April 30th, 2013
WATERLOO REGION — St. Mary’s General Hospital staff are being far more diligent about cleaning their hands after scoring poorly last year on hand hygiene compliance.
Grand River Hospital improved on already outstanding rates, while Cambridge Memorial Hospital continued with good compliance on the patient safety indicator, required to be publicly reported annually by the Ministry of Health.
Hospital staff are observed for proper hand cleaning, either using alcohol-based hand rub or washing with soap and water, before and after contact with a patient or their environment.
St. Mary’s saw a substantial drop in compliance before patient contact for fiscal 2011-12, down to 68.2 per cent from almost 84 per cent in the previous year.
“It’s not where we wanted to be,” said hospital president Don Shilton.
The Kitchener hospital bounced back up to 82 per cent in the latest numbers for 2012-13 released on Tuesday, while after-patient contact improved slightly to 88 per cent.
“We’re pleased. We want to continue to get better, but we’re encouraged by the results,” Shilton said.
Grand River reports a steady improvement over the past four years at both its sites. The rates for before and after contact were about 91 and 96 per cent respectively at the main hospital and 93 and 97 per cent at the Freeport site.
Cambridge Memorial’s compliance was around 82 and 89 per cent, little changed from the previous year.
Shilton said the hospital is realizing a drop in the incidence of hospital-acquired infections, thanks in part to its focus on cleaning for more than the past year. Housekeeping staff got specialized training to bolster their awareness of worrisome organisms and the best way to get rid of them, and additional duties like delivering supplies to the floors were dropped to avoid any distractions.
“We’ve really allowed these folks to focus on the cleaning,” Shilton said.
The hospital’s infection and prevention control team grew and got additional resources to put more attention on hand hygiene throughout the hospital to boost compliance, Shilton said.
Cleaning hands is “a simple and very cost-effective intervention,” said Dr. William Ciccotelli, medical director for infection prevention and control for Grand River and St. Mary’s.
Grand River is determined to improve its compliance rates every year to reduce the chances of spreading infections, which Ciccotelli said takes vigilance, because health care workers are busy and see many patients in a day.
To encourage the handwashing habit, brightly coloured alcohol hand rub dispensers were installed throughout the hospital and there’s a person dedicated to staff education.
“It’s something that we will maintain as an ongoing patient safety initiative,” Ciccotelli said.
This spring the Kitchener hospitals are doing preventive cleaning after a slight increase in C. difficile cases the past couple of years in late spring to early summer, both in hospitals and the community.
“We’re not really sure why,” Ciccotelli said. “I don’t know if it’s a pattern or if it’s by chance.”
While Cambridge Memorial doesn’t have any plans specific to C. difficile prevention, the hospital is reorganizing two in-patient floors over the next week and all rooms will get extra cleaning, while later in the month every bed will be stripped to the mattress and thoroughly cleaned.
It’s also focused on cleaning audits using a special marking agent and light to detect missed spots to give housekeeping staff immediate feedback, a process done 500 times last year.
President Patrick Gaskin said this year’s hand hygiene rates aren’t bad, “but there’s an opportunity still to improve. … We want those as close to 100 as possible.”
The hospital substantially increased hand hygiene audits and Gaskin said he would have liked to see that work reflected in the most recent rates. This past year, infection control staff armed with an iPad did 5,100 handwashing spot checks followed by coaching to boost compliance through education, up from 1,900 in 2010-11.
“It is a really important safety practice for us to continue to enforce,” Gaskin said.
Johanna Weidner, Waterloo Region Record