I'm supposed to wear an "Ask me if I washed my hands!" button?!

Nurses Activism

Published

Today, administrators launched a handwashing campaign, part of which includes having patient care staff wear giant buttons that say, "Ask me if I washed my hands!" Patients are encouraged to ask this of their nurse/CNA/etc. every time s/he walks into their room. Every time.

I find this incredibly insulting both to my intelligence and to my professional practice as an RN. I cannot imagine what patients must be thinking: does it imply that we don't know enough to wash our hands? What else do they need to be checking up on, if we can't be trusted to have washed our hands after patient contact?

I understand that the aim is to decrease the spread of microorganisms. We all learned that in Nursing Fundamentals. I've listened to all the inservices on handwashing, antimicrobial foam and gel, and standard precautions ad nauseum. But this is way over the top. I don't ask my mechanic if he remembered to put all the parts back in my car and I don't ask my accountant if she used a calculator to figure out my taxes. I don't think I should be asked over and over if I'm doing my job, either.

We've had a hard enough time trying to be recognized as professionals without this nonsense. If I wanted to wear giant silly buttons at work I'd be waiting tables at TGI Fridays.

I told one of the administrators I'd consider wearing one if all the docs had to wear them, too. It's been a long time since I've seen some of them lather up before performing a bare-handed dressing change.

I think we should wear buttons that say "ask me if I've had lunch today".

Seriously, I wouldn't wear it either. It is demeaning, and implies everything that everyone else has said. Might as well ask me to wear one that says " ask me if I calculated this dose correctly", or "ask me if I know what I am doing".

Specializes in ER (My favorite), NICU, Hospice.
I think we should wear buttons that say "ask me if I've had lunch today".

lol....I couldn't help but laugh. How about one that says, "ask me when the last time i peed was?"

Specializes in Family.

That is entirely too demeaning. I thought some of the scripts we had to wear on our badge (and were supposed to use) were dumb, but this idea is crazy!! I believe I know of a button that would do well as a replacement: Do you want fries with that?

Specializes in Clinical Research, Outpt Women's Health.

How about this button: ask me if I have had a chance to pee today? or: ask me how many nurses are staffed for your care today................

Ludicrous - at first I thought you were joking because it is so stupid.

Specializes in Nursing assistant.

This would be about the same as "Ask me if i pick my nose" button to me.

Not to mention a button typically has a pin on it. That's just asking for injury.

__________________

Marie, LPN in O.R., pursuing RN, Semester 1 of ?.

Nursing Advocacy does not speak for me.

This could cause a nose bleed!

Specializes in Nursing assistant.

A study of the hand washing habits of staff in an Irish intensive care unit found that doctors washed their hands less than other health professionals and were the least responsive to a hygiene campaign aimed at tackling this problem.

http://www.irishhealth.com/?level=4&id=7897

QUOTE]

ah ha! is this a subtle ethic slur against my people? I resemble that remark... ;)

Specializes in ICF/MR, ER.

Anybody here read Ben Hamper's "Rivethead"? It's worth reading to discover a novel "solution" to silly slogans foisted upon employees by management.

LPNadmin

(My inner child is playing with the buttons on YOUR car radio RIGHT NOW!)

Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac.
I told one of the administrators I'd consider wearing one if all the docs had to wear them, too. It's been a long time since I've seen some of them lather up before performing a bare-handed dressing change.

Good post. I agree with all you've said, especially the above.

Specializes in Critical Care.

brings new meaning to 'Here's your sign"

How about "ask me if i'm paid what I'm worth . . .'

'ask me if management has any respect for your primary healthcare provider'

'ask me if I know why there's a nursing shortage'

'ask me if we're understaffed this shift'

'ask me if the my managers fell off the stupid side of their beds when this idea hit them'

'ask me if i'm paid nearly enough to wear this badged. no wait, don't ask me, I'll tell you - NO i'm not'

~faith,

Timothy.

Specializes in Behavioral Health.
brings new meaning to 'Here's your sign"

How about "ask me if i'm paid what I'm worth . . .'

'ask me if management has any respect for your primary healthcare provider'

'ask me if I know why there's a nursing shortage'

'ask me if we're understaffed this shift'

'ask me if the my managers fell off the stupid side of their beds when this idea hit them'

'ask me if i'm paid nearly enough to wear this badged. no wait, don't ask me, I'll tell you - NO i'm not'

~faith,

Timothy.

Timothy...

You ROCK!!!

