Making it stick: when asking, telling and begging just isn’t enough
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The document discusses the importance of hand hygiene in healthcare settings, highlighting the results of quizzes taken by healthcare providers and patients regarding their hand hygiene practices. It emphasizes the need for continuous improvement and accountability in hand hygiene compliance, calling for behavioral change interventions and better communication between healthcare workers and patients. Presentations focus on sharing experiences, collaboration, and research to enhance understanding and implementation of effective hand hygiene practices.
Making it stick: when asking, telling and begging just isn’t enough
- 1. Making it stick: when asking, telling and begging just isn’t enough May 4, 2017
- 2. Welcome! Bienvenue! Jason Thompson Gina Peck Communications Officer - Moderator Project Coordinator – Technical Host
- 3. Thank you! Our partners Our sponsor
- 4. STOP! Clean Your Hands Day Ask Yourself… • Making a change to your behaviour can be as simple as asking yourself a question. • Small, incremental changes can lead to big things. • Not only can you improve your own practices, you’re setting a great, easy to follow example for everyone around you!
- 5. How clean are your hands? A quiz for patients and providers • Provider Quiz taken 1,046 times so far • Roughly 65 per cent of providers indicated they were cleaning hands at the 4 Moments of Hand Hygiene • Patient quiz taken 781 times so far • Only 47 per cent of patients say they speak up if their healthcare provider has not cleaned their hands
- 6. Lights! Camera! Action! STOP! Clean Your Hands Day Video Competition • 18 videos submitted • Can be viewed on CPSI’s YouTube channel • 13,106 minutes watched • 10,062 total views • And the winner’s are . . .
- 7. Before we get started • Enter your questions into the chat box • This webinar is being recorded • The slide presentations will also be available online • Stick around after the webinar to take our poll
- 8. Today’s Presenters Jignesh Padia Dr. Kim Corace Cecilia Bloxom
- 10. Patient Experiences Surgical Site Infections
- 11. Hi! My name is Jignesh Padia. What brings me to this session is my 5 year old son and some of the very positive experiences we had during his spinal cord detethering surgery. Before surgery, we were very concerned about the infection. Especially because we learned that a spinal cord infection could easily result in serious condition affecting our child’s development and future. We are very thankful to entire Neurosurgery Team and all the staff at Stollery’s for providing a positive outcome for my son’s surgery. Background
- 12. Summary of our surgical experience What went well….. We were provided antimicrobial soap for preoperative bathing at home. We actively noticed rigorous hand hygiene by Neurosurgeons. During post surgical follow-ups Neurosurgeon always sanitized their hands before touching or examining the wound. Sanitizing hands in front of us as a parent gave us more confidence in the providers taking care of our son. Potential opportunities….. Instruction on how many times and how to use soap were verbal. A written instruction (one pager) could ensure that parents are able to follow instructions to the point for better outcome. We had experienced that Nursing staff on the ward were less compliant and would even touch the wound without sanitizing hands after entering in the room. Ward floor was only mopped once everyday and by the end of shift you could visually see dirt on the floor. There was an opportunity for things such as catheter lines and other probes to touch the floor and get contaminated.
- 13. Below pictures show what are some of the risks for patients and especially young kids who get infected post surgery. Many factors could cause such infections and each step to prevent it becomes important. In the below picture you are seeing a baby who got infected post surgery. The parents of this baby are Facebook friend of ours. They told us that they never got any soap or instruction to clean their baby before surgery. Risks….
- 14. They are worried about infections and want to do their part Provide information about what they can do to prevent it Many times (at arrival, during care, etc), Many channels (written, 1:1 conversations, etc), Many voices (physician, nurse, patient advisors, cleaning staff) Ensure soap/ sanitizer and other equipment is available Be a role model Wash/ clean your hands in front of the patients Explain why and how you do it Ensure all staff follow the same processes Patient/family needs
- 15. Speaking up! Only 35% of respondents reported that they would ask a care provided to wash their hands!
- 16. Province Hand Hygiene Rate Ontario 87 % BC 83 % SK* 74 AB 80% Nova scotia 76% Manitoba* 70% Quebec* 42.5 % PEI * 73 % New Brunswick* 48.5% What I see as a patient / family More needs to be done to create an accountability to make the data more accessible and comparable! It took me hours and yet I couldn’t get latest data for provinces with * beside it. Some data is as old as from 2011.
- 17. By participating in this important work, you have already shown the leadership. Please spread the surgical check list and its use to each and every part of your organization. Promote best practices and most importantly hand hygiene. Thanks for listening and being passionate about this topic. You can make the difference
- 18. Dr. Kim Corace
- 19. Improving Healthcare Worker Hand Hygiene Compliance: Can behaviour change theories help? Kimberly M Corace, Jeffrey Smith, Tara MacDonald, Leandre Fabrigar, Andrea Chambers, Sam MacFarlane, Debbie Valickis, Gary Garber STOP! Clean Your Hands Day May 4, 2017
- 20. PublicHealthOntario.ca Disclosures • None of the presenters at this session have received financial support or in-kind support from a commercial sponsor. • None of the presenters have potential conflicts of interest to declare.
