Last week I attended a dinner event put on by the Royal Canadian Institute. Each table had a "theme" with which to base our conversation on. The theme for our table was "First Do No Harm: Healthcare Culture and Patient Safety". Dr. Michael Gardam (a past Talk Clean To Me guest blogger and current Director of Infection Prevention and Control at the University Health Network in Toronto) was the table host and started off the night with the concept of positive deviance (PD) by asking what we would do to ensure that each and every patient we saw was given a hospital acquired infection (HAI).
For those of your who are unfamiliar with PD, it is a strength-based, problem-solving approach for behavior and social change that finds uncommon but successful behaviors or strategies that enable someone to find better solutions to a problem than their peers. In healthcare (and in life) we often look at how we can solve or fix the problem. Taking the view of how we can create the problem sometime leads to finding a "better" solution. As expected, not washing ones hands was the first idea that came out as being "the way" to ensure we spread diseases.
As mentioned last week - May 5th is the global SAVE LIVES: Clean Your Hands campaign organized by the WHO. I had challenged you to ensuring you washed your hands when appropriate and to point out other peoples oversights in an effort to stop the transmission of HAIs.
This week I'm challenging you to be positively deviant....take the following hand hygiene quiz, BUT, the objective is to answer based on how NOT to follow hand hygiene best practices. Can you score an A+ and ensure that by following the wrong practices you can spread diseases?
1. How long should you scrub your hands together when washing with soap and water?
a. 2 minutes
b. 15 seconds
c. Just long enough to rinse the soap off
2. How often should you clean your hands after touching an environmental surface, for example a bedrail?
a. After each and every time I touch a surface
b. One if the surface is noticeably dirty
3. Use of artificial nails by healthcare workers should be promoted because pretty hands mean clean hands.
4. What is the primary purpose of hand hygiene?
a. Reduce microorganisms on the hands
b. To keep hands clean
c. To keep nails clean
d. None of the Above
5. Which is the preferred method for drying hands in a healthcare setting?
a. Paper Towel
b. Air Hand Dryer
c. Using the seat of my pants
6. It's important to wash your hands:
a. After you use the restroom
b. Before you start preparing food
c. After petting an animal
d. None of the Above
e. All of the Above
7. What supplies do you need for hand washing?
a. Warm water, soap, something clean to dry your hands with
b. Alcohol-based Hand Sanitizer
c. Nothing because there is no scientific evidence to support the importance of hand hygiene
d. A or B
8. A co-worker who examines a patient with VRE, then borrows my pen without cleaning his/her hands is likely to contaminate my pen with VRE?
I hope you're as positively deviant as I am! Give yourself an A+ if you answered 1-c, 2-c, 3-a, 4-d, 5-c, 6-d, 7-d, 8-b. Your Hand Hygiene practices suck!
Now that we know what not to do, can you think outside of the box to come up with a solution of how to ensure Healthcare workers wash their hands 100% of the time?