:bow: :bow: :bow:

Specializes in Vents, Telemetry, Home Care, Home infusion.

found out how this campaign started "a patient education and empowerment program"

article from 2000: hand washing by health care providers:

physicians and other healthcare providers must break the "code of silence" that makes it difficult for them to criticize their colleagues' clinical practices. senior staff must model handwashing for their subordinates and trainees. somewhat surprisingly, there are no national medical standards for handwashing. in an era of cost-containment and managed care, hospital infection-control departments (which drain, but do not generate, revenue) may not be given enough staff to monitor staff members' handwashing behavior and develop effective intervention programs. as well, patients may be discharged from the hospital before the infections take hold, making their sources more difficult to trace...

however important it may be in the abstract, handwashing is inconvenient and even aversive for staff. when one prominent medical school constructed a new pediatric hospital, the architects placed sinks only at the ends of each hallway, thus making it more difficult for doctors and nurses to wash between patients. infection-control officers recommend 10-15 seconds of vigorous soaping, followed by a thorough water rinse, before and after any contact with body secretions, mucous membranes, or blood. but this could mean hundreds of handwashings per day. such frequent and prolonged handwashing, coupled with drying with paper towels, dries and chafes the skin. waterless, alcohol-based microbial agents, faster to use and much kinder to the skin, are available in europe, but generally have not been adopted in the united states. improved compliance will require more than a change in attitudes and beliefs on the part of physicians, nurses, and other health-care workers. it will require a reorganization of the health-care environment to promote and maintain behavioral change. as a symbolic reflection of the kind of change required, a program at the university of pennsylvania medical school instructs new patients to ask every health-care worker they encounter whether they have washed their hands -- thus reversing the traditional roles of doctor and patient.

http://www.institute-shot.com/hand_washing_by_health_care_providers.htm

from university of pennsylvania:

improving handwashing in hospitals: a patient education and empowerment program

patients are encouraged to become "partners in your care" by asking all health care workers who come into contact with them, "did you wash your hands?"

staff compliance with the program was measured by soap usage per bed-day. soap dispensers were located in each patient's room, utility rooms, and nurses' stations. the number of handwashings was calculated by dividing soap usage by a standard amount for each handwashing..

... results of the study indicate that patients readily participate in the program, and that it significantly increases the amount of soap used, and by extension, the frequency of handwashing.

* more than 80% of the patients read the brochure on handwashing, and 95% recognized the importance of handwashing in preventing infections.

* 57% asked their health care workers whether they had washed their hands. of these patients, 90% asked nurses, but only 32% asked physicians. when they did ask, 81% of the patients received a positive response (washed hands).

* each site had an increase in soap usage during the 6-week intervention period, compared to its level in the control period 6 weeks earlier. across all sites, soap usage increased by an average of 34%. this represents an increase in average handwashings per bed-day from five in the control period to seven in the intervention period.

http://www.upenn.edu/ldi/issuebrief7_3.pdf

compliance with handwashing in a teaching hospital.

university of geneva medical school and university of geneva hospitals, switzerland

compliance with handwashing. results: in 2834 observed opportunities for handwashing, average compliance was 48%

in multivariate analysis, noncompliance was higher among physicians,

nursing assistants and other health care workers than among nurses and was lowest on weekends. noncompliance was higher in intensive care than in internal medicine units during procedures that carry a high risk for contamination and when intensity of patient care was high

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=retrieve&db=pubmed&list_uids=10068358&dopt=abstract

handwashing

holmes's ideas were greeted with disdain by many physicians of his time. ...

infections each year, due primarily to the lack of infection control programs. ...

www.accessexcellence.org/ae/aec/cc/hand_background.html

cdc - controlling antimicrobial resistance in hospitals: infection ...

controlling antimicrobial resistance in hospitals: infection control and use of antibiotics

...in most surveys of handwashing adherence, in various patient-care settings, personnel have practiced appropriate hand hygiene in only 25% to 50% of opportunities.

as we pass the sesquicentennial of semmelweis' seminal observations on the importance of hand hygiene in reducing the incidence of nosocomial childbed fever, why does handwashing remain the most breached infection control measure in hospitals? two frequently cited reasons are the large time commitment (up to 90 minutes per work shift if performed as recommended by the centers for disease control and prevention [cdc]) and the adverse effects of repeated handwashing on the skin (8).

alcohol -based hand rubs

if given a choice of changing human behavior (e.g., improving attention to hygiene and asepsis) or designing a technologically foolproof device to control infections, go for the device. for hand hygiene, we have the opportunity to fulfill the infection control "prime directive": use technologic advances to improve behavior. how? alcohol-based sinkless hand rubs (table 2) can overcome the time problems of handwashing (9) and actually improve skin condition (10). handwashing requires approximately 45 to 90 seconds to access and use a sink with running water, soap, and hand-drying facilities; an alcohol-based hand rub can degerm hands in less than 30 seconds and enhance killing of transient hand flora.

http://www.cdc.gov/ncidod/eid/vol7no2/weinstein.htm

infection control in physicians' offices -- committee on ...

let's be patient advocates and nurse friendly by having a pinning ceremony for all the physicians, interns, residents and medical students on your unit!

Specializes in Critical Care.

I don't know how others practice being professional.

I find that starting about day 2 into a string of shifts, I have to ask housekeeping to replace the soap and alcohol based hand wash dispenser around my patient care areas.

I'm a professional. I would be insulted and resentful of being told I needed to be reminded of my professionalism.

Reminds me of a song by tesla: 'Signs, signs, everywhere signs, blocking up the scenery, breaking my mind . . ."

~faith,

Timothy.

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