Handwashing in ICU
OVERVIEW
- nosocomial infection associated with:
- -> increased health costs
- -> increased morbidity and mortality
- and is potentially preventable
- ICU patients are at particular risk (immunocompromised, natural barriers breached, frequent interactions)
- hand washing = one of the most effective ways to prevent transmitted infection
- often ICU workers have very poor compliance
INITIATIVES
Education
- didactic teaching
- recognition of compliance
- adequate training of junior staff
- recognition that compliance among medical staff worse
- relatives and visitors
- ongoing education
Signage
- posters
- entrance and exit to unit
- labels on ventilators
- voice prompts at bedside
Hand cleansing products
- new emollient soap
- alcohol hand rub at each bed space
- non-allergenic handwash liquid
Sinks
- automated sinks
- adequate number of sinks
Audit
- data collection before and after institution of initiatives
- microbiological surveillance
- observation of unit practice by independent assessment
Feedback to Staff
References and Links
LITFL
- CCC — Standard precautions
- CCC — Universal precautions
- CCC — Transmission-based precautions
- CCC — Hand Hygiene
Social media and web resources
Critical Care
Compendium
Chris is an Intensivist and ECMO specialist at the Alfred ICU in Melbourne. He is also a Clinical Adjunct Associate Professor at Monash University. He is a co-founder of the Australia and New Zealand Clinician Educator Network (ANZCEN) and is the Lead for the ANZCEN Clinician Educator Incubator programme. He is on the Board of Directors for the Intensive Care Foundation and is a First Part Examiner for the College of Intensive Care Medicine. He is an internationally recognised Clinician Educator with a passion for helping clinicians learn and for improving the clinical performance of individuals and collectives.
After finishing his medical degree at the University of Auckland, he continued post-graduate training in New Zealand as well as Australia’s Northern Territory, Perth and Melbourne. He has completed fellowship training in both intensive care medicine and emergency medicine, as well as post-graduate training in biochemistry, clinical toxicology, clinical epidemiology, and health professional education.
He is actively involved in in using translational simulation to improve patient care and the design of processes and systems at Alfred Health. He coordinates the Alfred ICU’s education and simulation programmes and runs the unit’s education website, INTENSIVE. He created the ‘Critically Ill Airway’ course and teaches on numerous courses around the world. He is one of the founders of the FOAM movement (Free Open-Access Medical education) and is co-creator of litfl.com, the RAGE podcast, the Resuscitology course, and the SMACC conference.
His one great achievement is being the father of three amazing children.
On Twitter, he is @precordialthump.
| INTENSIVE | RAGE | Resuscitology | SMACC