Transcript: Hand washing safety in the kitchen wash after picking things of the floor wash hands before handling food wash hands after you cough or sneeze Conclusion is here And one more thing... Thank you for your attention! wash hands after using the bathroom
Transcript: More than 32,000 patients/year 15 different wards 5 medical wards 5 surgical wards 2 emergency department wards 2 ICU wards 1 bone marrow transplant ward Over 520 hours Soap & Water: Wet hands thoroughly Apply soap & vigorously rub hands together for at least 15 seconds Rinse thoroughly Avoid hot water (decreases risk of dermatitis) Dry hands with paper towel Turn off water using paper towel Alcohol-Based Hand Sanitizer: Apply to palm of one hand or one "pump" Vigorously rub hands together, including fingernails for 15 seconds Allow hands to dry Purpose: Hand hygiene is the most important control measure to reduce the transmission of organisms to patients and personnel Education & Compliance: Patients should receive literature and education about hand hygiene when admitted to the hospital Education is conducted annually for all staff Alcohol hand sanitizers are widely available and visible in hospital setting Dispensers/sinks in inappropriate locations Lack of accountability Failure to stress the importance Ineffective/insufficient education Hands full of equipment/supplies Belief it is not necessary if gloves are worn Inattentiveness/distractions 1 in 20 people get hospital inquired infections Hand hygiene includes hand washing with plain soap and water, use of antiseptic hand rubs including waterless alcohol-based products, or surgical hand antiseptics Compliance rates are below 50% and as low as 41% when gloves are involved. Study in ICU Rubbing palm to palm fingers enlaced Palm over dorsum fingers interlaced Back of fingers to opposing palms fingers interlocked Rotational rubbing of thumb clasped in opposite palm Rotational rubbing backwards & forwards with clasped fingers of opposite hands Study of Handwashing Over Shifts References Included 279 patients in Canada in 3 multi-organ transplant units over an 8-month period. Electronic monitoring sensors were installed on all soap & hand sanitizer dispensers 30% washed their hands after toileting 40% washed their hands during meal time 3% washed hands when using the kitchen on unit 3% washed hands when entering the hospital 7% washed hands when leaving the hospital (AARC Times) HANDWASHING Results ORMC Hand Hygiene Protocol ORMC Protocol 5 Moments: Before touching patient After touching patient After touching surroundings After body fluid exposure risk Before clean/aseptic procedures Included 4,157 caregivers at 35 U.S. hospitals over 3 years Results: Compliance dropped an average of 8.7% from the beginning of the 12 hour shift to the end of the shift Higher work intensity led to lower hand-washing rates Longer times off throughout shifts led to increase in compliance (AARC Times) Studied staff in a 20-bed ICU at a large university hospital over 10 days and included 47,694 hand hygiene opportunities. Automated hand hygiene monitoring systems were installed and detected whether staff washed hands prior to entering the patient's room and estimated location of other staff in vicinity. Results: When staff was alone - 20.85% compliance When other staff was nearby - 27.9% compliance However, the monitoring system didn't record the dispensing systems inside the room (AACN Bold Voices) Factors that Contribute to Poor Compliance Indications: At the start of a shift Before & after patient contact When C.diff is suspected or confirmed When moving from a contaminated body site to a clean site during care Before inserting or handling invasive devices After contact with inanimate objects After removing gloves After sneezing, coughing or wiping nose Before eating After using the restroom 6 Individual Steps: Procedure Patient Study Hand Hygiene Suffers as the Shift Wears On. (2015). AARC Times. 39 (2), 65. Patients Need to Wash Up, Too. (2015). AARC Times. 39 (1), 47. Peer Pressure May Influence Hand Hygiene Compliance. (2014). AACN Bold Voices. 6 (12), 15. Tschudin-Sutter, S., Sepulci, D., Dangel, M., Schuhmacher, H., & Wildmer, A.F. (2015). Compliance with the World Health Organization Hand Hygiene Technique: A Prospective Observational Study. Infection Control & Hospital Epidemiology. 36 (4), 482-483. Orange Regional Medical Center and All Outpatient Facilities Policy/Procedure FACTS Hand hygiene is a top priority in the prevention of cross infection and healthcare associated infections HAIs result in: Increased morbidity and mortality Prolonged hospital stays Increased health care costs Antibiotic resistance World Health Organization (WHO) Hand Hygiene ORMC Protocol Indications Hand hygiene was performed in 93.2% of opportunities (2,480 out of 2,662) ICU - 100% Medical wards - 94% Surgical wards - 90% Technique Compliance with all 6 steps was 8.5% Majority adhered to 2-3 steps Workers younger than 25 years old showed higher compliance Compliance decreased with increase duration of employment (Tschudin-Sutter, S., Sepulci, D., Dangel, M., Schuhmacher, H., & Wildmer, A.F) Study at University Hospital Basel (Switzerland) Health-Care Associated Infections 62 ECG bpm
