away…..”

Always Foam OUT

Save Lives

Clean Hands

Always Foam IN

Small 4 x 3 ½ inch magnetized signs that are attached to every

patient doorway

Problem: • They tend to “disappear”

and must be replaced frequently.

• IC practitioner carries them during daily rounds for replacing.

Page 15: “No Butts About  It, Let’s  Wipe It Away…..”

• Hand hygiene monitoring• 46 hand hygiene observers• each observer has monthly assignment to specific units• minimum of 500 observations per month (more is

always OK!!!)• real-time feedback• NO person is exempt from being observed• IP cannot observe for statistics.......are considered

“biased”• IP’s can issue “tickets” if violations are observed by IP’s• “Ticket” for attending physicians results in $100 fine

per violation, must be paid before allowed to recredential

• Weekly update sent via email to all observers and leadership team

Hand Hygiene Program(continued)

Page 16: “No Butts About  It, Let’s  Wipe It Away…..”

Thanks for being a STAR and

keeping our patients safe!♪ You were observed performing Hand

Hygiene ♪

Name: _______________________________________Date: _______________________________________Observer:_______________________________________

Infection Control Committee: Violation Documentation FormDate of Event: ________________ Location: _______________

Name of Person Observed ___________________________________

Deviation (check all that apply):

1. Was observed not disinfecting hands before / after direct patient contact ______

2. Was observed not adhering to posted precautions ______

3. Was observed eating or drinking in patient care area. ______

4. Was seen inappropriately discarding infectious waste ______

Action:

Deviation brought to person’s attention Yes No

Comment:

________________________________________________________

_________________________________________________________

Name of person completing form:_________________________

Approved by SVH Infection Control Committee July 2008

Page 17: “No Butts About  It, Let’s  Wipe It Away…..”

75

80

85

90

95

100

86.788.6

91.792.9

94.6

90.8

95.5

85.3

95.7 95.6 95.292.5 Hand

Hygiene Compliance Rate per 100 Observations

Jan 11 Feb 11 Mar 11 Apr 11 May 11 June 11 July 11 Aug 11 Sept 1175.0%

80.0%

85.0%

90.0%

95.0%

100.0%

85.6%

90.8%89.0%

94.3% 93.6%

86.8%

93.1%90.7%

95.4%

2010

2011

Page 18: “No Butts About  It, Let’s  Wipe It Away…..”

• Decrease hospital acquired C.Diff by 25% by the end of 2011. Will set new goals for 2012.• Decrease overall hospital acquired infections

• Increase hand hygiene rates to ??? 100%

Continue to engage front line staff regularly• Increase patient education regarding:

transmission, prevention, empowerment, etc.• Maintain and increase effective environmental cleaning

• Bleach wipes in ICU and other areas when appropriate• Cleaning is everyone's responsibility, not just

“housekeeping”• Maintain IP visibility on patient care units (this is NEVER ending!!)

Goals:

GO Pa

triot

s!

Page 19: “No Butts About  It, Let’s  Wipe It Away…..”

Team EffortAll staff are responsible for patient

safety

Infection prevention is patient safety

Safety trumps all!!! Take away messages:

• Wash, Wash, Wash (both hands and surfaces)• Include all clinical disciplines in the prevention of infection• Cleaning is everyone's responsibility, not just “housekeeping”• If something isn’t working, then step back and look at the big and little picture again. Use rapid cycle PDSA (plan, do, study, act)• Reach out for help!! Either on a unit, supervisor, another discipline, another facility.............include all appropriate disciplines

Page 20: “No Butts About  It, Let’s  Wipe It Away…..”

Questions?

??

Page 21: “No Butts About  It, Let’s  Wipe It Away…..”

Debra Berube MS RNC CICDirector of Infection PreventionSt. Vincent Hospital123 Summer St, Worcester MA 01608Office: [email protected]