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Hand hygiene – Where the mind rules
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journal of patient safety & infection control 3 ( 2 0 1 5 ) 40–49
needs, and 76% felt confident to safely don and remove their PPE after training compared to 7% prior to the session. Conclusions: EVD PPE sequencing requires more extensive training than routine PPE training. Designated time away from the unit within a simulation lab appears to enhance the confidence of the trainee. Future considerations should include a comparison of intensive lab training versus the usual environment; assessment of the ability to apply these skills in real clinical situations after training, and an evaluation of the frequency at which training needs to be repeated in order to maintain competence. Conflicts of interest: The authors have none to declare. http://dx.doi.org/10.1016/j.jpsic.2015.10.068
O-017 Hand hygiene – Where the mind rules L. Mendiratta 1,∗ , R. Sardana 1 , E. Soni 2 , J.M. Dua 3 , Arpita 4 , V. Sharma 5 1
Department of Microbiology, India Clinical Psychologist, India 3 Department of Internal Medicine, India 4 Department of Quality, India 5 Infection Control Nurse, India 2
Introduction: Hand-hygiene forms an integral component of an infection prevention and control program, apart from being one of the International Patient Safety Goals. Method: Although, our average hand-hygiene compliance was depicting occasional peaks, what we were aiming was for more sustained results. It was this look-out that prompted us to have repeated one-to-one sessions with the non-compliant staff, in which we realized that the most common reason for defaulting was a casual attitude with an overwhelming belief of better things to do. This goaded us to delve deeper into the cause of such behavior and to actually strike at behavioral strategies rather than theoretically forcing them to do it. With this in mind, a clinical psychologist was included into our multi-disciplinary Infection Control Committee and the project was conceptualized on basis of the human behavioral approach-that is, to become aware of the need to change, contemplate and prepare for change, act and maintain that change. This interactive behavioral toolkit for hand-hygiene was based on multiple behavior change theories and primarily addresses individual factors, such as beliefs, knowledge, attitudes of the various staff. This game plan was built upon such tools that it impinges the core noncompliant mindset by focusing upon motivational aspects like one-to-one personalized counseling, request rounds, interICU trophy, catchy individualized colorful visual reminders and intercom addresses repeatedly reminding the staff about hand-hygiene such that it becomes integrated as a compulsive behavior. Result: The compliance increased remarkably by an average of 60%, 80%, 76% and 70% by the doctors, nursing, house-keeping, paramedical staff respectively.
Conclusions Our increasing hand-hygiene compliance has encouraged us towards incorporation of such behavioral strategies as a mandatory component of our infection control program. Conflicts of interest: The authors have none to declare. http://dx.doi.org/10.1016/j.jpsic.2015.10.069
O-18 Ebola outbreak arrangements in Germany Birgit Ross ∗ , Walter Popp University Hospital Essen, Department of Kidney Diseases, Transplant Unit, Germany The West African Ebola outbreak causes great concern worldwide, in hospital employees as well as in the general population. We present the handling of potentially affected patients in Germany and some specific German problems. Germany has seven high level isolation wards available with specially trained staff for the treatment of highly infective diseases. These wards are fully equipped and separated from the publicly accessible hospital area. Sewage and waste are collected separately for specific treatments; waste has to be sterilized prior to the transport to incineration. High level isolation wards in Germany provide about 50 beds. Actual experience shows that the treatment of one confirmed Ebola case requires about 30 health care workers per day and around 100 single use protective suits. Due to the high number of staff needed, we reckon that in a real world scenario only 10 beds are available for critically ill patients. To this day, 3 WHO employees, who were infected in West Africa, were flown to Germany and treated in one of the aforementioned units. One patient died, two patients survived after several weeks in hospital with extended therapy. Suspected patients (as travelers from the affected countries or health care workers returning from West Africa) usually attend general hospitals (without high level isolation wards), which might cause dangerous situations for health care workers and other patients. To minimize the risk, health-care workers were trained in the use of protective gear in order to interview and examine suspected cases with least risk for infection. Suspected Ebola patients must be treated in local hospitals–even if they are critically ill - with a maximum of staff protection until the result of Ebola PCR is available. Transportation to a special unit is only possible for confirmed Ebola patients. Most German hospitals without the units described above are preparing for attending Ebola suspects as well as isolation on normal wards. We describe such precautionary arrangements for suspected Ebola cases in an University Hospital that has no special isolation unit. We comment on the cooperation with local emergency services and local health authorities and give details of first cases of Ebola-suspects in Germany. http://dx.doi.org/10.1016/j.jpsic.2015.10.070