- 21. PublicHealthOntario.ca Background • Hand hygiene (HH) is key in preventing healthcare associated infections, yet adherence rates are known to be suboptimal • We lack data on HH barriers and motivators in long-term care facilities • HH is a complex, automatic behaviour • Psychological theories of behaviour change could be used to develop effective hand hygiene compliance interventions Do we use what we know about behaviour change to change HH behaviour?
- 24. PublicHealthOntario.ca Objectives • To identify modifiable motivators and barriers for hand hygiene compliance in long-term care facilities based on psychological theories of behaviour change • To utilize this new information to inform novel interventions to improve hand hygiene compliance • To explore opportunities to foster multidisciplinary collaborations between public health and behaviour change experts 24
- 25. PublicHealthOntario.ca Building a novel collaboration to build a new approach 25
- 26. PublicHealthOntario.ca Collaboration is Key 26 • Initial meeting bringing together public health, infection control, and psychologists with expertise in behaviour change • Reviewed the current literature; identified gaps and opportunities • Identify common agenda to foster collaboration and move things forward • Created momentum through conducting a systematic review of the applicability of behaviour change theory to HH compliance • Srigley JA, Corace K, Hargadon DP, Yu D, MacDonald T, Fabrigar L, Garber G. Applying psychological frameworks of behaviour change to improve healthcare worker hand hygiene: a systematic review. Journal of Hospital Infection. 2015 Nov 30;91(3):202-10.
- 27. PublicHealthOntario.ca Study #1: Systematic Review Objectives • Primary • To review the effectiveness of interventions based on psychological theories of behaviour change to improve HCW hand hygiene compliance • Secondary • To determine which frameworks have been used to predict HCW hand hygiene compliance 27
- 28. PublicHealthOntario.ca Systematic Review Methods 28 • Multiple databases and reference lists of included studies were searched • Eligibility criteria • Studies that applied psychological frameworks to improve and/or predict HCW hand hygiene compliance • English language, published, peer-reviewed studies with primary data • All steps in selection, data extraction, and quality assessment performed independently by 2 reviewers
- 29. PublicHealthOntario.ca Systematic Review Results • 4 theory-informed interventions had mixed results but generally resulted in increased HCW hand hygiene adherence • Operant Learning (positive reinforcement) • Change theory • Theory of Planned behaviour • Transtheoretical Model • 2 of 3 studies found that behavioural theory could predict hand hygiene behaviour • Theory of Planned behaviour • Transtheoretical Model • Theoretical Domains Framework 29
- 30. PublicHealthOntario.ca Systematic Review Conclusions • Potential benefit of applying behaviour change theory to HH adherence • Heterogeneity in frameworks studied • Methodological limitations of studies (bias) • Unclear how the frameworks are informing interventions • Interventions relied largely on standard multimodal programs focusing on education, reminders, and availability of hand hygiene products • Sustainability and generalizability across clinical settings has yet to be demonstrated 30
- 31. PublicHealthOntario.ca Back to Our Collaboration.... 31 How can we design an intervention if we don’t know what we’re targeting? • Collaborated on a grant proposal that would assess targets for the intervention: successfully awarded • Completed Phase 1 of project building on information gathered in the systematic review
- 34. PublicHealthOntario.ca Discussion • Psychological theories of behaviour change provide a useful framework for understanding motivators and barriers for HCW hand hygiene compliance. • Knowledge and training was not a major barrier identified in either closed-ended or open-ended questions reaffirming the need to explore other interventions to improve HH, such as applying behaviour change theory • Collaboration between behaviour change psychology and public health experts is a feasible approach to developing novel solutions for complex public health problems 34
- 35. PublicHealthOntario.ca Limitations • These data are based on self-report; therefore, participants may not always recognize or express factors that function as motivators or barriers to hand hygiene behaviour 35
- 36. PublicHealthOntario.ca Future Directions • We are in the infancy of applying psychological frameworks to the infection prevention and control arena • Many theories remain untapped • We are continuing to identify the promising behaviour change constructs we need to target to improve HH compliance • These targets will be used to develop a behaviour change intervention study in collaboration with our partners in long- term care 36
- 37. Cecilia Bloxom
- 38. Engaging Behaviour Change May 4th, 2017
- 39. What does it mean to be engaged?
- 40. How do you change behaviour?
- 41. 1. Aim High (reach the right audience) 2. Give incentive 3. Be memorable 4. Make it easy 5. Create a positive feedback loop
- 42. Aim High (reach the right audience)
- 46. Give Incentive
- 47. Questions Save Lives Campaign
- 49. Providers from across the country responded
- 50. Patient from across the country responded
- 51. Be Memorable
- 53. Make it easy
- 57. Patient Safety Quiz English Stats Only Patient QuizProvider Quiz We asked providers and the public about their knowledge of Patient Safety
- 58. STOP! Clean Your Hands Day
- 60. Thank you for joining us! Please visit our website to review the presentation and recording of this webinar patientsafetyinstitute.ca