Transcript: HANDWASHING cleanse the hands of pathogens and chemicals which can cause personal harm or diseases five critical times in washing hands Substances used Soap and detergents Water temperature Solid soap Antibacterial soap Hand antiseptic Bahá'í Faith in Hinduism tevilah and netilat yadayim in Judaism. Lavabo in Christianity Wudu in Islam Misogi in Shintō. Photo based on: 'horizon' by pierreyves @ flickr pros cons avoiding respiratory infections prone to skin damage Ritual Handwashing of Many Religions helps minimize the spread of influenza diarrhea prevention a preventive measure for infant deaths at their home-birth-deliveries after using a bathroom (private or public) after changing a diaper before feeding a child before eating before preparing food or handling raw meat, fish, or poultry, or any other situation leading to potential contamination and see below especially important for people who handle food or work in the medical field, but it is also an important practice for the general public
Transcript: Importance Parents not complying with Hand Washing Policies in the NICU Collect and review data on hand washing compliance. Review infection rates. Determine what is not occurring. Determine what is occurring. Everyone has washed their hands but understanding and performing proper hand washing techniques is what is important to teach the learner. Needs Assessment Doris Ladiong RN The amount of time the learner is willing to spend to learn which is affected by motivation and desire to learn. Understanding the consequences of infection may motivate parents to be vigilant about hand washing. A systematic process for defining and addressing the needs or gaps between current conditions and desired conditions or wants. The inconsistency between the current condition and wanted condition must be measured to identify the need. The needs can be a desire to improve current performance or to correct a deficiency. Quality of Instruction Problem Ability to Understand Instructions A learning assessment is done to determine their level of understanding as well as their limitations. Carroll's Model Language assessment (use interpreter if needed), Utilization of language they understand Age can impact learning; teaching style will change depending on the audience (i.e. adult/teen). Physical/Mental disabilities- alter teaching for those with disabilities. Model of Instruction The learner will be able to independently perform proper hand washing technique. The learner will be able to state the importance of hand washing. The learner will be able to state when hand washing is necessary. Needs Assessment Aptitude- Amount of time needed to learn the task. Relationship exist between the amount of time needed to learn the task and learner's aptitude. The shorter the time needed to learn the task the greater the aptitude. Variable affecting aptitude- * Amount of prior learning * Age * Language * Emotional state * Mental/Physical disabilities Make sure the learner understands the terminology. Instead of preventing nosocomial infection use " prevent spread of germs in the hospital" Objectives Perseverance Hand Washing in The NICU Educate Parents of NICU Goals and Expectations Verbal Explanation/Demonstration Hand out Video Carroll's Model In this model, teaching is tailored to the learner's abilities and needs so learner can achieve a high level of learning. Are instructions given once ? Are instructions reinforced ? Are they reassessed ? Most effective way of preventing the transmission of germs. Immune system of infants (premature) not fully developed. Amount of time Allowed for Learning Organization and structure of the instructions. Use of senses (hearing, feeling, seeing). Sequencing of instruction. Needs Assessment Awareness of Problem If parents need further teaching; give instructions and demonstration at subsequent times until they learn the task.
