December is National Handwashing Month

[traumaRUs, MSN, APRN]

December is National Handwashing Month, a global advocacy day dedicated to increasing awareness and understanding about the importance of handwashing.

The Centers for Disease Control (CDC) considers hand hygiene to be one of the most important acts that hospital personnel accomplish on a daily basis. It is estimated that hospital personnel can wash their hands more than 100 times in a typical 12 hour shift. Some questions that healthcare workers have about hand hygiene are answered by the CDC:

1 ) Germs are everywhere. They are within and on our bodies and on every surface you touch. But not all germs are bad. We need some of these germs to keep us healthy and our immune system strong.

2 ) Your hands have good germs on them that your body needs to stay healthy. These germs live under the deeper layers of the skin.

3 ) Your hands can also have bad germs on them that make you sick. These germs live on the surface and are easily killed/wiped away by the alcohol-based hand sanitizer.

4 ) Using an alcohol-based hand sanitizer is the preferred way to keep your hands clean.

5 ) Alcohol-based hand sanitizers kill the good and bad germs, but the good germs quickly come back on your hands.

Perhaps nowhere is handwashing more of a focus than at America's largest pediatric hospital, Nationwide Children's Hospital, based in Columbus, Ohio.

allnurses.com recently interviewed Dr. J. Terrance Davis, MD, Assistant to the Chief Medical Officer, Nationwide Children's Hospital. Dr Davis also is a Professor Emeritus of Clinical Surgery, Division of Cardiac Surgery, Department of Surgery, The Ohio State University College of Medicine.

Your Zero Hero patient and employee safety campaign is laudable. How do you ensure "gel in, gel out" during each and every patient encounter?

We did a military style "Stand Down" for 15 minutes one day in November of 2010 that was the culmination of a major hand hygiene effort that included placing hand gel dispensers everywhere, and holding a Safety Summit of all medical and hospital departmental leadership. Monitors from the Quality Improvement department continue intermittent monitoring, and compliance has remained ~95% to this day.

Hand washing gel contains alcohol. In a children's hospital, how do you keep your young patients safe from ingestion or exposure to hand sanitizing gel?

The dispensers are wall mounted, high, and need to be pressed from the top with a specific motion. In seven years of use of hundreds of dispensers throughout the hospital we have not had any such problems.

How many times can you use hand sanitizing gel before it becomes necessary to use soap and water? Or is this necessary?

It does not become necessary to use soap and water after any specific number of times of using the gel. Soap and water are indicated (as opposed to gel) if the hands are visibly soiled.

How do you get all the parents and visitors to comply with hand gel use? What kind of signage do you use?

We cannot mandate visitors or family to comply with gel in-gel out; but we do have signage throughout regarding hand hygiene. Mostly the culture is so strong that everyone entering and leaving are doing hand hygiene, so it tends to "rub off" on the families - albeit not to the extent present in our employees and medical staff.

What else would you like our audience of >1 million nurse-members to know about this program?

The "stick" we used to encourage compliance early on was that non-compliers identified by our monitors, were required to have a chat with the Chief Medical Officer (or his designee) if a member of the medical staff. Nurses or other health care professionals who were found to be non-compliant were required to meet with the Chief Nursing Officer or her designate. Getting "called up to the Principal's office" was apparently noxious enough that, once the word got out we were serious about this, non-compliance dropped dramatically. We did not have any repeat non-compliers.

Here is a video about Nationwide's Hand Hygiene Program

[audreysmagic, RN]

This is really great information! Thanks - we're really pushing hand hygiene at my facility, and now that I'm working Infection Control, following up on it is my job. I'm going to share this article with my staff members!

[wondern, ASN]

I like to use/see handwashing and gel between a sick child and a well child. Maybe overkill but I'm kind of old fashioned regarding handwashing. I like it.