Issue link: https://beckershealthcare.uberflip.com/i/774606
17 INFECTION CONTROL & PATIENT SAFETY • Direct observation: is method involves monitoring the actu- al hand hygiene actions of staff. It can be done manually — with an actual person doing the monitoring — or it can be done with the assistance of technology such as smartphone apps. e smart- phone apps can improve the likelihood of making covert obser- vations and reduce the instances of Hawthorne effect, which is a social occurrence in which individuals alter or improve their be- havior in response to their awareness of being observed. • Measuring product use: is is an indirect way of conducting ob- servations by quantifying the amount of soap and sanitizer used. Mathematical models can be used to determine the amount of available hand hygiene opportunities versus how oen staff ac- tually took advantage of these opportunities. • Electronic monitoring: Several different types of sensors are now available to measure hand-washing compliance. While they can be expensive, a major benefit of electronic monitoring is it can provide administrators with real-time feedback on compliance prior to a healthcare worker's interaction with patients. Compliance with environmental hygiene can be measured by direct observation, fluorescent markers, ATP or environmental culture. ere are advantages and disadvantages for each of these measures, but according to the CDC Toolkit: Options to Evaluate Environmental Hygiene, the goal is to optimize high touch surface cleaning using an objective monitoring and feedback method. 4. Create. Another crucial aspect of maximizing compliance is a culture of support in which providers feel the organization advo- cates for them in their endeavors and is not eager to punish them, according to Ms. Homan. It's important to encourage providers to be active participants in a facility's culture of compliance, which requires honest feedback. Staff are less likely to provide admin- istrators with candid information if they believe they work in a punitive environment. "Punishing really doesn't work," said Ms. Homan. "Whenever there is a near miss or an accident, [everyone must] learn from the mistake. Don't blame or punish people, but use it as a learning opportunity to change the process, to change the workflow. is [is] going to create a culture of support that's going to make it easier for people to want to work to improve the process." n National Patient Safety Efforts Save $28B, More Than 100k Lives Since 2010 By Brian Zimmerman F rom 2010 through 2015, national efforts to reduce hospital-acquired conditions saved the lives of approx- imately 125,000 patients and reduced overall healthcare costs by $28 billion, according to a report released by HHS in December. Researchers at the Agency for Healthcare Research and Quality compiled and ana- lyzed the data for the study. In total, they found hospital patients experienced more than 3 million fewer hospital-acquired conditions from 2010 through 2015. The new data builds on previously achieved improvements. From 2010 through 2014, 87,000 fewer patients died from a hospi- tal-acquired condition and $20 billion in healthcare costs were saved. "The Affordable Care Act gave us tools to build a better healthcare system that pro- tects patients, improves quality and makes the most of our healthcare dollars, and those tools are generating results," said HHS Sec- retary Sylvia Burwell. n New SSI Guidance Emphasizes Patients' Role in Infection Prevention By Heather Punke T he American College of Surgeons and the Surgical Infection Soci- ety issued new guidelines to prevent, detect and manage surgical site infections that focus in part on the role patients themselves play in preventing infections. Expert panels from both organizations, as well as outside experts, re- viewed available research and clinical practice experience and came to a consensus for best practices to prevent and treat SSIs before, during and after surgery. "An important message coming out of these guidelines is that patients have a major role in their own outcomes," said Therese Duane, MD, vice- chair of quality and safety of the department of surgery and medical di- rector of acute care surgical research at Texas Health Care in Fort Worth. "That message cannot be underscored enough. Smoking cessation, blood glucose control for diabetic patients and weight loss are some of the things patients can do to prevent SSIs." For instance, one of the new recommendations set target blood glucose levels for all patients, not just those with diabetes, at 110-150 mg/dL be- cause excessively low blood sugar levels increase the risk of complications. Another recommendation encourages surgeons to talk to patients about stopping smoking four to six weeks prior to their surgery, as smokers have the highest risk of SSIs. Clinicians should also educate patients about what wound care is neces- sary after discharge, according to the new recommendations. "These days, you can do all the right things preoperatively and in the hospital, but if clinicians do not give patients sufficient guidance about wound care and follow up once they leave the hospital, patients can set themselves up for infections down the line," Dr. Duane said. n