Hand Hygiene Opportunities in Pediatric Extended Care Facilities

Buet, Amanda; Cohen, Bevin; Marine, Melissa; Scully, Fiona; Alper, Paul; Simpser, Edwin; Saiman, Lisa; Larson, Elaine

doi:10.1016/j.pedn.2012.04.010

Cited by 17 publications

(21 citation statements)

References 17 publications

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“…Specifically in children, increased acuity level and indwelling devices (e.g., urinary catheters, tracheostomies, feeding tubes) with subsequent delivery of care from multiple healthcare professionals are among the many factors associated with HAI-related morbidity and mortality (Kopel et al, 2010; Immergluck, 2007; James et al, 2007). Additionally children often remain in extended care facilities for months and sometimes years involving daily contact with other residents and caregivers (Buet et al, 2013). Yet hand hygiene in pediatric LTC facilities has been reported to range from 27.0% - 65.0%, adding to transmission risk of infectious agents (Buet et al, 2013).…”

Section: Discussionmentioning

confidence: 99%

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Assessing Nursing Care Needs of Children With Complex Medical Conditions: The Nursing-Kids Intensity of Care Survey (N-KICS)

Navarra

Schlau²,

Murray

et al. 2016

Journal of Pediatric Nursing

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Background Recent medical advances have resulted in increased survival of children with complex medical conditions (CMC), but there are no validated methods to measure their care needs. Objectives/Methods To design and test the Nursing-Kids Intensity of Care Survey (N-KICS) tool and describe intensity of nursing care for children with CMC. Results The psychometric evaluation confirmed an acceptable standard for reliability and validity and feasibility. Intensity scores were highest for nursing care related to infection control, medication administration, nutrition, diaper changes, hygiene, neurological and respiratory support, and standing program. Conclusions Development of a psychometrically sound measure of nursing intensity will help evaluate and plan nursing care for children with CMC.

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Section: Discussionmentioning

confidence: 99%

“…Additionally children often remain in extended care facilities for months and sometimes years involving daily contact with other residents and caregivers (Buet et al, 2013). Yet hand hygiene in pediatric LTC facilities has been reported to range from 27.0% - 65.0%, adding to transmission risk of infectious agents (Buet et al, 2013). …”

Section: Discussionmentioning

confidence: 99%

Assessing Nursing Care Needs of Children With Complex Medical Conditions: The Nursing-Kids Intensity of Care Survey (N-KICS)

Navarra

Schlau²,

Murray

et al. 2016

Journal of Pediatric Nursing

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“…As part of our baseline data collection, we found suboptimal hand hygiene at these study sites (Buet et al, 2013). Interventions that have been implemented in our current study include the installation of an electronic group monitoring system to measure the frequency of hand hygiene, formation of staff-managed “KICK teams,” education, posters, and continuous surveillance of infection rates.…”

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confidence: 99%

Staff Knowledge, Awareness, Perceptions, and Beliefs About Infection Prevention in Pediatric Long-term Care Facilities

Løyland

Wilmont

Hessels³

et al. 2016

Nursing Research

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Background The burden of healthcare-associated infection worldwide is considerable, and there is a need to improve surveillance and infection control practices such as hand hygiene. Objectives The aims of this study were to explore direct care providers’ knowledge about infection prevention and hand hygiene, their attitudes regarding their own and others’ hand hygiene practices, and their ideas and advice for improving infection prevention efforts. Methods This exploratory study included interviews with direct care providers in three pediatric long-term care facilities. Two trained nurse interviewers conducted semistructured interviews using an interview guide with open-ended questions. Two other nurse researchers independently transcribed the audio recordings and conducted a thematic analysis using a strategy adapted from the systematic text condensation approach. Results From 31 interviews, four major thematic categories with subthemes emerged from the analysis: (a) hand hygiene products; (b) knowledge, awareness, perceptions, and beliefs; (c) barriers to infection prevention practices; and (d) suggested improvements. There was confusion regarding hand hygiene recommendations, use of soap or sanitizer, and isolation precaution policies. There was a robust “us” and “them” mentality between professionals. Discussion One essential driver of staff behavior change is having expectations that are meaningful to staff, and many staff members stated that they wanted more in-person staff meetings with education and hands-on, practical advice. Workflow patterns and/or the physical environment need to be carefully evaluated to identify systems and methods to minimize cross-contamination. Further studies need to evaluate if personal sized containers of hand sanitizer (e.g., for the pocket, attached to a belt or lanyard) would facilitate improvement of hand hygiene in these facilities.

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“…Buet et al (2013) used the WHO 5 Moments to observe HH in four pediatric extended care facilities and found that overall HH compliance was sub-optimal (43%, 370/865). In the same year, the Society for Healthcare Epidemiology of America published the first infection prevention and control guideline for pediatric residential facilities (Guzman-Cottrill et al, 2013).…”

Section: Discussionmentioning

confidence: 99%

“…In our previous work, for example, we found sub-optimal adherence to recommended hand hygiene (HH) guidelines (43%, 370/865) in several pediatric facilities in the New York metropolitan area (Buet et al, 2013). Based on findings from this previous study as well as the work of Son et al (2011), our aim was to engage staff in the development of workflow diagrams, which highlighted HH practices during commonly performed patient-care activities.…”

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confidence: 99%

Using Workflow Diagrams to Address Hand Hygiene in Pediatric Long-Term Care Facilities

Carter

Cohen

Murray

et al. 2015

Journal of Pediatric Nursing

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Hand hygiene (HH) in pediatric long-term care settings has been found to be sub-optimal. Multidisciplinary teams at three pediatric long-term care facilities developed step-by-step workflow diagrams of commonly performed tasks highlighting HH opportunities. Diagrams were validated through observation of tasks and concurrent diagram assessment. Facility teams developed six workflow diagrams that underwent 22 validation observations. Four main themes emerged: 1) diagram specificity, 2) wording and layout, 3) timing of HH indications, and 4) environmental hygiene. The development of workflow diagrams is an opportunity to identify and address the complexity of HH in pediatric long-term care facilities.

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Hand Hygiene Opportunities in Pediatric Extended Care Facilities

Cited by 17 publications

References 17 publications

Assessing Nursing Care Needs of Children With Complex Medical Conditions: The Nursing-Kids Intensity of Care Survey (N-KICS)

Assessing Nursing Care Needs of Children With Complex Medical Conditions: The Nursing-Kids Intensity of Care Survey (N-KICS)

Staff Knowledge, Awareness, Perceptions, and Beliefs About Infection Prevention in Pediatric Long-term Care Facilities

Using Workflow Diagrams to Address Hand Hygiene in Pediatric Long-Term Care Facilities

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