Stacy Haverstick et al. | Patients’ Hand Washing and Reducing Hospital-Acquired Infection
Critical Care Nurse | June 2017 | 37:e1-e8;
Background: Hand hygiene is important to prevent hospital-acquired infections. Patients’ hand hygiene is just as important as hospital workers’ hand hygiene. Hospital-acquired infection rates remain a concern across health centers.
Objectives: To improve patients’ hand hygiene through the promotion and use of hand washing with soap and water, hand sanitizer, or both and improve patients’ education to reduce hospital-acquired infections.
Methods: In August 2013, patients in a cardiothoracic postsurgical step-down unit were provided with individual bottles of hand sanitizer. Nurses and nursing technicians provided hand hygiene education to each patient. Patients completed a 6-question survey before the intervention, at hospital discharge and 1, 2, and 3 months after the intervention. Hospital-acquired infection data were tracked monthly by infection prevention staff.
Results: Significant correlations were found between hand hygiene and rates of infection with vancomycin-resistant enterococci (P = .003) and methicillin-resistant Staphylococcus aureus (P = .01) after the intervention. After the implementation of hand hygiene interventions, rates of both infections declined significantly and patients reported more staff offering opportunities for and encouraging hand hygiene.
Conclusion: This quality improvement project demonstrates that increased hand hygiene compliance by patients can influence infection rates in an adult cardiothoracic step-down unit. The decreased infection rates and increased compliance with hand hygiene among the patients may be attributed to the implementation of patient education and the increased accessibility and use of hand sanitizer.
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This case study shares the experience of Leeds Teaching Hospital NHS Trust on how they reduced levels of medical agency spending | NHS Employers
The Leeds Teaching Hospitals NHS Trust has reduced its medical agency spend by introducing a central deployment service and making effective use of e-rostering to deliver a consistent and professional approach to the deployment of junior doctors.
This case study details the work the trust has carried out, from the medical workforce team working with medical managers, consultants and junior doctors to standardisation of processes. Read up on the steps they took towards improvement and the successes that have been achieved.
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A systematic review was undertaken to examine the quantity and quality of data-based research aimed at improving the (a) processes and (b) outcomes associated with delivering end-of-life care in hospital settings | BMC Palliative Care
A total of 416 papers met eligibility criteria. The number increased by 13% each year (p < 0.001). Most studies were descriptive (n = 351, 85%), with fewer measurement (n = 17) and intervention studies (n = 48; 10%). Only 18 intervention studies (4%) met EPOC design criteria. Most reported benefits for end-of-life processes including end-of-life discussions and documentation (9/11). Impact on end-of-life outcomes was mixed, with some benefit for psychosocial distress, satisfaction and concordance in care (3/7).
More methodologically robust studies are needed to evaluate the impact of interventions on end-of-life processes, including whether changes in processes translate to improved end-of-life outcomes. Interventions which target both the patient and substitute decision maker in an effort to achieve these changes would be beneficial.
Full reference: Waller, A. et al. (2017) Improving hospital-based end of life care processes and outcomes: a systematic review of research output, quality and effectiveness. BMC Palliative Care. Published: 19 May 2017