journal of patient safety & infection control 3 ( 2 0 1 5 ) 40–49
needs, and 76% felt confident to safely don and remove their PPE after training compared to 7% prior to the session. Conclusions: EVD PPE sequencing requires more extensive training than routine PPE training. Designated time away from the unit within a simulation lab appears to enhance the confidence of the trainee. Future considerations should include a comparison of intensive lab training versus the usual environment; assessment of the ability to apply these skills in real clinical situations after training, and an evaluation of the frequency at which training needs to be repeated in order to maintain competence. Conflicts of interest: The authors have none to declare. http://dx.doi.org/10.1016/j.jpsic.2015.10.068
O-017 Hand hygiene – Where the mind rules L. Mendiratta 1,∗ , R. Sardana 1 , E. Soni 2 , J.M. Dua 3 , Arpita 4 , V. Sharma 5 1
Department of Microbiology, India Clinical Psychologist, India 3 Department of Internal Medicine, India 4 Department of Quality, India 5 Infection Control Nurse, India 2
Introduction: Hand-hygiene forms an integral component of an infection prevention and control program, apart from being one of the International Patient Safety Goals. Method: Although, our average hand-hygiene compliance was depicting occasional peaks, what we were aiming was for more sustained results. It was this look-out that prompted us to have repeated one-to-one sessions with the non-compliant staff, in which we realized that the most common reason for defaulting was a casual attitude with an overwhelming belief of better things to do. This goaded us to delve deeper into the cause of such behavior and to actually strike at behavioral strategies rather than theoretically forcing them to do it. With this in mind, a clinical psychologist was included into our multi-disciplinary Infection Control Committee and the project was conceptualized on basis of the human behavioral approach-that is, to become aware of the need to change, contemplate and prepare for change, act and maintain that change. This interactive behavioral toolkit for hand-hygiene was based on multiple behavior change theories and primarily addresses individual factors, such as beliefs, knowledge, attitudes of the various staff. This game plan was built upon such tools that it impinges the core noncompliant mindset by focusing upon motivational aspects like one-to-one personalized counseling, request rounds, interICU trophy, catchy individualized colorful visual reminders and intercom addresses repeatedly reminding the staff about hand-hygiene such that it becomes integrated as a compulsive behavior. Result: The compliance increased remarkably by an average of 60%, 80%, 76% and 70% by the doctors, nursing, house-keeping, paramedical staff respectively.
Conclusions Our increasing hand-hygiene compliance has encouraged us towards incorporation of such behavioral strategies as a mandatory component of our infection control program. Conflicts of interest: The authors have none to declare. http://dx.doi.org/10.1016/j.jpsic.2015.10.069
O-18 Ebola outbreak arrangements in Germany Birgit Ross ∗ , Walter Popp University Hospital Essen, Department of Kidney Diseases, Transplant Unit, Germany The West African Ebola outbreak causes great concern worldwide, in hospital employees as well as in the general population. We present the handling of potentially affected patients in Germany and some specific German problems. Germany has seven high level isolation wards available with specially trained staff for the treatment of highly infective diseases. These wards are fully equipped and separated from the publicly accessible hospital area. Sewage and waste are collected separately for specific treatments; waste has to be sterilized prior to the transport to incineration. High level isolation wards in Germany provide about 50 beds. Actual experience shows that the treatment of one confirmed Ebola case requires about 30 health care workers per day and around 100 single use protective suits. Due to the high number of staff needed, we reckon that in a real world scenario only 10 beds are available for critically ill patients. To this day, 3 WHO employees, who were infected in West Africa, were flown to Germany and treated in one of the aforementioned units. One patient died, two patients survived after several weeks in hospital with extended therapy. Suspected patients (as travelers from the affected countries or health care workers returning from West Africa) usually attend general hospitals (without high level isolation wards), which might cause dangerous situations for health care workers and other patients. To minimize the risk, health-care workers were trained in the use of protective gear in order to interview and examine suspected cases with least risk for infection. Suspected Ebola patients must be treated in local hospitals–even if they are critically ill - with a maximum of staff protection until the result of Ebola PCR is available. Transportation to a special unit is only possible for confirmed Ebola patients. Most German hospitals without the units described above are preparing for attending Ebola suspects as well as isolation on normal wards. We describe such precautionary arrangements for suspected Ebola cases in an University Hospital that has no special isolation unit. We comment on the cooperation with local emergency services and local health authorities and give details of first cases of Ebola-suspects in Germany. http://dx.doi.org/10.1016/j.jpsic.2015.10.070