Your Montana Public Radio
Healthcare Associated Infections
Wed April 2, 2014
Why its important for both patients and healthcare workers to wash their hands
Say you’re in the restroom at a public place, like the mall. You’re at the sink, washing your hands, and you see the sign, complete with step-by-step pictures, on how to wash your hands.
Ever actually read that sign? It tells you to wash your hands for 20-seconds.
Registered Nurse Melody Finch said proper hand hygiene is the first step in prevention, and this relates to alcohol-based hand sanitizers as well as soap and water.
“One of the things I’ve run into is when they’re doing the alcohol sanitizer; that they’re putting the dollop on their hand, and they’re just rubbing their palms together for just a few seconds, and then they kind of wave their hands in the air for it to dry. That’s not the correct way to do it. You actually put it in your hands, and you rub it all over your hands until it’s actually dry, and that should take 15 to 20 seconds, otherwise you’re not really doing it effectively,” Finch said.
Finch and Registered Nurse Laura Bermel work in the Infection Prevention department at Kalispell Regional Medical Center.
Bermel said she’s worked as a nurse for about 30-years, and over the last several years she’s seen a growing focus on what patients can do to help themselves avoid acquiring an infection.
“We spend a lot of time talking to people about making sure you’re clean and prepared for surgery, making sure you don’t smoke; because that inhibits the immune system and makes you less able to fight infection,” Bermel said this also means encouraging patients to ask their doctor or nurse if they’ve washed their hands.
Montana as a state comes in below the national average for people picking up an infection at the hospital. Nationally, the Centers for Disease Control said hospitals are making improvements, however, the statistics are still scary. In a recent report it found each day 1 in 25 U-S patients contracts an infection in the hospital, adding up to more than 722,000 each year. The report said every day more than 200 Americans with healthcare-associated infections will die.
Bigfork resident Dr. Rodney Ogrin created a product called Sprixx that he believes could go a long way toward preventing infection and death.
It’s a portable hand-sanitizer that clips to a person’s clothes. Ogrin’s background is in dentistry, he said about 10-years ago he was talking with a physician bemoaning the state of hand-hygiene in the healthcare industry.
“He said, I think if they had something attached to their body, they wouldn’t have to take the time to walk to a dispenser; and he pointed out, because they’re really tight on their time, taking care of patients, that they’ll skip hand sanitation in favor of getting the job done,” Ogrin said.
Ogrin said this makes it available to a health care worker at every “point of care”.
“That’s everything in the patients immediate environment. And, so, that means they sanitize their hands before they touch a patient, after they touch a patient, whenever they touch anything in the patients immediate environment,” Ogrin said.
Some hospital systems have adopted his product in the past year including the University of California in San Francisco, Irvine, and Barnabus Health on the east coast.
All the prevention efforts aim to keep people from transmitting infections from one patient to another by keeping hands, tools, and surfaces clean.
Bermel said a change on the caregiver side of prevention over the past several years is how antibiotics are used.
“You don’t go to the doctor, I think, and get an antibiotic prescribed for colds and things like that as readily. They really do wait to see if it warrants it; if you’re not recovering after a week, they might consider antibiotics for example. So they are trying to be very much more careful, they’ve recognized that antibiotics are not a silver bullet, they’re not going to kill everything every time,” Bermel said now specific antibiotics are administered at particular times during a surgery, and, generally, for a set amount of time afterwards.
The goal is reducing or avoiding antibiotic-resistant “superbugs”, and then keeping hands, surfaces, and people clean so they don’t pick up superbugs while at the hospital.
The CDC measures three specific areas to determine how hospitals are doing with healthcare-associated-infections. A central line is a tube that a doctor usually places in a large vein on a patients’ neck or chest. These are at high risk for bloodstream infections. In the CDC’s recent report, Montana didn’t have enough data to report how the state’s hospitals are doing, the same is true for Surgical site infections for colon surgery and abdominal hysterectomy surgery.
However, in catheter associated infections, no Montana hospitals had infection rates higher than the national average of 1-percent.
Bermal said Kalispell also comes in under the national average, but their target is zero.
“People who develop a urinary tract infection because they’ve had a catheter in will end up staying longer, they will end up with additional treatment that they wouldn’t have had to have. People who develop surgery-site infections might sometimes come back for an additional procedure then, and it causes life changes for those people,” Bermel said.
Bermal said they look at each infection that does occur, to see if a step was missed, and how it can be prevented in the future.