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

Carter, Eileen J.; Cohen, Bevin; Murray, Meghan; Saiman, Lisa; Larson, Elaine

doi:10.1016/j.pedn.2014.12.002

Cited by 6 publications

(6 citation statements)

References 5 publications

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“…Conducting work flow assessments-KICK teams identified work flow patterns for common, repetitive patient care tasks (e.g., diaper change, tracheostomy care) and developed and distributed visual diagrams to identify HH opportunities. 26,27 Component 4: Training staff in the WHO "5 Moments for HH"-The KICK teams led staff training efforts for the "5 Moments for HH" 25 using materials available in WHO toolkits. Staff also had hands-on experience performing HH observations using a standardized instrument (http://www.who.int/gpsc/5may/tools/en/).…”

Section: Componentmentioning

confidence: 99%

Behavioral Interventions to Reduce Infections in Pediatric Long-term Care Facilities: The Keep It Clean for Kids Trial

Larson

Murray

Cohen

et al. 2017

Behavioral Medicine

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Children in pediatric long-term care facilities (pLTCF) represent a highly vulnerable population and infectious outbreaks occur frequently, resulting in significant morbidity, mortality, and resource use. The purpose of this quasi-experimental trial using time series analysis was to assess the impact of a 4-year theoretically based behavioral intervention on infection prevention practices and clinical outcomes in three pLTCF (288 beds) in New York metropolitan area including 720 residents, ages 1 day to 26 years with mean lengths of stay: 7.9-33.6 months. The 5-pronged behavioral intervention included explicit leadership commitment, active staff participation, work flow assessments, training staff in the World Health Organization "'five moments of hand hygiene (HH)," and electronic monitoring and feedback of HH frequency. Major outcomes were HH frequency, rates of infections, number of hospitalizations associated with infections, and outbreaks. Mean infection rates/1000 patient days ranged from 4.1-10.4 pre-intervention and 2.9-10.0 post-intervention. Mean hospitalizations/1000 patient days ranged from 2.3-9.7 before and 6.4-9.8 after intervention. Number of outbreaks/1000 patient days per study site ranged from 9-24 pre- and 9-18 post-intervention (total = 95); number of cases/outbreak ranged from 97-324 (total cases pre-intervention = 591 and post-intervention = 401). Post-intervention, statistically significant increases in HH trends occurred in one of three sites, reductions in infections in two sites, fewer hospitalizations in all sites, and significant but varied changes in the numbers of outbreaks and cases/outbreak. Modest but inconsistent improvements occurred in clinically relevant outcomes. Sustainable improvements in infection prevention in pLTCF will require culture change; increased staff involvement; explicit administrative support; and meaningful, timely behavioral feedback.

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Section: Componentmentioning

confidence: 99%

Behavioral Interventions to Reduce Infections in Pediatric Long-term Care Facilities: The Keep It Clean for Kids Trial

Larson

Murray

Cohen

et al. 2017

Behavioral Medicine

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“…Family members wearing access cards were frequently observed because, after installing the sliding doors, some facilities such as a room with cupboards and a laundry room were shared by the two wards. This frequent need to leave the ward should be considered along with developing remedial measures to minimize the inflow of external sources of infection (Carter, Cohen, Murray, Saiman, & Larson, 2015). Regarding type of visit, the HHC rate of groups was significantly higher than that of individuals, which was regarded as resulting from the influence of social pressure (Hobbs, Robinson, Neyens, & Steed, 2016).…”

Section: Discussionmentioning

confidence: 99%

Effects of Audio-Visual Stimulation on Hand Hygiene Compliance among Family and Non-Family Visitors of Pediatric Wards: A Quasi-Experimental Pre-post Intervention Study

Kim

Lee

2019

Journal of Pediatric Nursing

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a b s t r a c tPurpose: This study aimed to identify the differences in interventional effects on hand hygiene compliance (HHC) among families and visitors in pediatric wards. Design & methods: A total of 2787 family and non-family visitors entering through the glass sliding door of 6 pediatric wards at a university children's hospital were observed for 4 h, respectively, before and after interventions between April 27 and May 20, 2018. In the first intervention, a visual stimulus emphasized the location of the hand sanitizer. In the second intervention, an additional auditory stimulus transmitted a cue through a motion sensor speaker. Results: During the preliminary observation, the HHC rates of family and non-family visitors were 0.0% and 1.5%, respectively; after the visual stimulus, they were 0.6% and 5.4%, and after the audio-visual stimulus, 1.8% and 8.2%. There was a significant increase in the overall HHC with the visual (OR, 5.22; 95% CI, 1.76-20.90) and audio-visual (OR, 8.67; 95% CI, 3.08-33.70) stimuli (Fisher's exact test, p b .05). Conclusions: The HHC of family and non-family visitors entering pediatric wards was very low and the audiovisual stimulus was found to be more effective than was the visual stimulus alone. Practice implications: To reduce healthcare-associated infection, pediatric wards must actively implement effective interventions. Using audio-visual stimulation to increase HHC among visitors will provide advantages. Follow-up research should examine the current state of HHC among visitors in various locations and conditions.

