Patient Centered Hand Hygiene DeAnn Richards MetaStar Improvement Forum June 23, 2016

2 Objectives Engage the Patient and Beneficiaries in their role in preventing infections Increase staff compliance by engaging them in conversation and plan for patient needs Incorporate methods and tools to increase and monitor compliance

3 February Poll Results What is your organization’s greatest hand hygiene challenge? 1.Obtaining administrative support – 2% 2.Consistent observations – 37% 3.Staff engagement – 20% 4.Compliance of staff – 49% 5.Addressing barriers and gaps – 2%

4 Patient Hand Hygiene Patients as monitors and auditors: It’s OK to ask Clean Your Hands Partners in their care Patient’s own hand hygiene: Supports model of patient centered care And, including patients in hand hygiene also increases HCW hand hygiene

5 What’s Your Plan

6 Patient Hand Hygiene Timing: After toileting When leaving and entering room Before eating, drinking, or taking medications After coughing or sneezing Also consider: Before and after contact with visitors

7 Possible Interventions to Increase Compliance Two Types of Challenge to Change 1.Technical – staff share their knowledge 2.Adaptive – provide product for the patient to clean their hands Goal = Behavioral Change

8 Precede/Proceed 1.Predisposing – patients to be aware consequences of exposure to common HAIs. 2.Enabling – patients have easy access to sinks with antimicrobial soap or waterless wipes. 3.Reinforcing – patients and visitors are rewarded when observed cleaning hands.

9 Social Cognitive Theory Person BehaviorEnvironment

10 Transtheoretical Model or Stage Theory I won’t I might I will I am I have

11 Learning and Behavioral Science Theories 1.Representative of the target group 2.Cultural diversity 3.Repetition 4.Active learning 5.Enhance learning 6.Multisensory learning

12 Influencer Change the Way You Change Minds Convince: Feel it will be worth it Believe they can do what is required Personal experiences: Share stories Create experiences Tell the whole story

13 Influencer Six Sources of Influence Source 1 – Personal Motivation Source 2 – Personal Ability Source 3 – Social Motivation Source 4 – Social Ability Source 5 – Structural Motivation Source 6 – Structural Ability

14 Influencer Deliberate Practice Demand full attention or brief intervals Provide immediate feedback against a clear standard Break mastery into mini-goals Prepare for setbacks Build emotional skills

15 Influencer Deliberate Practice Harness peer pressure The power of one Enlist Social support Make undiscussables discussable Become an opinion leader Create a village

16 Influencer Deliberate Practice Find strength in numbers Blind spots Design rewards and demand staff accountability

17 Tools to Implement LSQIN has combined these approaches to create a tools that you may find useful for your hand hygiene program. Patient Centered Hand Hygiene (Presentation): Patient Centered Clean Hands: TeamSTEPPS Overview: Hand Hygiene Dispensers: Wisconsin Hand Hygiene TAP: Design for Small Test of Change – Hand Hygiene:

18 Summary Patients need to be engaged in infection prevention Utilize frontline staff to improve infection prevention practices by teaching patients Utilize theory-based tools and processes to create sustainable change

19 Contact Information DeAnn Richards, RN, CIC MetaStar, Inc Landmark Place Madison, WI , Ext

This material was prepared by the Lake Superior Quality Innovation Network, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The materials do not necessarily reflect CMS policy. 11SOW- WI-C