Putting Human Factors To The Test – Hand Hygiene

Focusing on people as the problem is rarely beneficial. Focusing on their environment can lead to massive improvements.

A user-friendly hand hygiene environment is one where staff, patients, and visitors are supported in such a way that participating in optimal hand hygiene activities can take place in the right place and at the right time. (Canadian Patient Safety Institute – Hand Hygiene Human Factors Toolkit)

We put recent hand hygiene initiatives through our ‘Hazard Feedback Framework

Hazard – Poor hand hygiene practice risks increased hospital infections.

Suggested Solution:

Alcohol-Based handwash at multiple locations as a solution to poor hand hygiene practices.

1.1 Intuitive – based on what one feels to be true even without conscious reasoning.

More hand pumps easier it is for healthcare to access them to wash hands. Multiple dispensers act as a visual cue. Self drying. Time efficient. Improved workflow.

1.2 Evidence Based – Is there sufficient evidence to refute this intuitive solution?

No evidence to refute solution.

1.3 Cost Conscious – occasionally the increased safety a solution offers can’t be afforded.

Increased cost of multiple dispensers requiring frequent replacement, may be offset by potential savings through reduced infection rates.  More expensive than soap and water.

2. Decrease or same workload on the front line

Decreased workload for front line as less time to reach hand washing location, and can pump out solution into hands and keep moving to work location while solution drys in hands

3. Does not introduce its own set of problems

Cause less skin irritation than frequent use of soap and water. However are not effective on hands that are visibly dirty, does not kill Closridium bacteria, flammable (but okay when evaporated).

4. Goes to source of problem – approach equipment or system manufacturers.

Improves hand washing efficiency.

5. Survey front line staff – ‘How will the solution fail?’

Solution already in place.

6. Trial solution –  consider using simulation centres.

Solution already in place.

7. Implementation, follow up, further feedback – ensure agreement and transparency.

Solution appears well received by frontline staff.

8. Presentation and transparency – present to other patient safety groups.

Solution adopted throughout healthcare facilities. (See CEC Hand Hygiene Program)

We will constantly test the robustness of the ‘Hazard Feedback Framework‘ in developing patient safety solutions. We believe it will act as a catalyst for improving safety culture.

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