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“…23 Estudo australiano concluiu que enfatizar atitudes desfavoráveis entre enfermeiros, não contribuem para o aprendizado, portanto, devem ser centradas em estratégias de educação em saúde aliadas as normas e percepções de controle de risco para ampliar a adesão dos profissionais para adequada HM. 24 Outra investigação realizada em unidade pediátri-ca autores utilizaram diagramas de fluxo de trabalho e avaliaram como importantes, com o intuito de envolver a equipe na identificação e abordagem da complexidade da HM no ambiente de cuidados pediátricos, em longo prazo. 25 O estudo possui algumas limitações, e considera-se que pelo fato de avaliar o conhecimento acerca da HM por meio do auto relato, pode superestimar as taxas de adesão em relação à coleta por observação.…”

Section: Discussionunclassified

Conhecimento Da Prática De Higienização Das Mãos Na Perspectiva De Profissionais De Enfermagem

Souza¹,

Alievi²,

Piasentin

et al. 2018

Rev Epidemiol Control Infect

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Exceto onde especificado diferentemente, a matéria publicada neste periódico é licenciada sob forma de uma licença Creative Commons -Atribuição 4. //dx.doi.org/10.17058/reci.v8i2.11199 Páginas 01 de 08 não para fins de citação Justificativa e Objetivos: Diante da importância do conhecimento e da prática da higiene das mãos na perspectiva da enfermagem, objetivou-se analisar o conhecimento dos profissionais de enfermagem no âmbito hospitalar quanto à higienização das mãos em unidades abertas e fechadas. Métodos: Estudo descritivo, do tipo transversal, desenvolvido em um hospital da região Noroeste do estado do Rio Grande do Sul, com 159 profissionais de enfermagem. Os dados foram coletados com a aplicação do questionário "Teste de Conhecimento a Respeito da Higienização das Mãos para profissionais da saúde" validado pela Organização Mundial da Saúde, e analisados por meio de estatística descritiva, teste de hipótese do Qui-quadrado de Pearson e Exato de Fischer, considerando estatisticamente significativo p<0,05. Resultados: Prevaleceram profissionais de nível técnico (89,3%) e sexo feminino (94,3%). Profissionais reconheceram rota de transmissão cruzada de micro-organismo (96,9%). Evidenciou-se diferença estatisticamente significativa entre unidades quanto ao tempo mínimo para preparação alcoólica nas ações antes do contato com o paciente (p=0,018), ao chegar na unidade após o almoço (p=0,014), antes da aplicação de injeção (p=0,077), antes de esvaziar o urinol (p=0,020) e ao se afastar do paciente (p=0,002). Quanto as ações de ambas as unidades para evitar contaminação, apresentou diferença estatística antes de realizar procedimento asséptico (p=0,013). Conclusão: Demonstrou-se que a equipe de enfermagem possuía conhecimento sobre a temática, mas faz-se necessário que sejam produzidas tecnologias que permitam ao profissional de saúde repensar suas práticas desde seu ingresso na instituição. RESUMO ARTIGO ORIGINALAnálise do conhecimento dos profissionais de enfermagem em relação à higienização das mãos Analysis of the knowledge of nursing professionals in relation to hygienization of hands Análisis del conocimiento de profesionales de enfermería en relación con la higienización de las manos

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

Cited by 6 publications

References 5 publications

Behavioral Interventions to Reduce Infections in Pediatric Long-term Care Facilities: The Keep It Clean for Kids Trial

Behavioral Interventions to Reduce Infections in Pediatric Long-term Care Facilities: The Keep It Clean for Kids Trial

Effects of Audio-Visual Stimulation on Hand Hygiene Compliance among Family and Non-Family Visitors of Pediatric Wards: A Quasi-Experimental Pre-post Intervention Study

Conhecimento Da Prática De Higienização Das Mãos Na Perspectiva De Profissionais De Enfermagem

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