Clean Hands Across Newfoundland Labrador Hand Hygiene Auditor ...

Clean Hands Across Newfoundland Labrador Hand Hygiene Auditor ...

Clean Hands Across Newfoundland Labrador Hand Hygiene Auditor Education Auditor Education 20 1 Goal & Objectives

Goal: To provide a consistent approach to hand hygiene auditor training Objectives : At the completion of this session hand hygiene auditors will have: Completed the Hand Hygiene Auditor Education Program 2 Key Concepts: Indication & Opportunity Health Care Activity = a succession of tasks during which health care

providers (HCP) hands touch different types of surfaces: the patient, his/ her body fluids, objects or surfaces located in the patient environment Each contact is a potential source of contamination for health care providers hands Indication: the reason why hand hygiene is necessary at a given moment. It is justified by a risk of organism transmission from one surface to another Opportunity: the need to perform hand hygiene, whether there are single or multiple indications. Hand hygiene must correspond to each opportunity. Multiple indications (Moments) may come together to create a single opportunity.

3 How to Observe Hand Hygiene Direct observation, using a consistent approach and validated tool, is the most accurate methodology The auditor must be familiar with the methods and tools and trained to identify and distinguish the indications for hand hygiene occurring at the point of care The auditor must conduct observations openly, without interfering with the ongoing work, and keep the identity of the health care providers (HCP)

confidential Compliance should be determined according to the indications for hand hygiene 4 Preparing to Audit Find a convenient place to observe without disturbing care activities follow the HCP, but do not interfere with their work Take into account any concerns the HCP may have with your presence

Be as discreet as possible Do not infringe on patient privacy Record only what you observe: Do not record when a HCP tells you they have performed hand hygiene unless you observe it Provide feedback after the session, if appropriate to do so 5 Preparing to Audit

Initially observe one HCP (As you become more proficient you may observe up to three HCP simultaneously) Note: Multiple HCPs performing sequential tasks quickly may interfere with audit accuracy You may include more HCPs sequentially during one observation session Be vigilant to observe all aspects of hand hygiene of those HCPs you are auditing Do not document more than 5 observations per HCP End the observation when the curtain is drawn around the patient unless you are involved in the direct care

6 Auditing Activity Each audit session should be no longer than 20 minutes. (+-10 minutes to complete a session) Audits should take place at a variety of times. 24 hours/day and 7 days/week Audits do not need to be done on consecutive days.

7 Factors Influencing Hand Hygiene Nails/Rings Wrists/Sleeves Indicate if the HCP does not meet the guidelines:

Nails must be kept clean and short. Nail polish must not be worn. Artificial nails or nail enhancements must not be worn. Rings are not worn during Hand Hygiene. Arm jewelry, including watches and medical alert bracelets, must be removed

or pushed up. 8 Factors Influencing Hand Hygiene Gloves Hand hygiene done with gloves on is incorrect; therefore, it is marked as a missed opportunity Indicate if the health care

provider was wearing gloves when the opportunity occurred In this audit, wearing gloves does not change the number of opportunities for health care providers to clean their hands Indications for glove use include: Contact with non-intact skin Contact Precautions

Anticipated contact with blood and/or body fluids 9 Hand Hygiene Monitoring Videos Please view as instructed the following six slides

Source: Ontario Agency for Health Protection and Promotion (Public Health Ontario), Provincial Infectious Diseases Advisory Committee. Best Practices for Hand Hygiene. Used with permission. 10 Monitoring Program Moment 1 Before Initial Patient/Patient Environment Contact Please watch the first 36 seconds of the video below:

Moment 1 Audit Scenario A Please watch the first 20 seconds of the video below: Moment 1 Audit Scenario B 11 Monitoring Program Moment 1 Before Initial Patient/Patient Environment Contact Please watch the first 36 seconds of the video below: Moment 1 Audit Scenario C

Please watch the first minute and 39 seconds of the video below: Moment 1 Audit Scenario D 12 Monitoring Program Moment 4 After Patient/Patient Environment Contact Please watch the first 43 seconds of the video below: Moment 4 Audit Scenario A Please watch the first 22 seconds of the video below:

Moment 4 Audit Scenario B 13 Monitoring Program Moment 4 After Patient/Patient Environment Contact Please watch the first 11 seconds of the video below: Moment 4 Audit Scenario C 14

Monitoring Program The following videos demonstrate more complex scenarios Please watch the first 22 seconds of the video below: Complex Audit Scenario A Please watch the first 37 seconds of the video below: Complex Audit Scenario B 15

Monitoring Program Please watch the first 42 seconds of the video below: Complex Audit Scenario C Please watch the first 1 minute and 29 seconds of the video below: Complex Audit Scenario D Scenario D is the last Scenario for teaching purposes 16 How to use the Observation Tool

Crede Auditing Instructions 17 How to use the Observation Tool Crede Auditing Instructions 18 How to use the Observation Tool

Crede Auditing Instructions 19 How to use the Observation Tool Crede Auditing Instructions 20 How to use the Observation Tool

Crede Auditing Instructions The ADD HCP button is used to start observations . Select HCP to start your first observation ( Button 3) 21 How to use the Observation Tool Crede Auditing Instructions

HCP descriptor 22 How to use the Observation Tool Crede Auditing Instructions Please refer to notes that you printed at the beginning of this session. 23

How to use the Observation Tool Crede Auditing Instructions 24 How to use the Observation Tool Crede Auditing Instructions Use Save Incomplete to save audit locally for later editing (button 4).

The Summary button allows you to see a quick summary of the current audit , including the number of observations (button 5). 25 How to use the Observation Tool Crede Auditing Instructions Use the Finish Button (6)when audit complete to submit to server. If no network connection is present the audit is saved locally. It can be retrieved

later using Open Existing Audit and submitted. 26 How to use the Observation Tool Crede Auditing Instructions Use the Back button(7) to return to audit parameter and change parameters or to edit a saved incomplete audit and to go back to the original audit ,discarding changes.

Touching the Clear All (8) button will clear current observations deleting the audit. 27 How to use the Observation Tool Crede Auditing Instructions 28 Recording Observations

Crede Auditing Instructions BEF-PAT/ ENV = before initial patient/patient environment contact Moment 1 Before a) if the health care provider touches the patients environment and then touches the patient or b) goes directly to touch the patient after having touched the hospital environment (= any other surface not in the patients environment) or

another patients environment c) if the health care provider enters the patients environment from the hospital environment and touches only the patients environment (does not touch patient) and then leaves the patients environment. 29 Recording Observations Crede Auditing Instructions AFT-PAT/ ENV = after patient/patient environment contact

a) if the health care provider is leaving the patient and his/her environment to go on working in the hospital environment or with another patient b) if the health care provider is leaving the patient area after touching objects in the patient environment (without touching the patient) to go on working in the hospital environment or with another patient. 30 Recording Observations

Crede Auditing Instructions Wash with soap Use ABHR No HH

31 Recording Observations Crede Auditing Instructions No HH 32

Recording Observations Crede Auditing Instructions 33 Recording Observations Crede Auditing Instructions Factors which influence Hand Hygiene Nails too long, nail

polish, gel nails etc 34 Cleaning your IPad Electronic devices such as IPads are a potential source for transmission of microorganisms It is the responsibility of the user to routinely clean & disinfect the IPad according to the RHAs policy

35 Congratulations You have completed the requirements to be a Hand Hygiene Auditor Please follow up with your ICP if you have any questions 36

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