Transcript: 3 gallons/minutes (.05 gallons/second) Lever (liquid)- 6 cups Dove (bar)- 2.5 cups Irish Springs (bar) 6 cups Hotel (bar) 4 cups Soft Soap 5-6 cups Generic liquid- 2 cups Indirect Water Usage - SOAP But the amount of water used says otherwise..... The Water Usage Breakdown: rinse hands under clean, running water rub hands together to form later scrub various parts of hands, fingers, and under nails rinse well dry Sing 'Happy Birthday' twice to ensure the perfect cleansing! It's as simple as Rinse Lather Repeat.. A 40 second Process.. Seems Quick and Simple... Water Saving Fixture Water Usage During Hand Washing Hand washing... 40 WITH running water 20 WITHOUT running water Sink Fixture Basis: 2.2 gallons/minute (.037 gallons/second) By: Justin, Marissa, Grace, Leah, Dan, and Nicole Hand Washing Usage Regular Fixture majority of students at MSU... wash hands for 10-30 seconds - using .5 - .15 gallons of water SAVING .5 gallons of water from their misuse females daily - 4.5 to 13.5 gallons of water washing 0-20 seconds males daily - 3 to 9 gallons washing for 10-30 seconds REGULAR: 2 gallons/1.48 gallons WATER SAVING: 1 gallon/.74 gallons Michigan State's Results: IN 40 SECONDS Saving .8 gallons/minute
Transcript: Hand Washing When should you wash your hands? Before, during, and after preparing food Before eating food Before and after caring for someone who is sick Before and after treating a cut or wound After using the toilet After changing diapers or cleaning up a child who has used the toilet After blowing your nose, coughing, or sneezing After touching an animal or animal waste After touching garbage How do you wash your hands?
Transcript: Solution #1 Problem #2 Solution #2 Problem #1 4 types of germs * Bacteria - are tiny, one-celled creatures that get nutrients from their environments in order to live. In some cases that environment is a human body. *Viruses need to be inside living cells to grow and reproduce. Most viruses can't survive very long if they're not inside a living thing like a plant, animal, or person. *Fungi are multi-celled (made of many cells), plant-like organisms. Unlike other plants, fungi cannot make their own food from soil, water, and air. Instead, fungi get their nutrition from plants, people, and animals. *Protozoa are one-cell organisms that love moisture Do It Handwashing
Transcript: Nobody knows babies like we do! Quality products . Good Customer service. Every Kid really loves this store.. BABYLOU ABOUT US About Us BabyLou was established in 2004. It has been more than a decade since we started, where we have ensured to take care of every need and want of every child and infant under one roof, true to the caption “NO BODY KNOWS BABIES LIKE WE DO”. Our benchmark is to provide 100% customer service and satisfaction and continue to deliver the same with a wide range of toys, garments and Baby Products. Play and Create We Are Best 01 02 03 Block games Building Blocks help Kids to use their brain. PLAY TO LEARN in Crusing Adventures Our Discoveries Enjoy a sunny vacation aboard a luxury yacht with the LEGO® Creator 3in1 31083 Cruising Adventures set. This ship has all the comforts you need, including a well-equipped cabin and a toilet. Sail away to a sunny bay and take the cool water scooter to the beach. Build a sandcastle, enjoy a picnic, go surfing or check out the cute sea creatures before you head back to the yacht for a spot of fishing. Escape into the mountains Disney Little Princes in Also available for your Babies..... Also... Out of The World… Our reponsibility BABYLOU…. Our Responsibility All children have the right to fun, creative and engaging play experiences. Play is essential because when children play, they learn. As a provider of play experiences, we must ensure that our behaviour and actions are responsible towards all children and towards our stakeholders, society and the environment. We are committed to continue earning the trust our stakeholders place in us, and we are always inspired by children to be the best we can be. Innovate for children We aim to inspire children through our unique playful learning experiences and to play an active role in making a global difference on product safety while being dedicated promoters of responsibility towards children.
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