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School of Medicine
First place artwork by Staci Lindblad
The Hopkins Hands contest brought out more than a dozen creative, fun and educational entries from a variety of departments across several different Johns Hopkins member organizations. The entries included mixed media, poetry, artwork and videos to reflect Hopkins Hands’ mission of emphasizing the importance of improving patient safety through clean hands.
Three winners were chosen:
- First Place: Mixed-media artwork by Staci Lindblad, communications manager from Suburban Hospital’s Marketing and Communications Department, earned first place. In evaluating the piece, judges noted the appealing design and the variety of messages, such as “wash me” and a reminder that “although your hands might look clean, there’s dirt and germs that can’t be seen,” and media.
- Second Place: Second place went to a collage created by the Environmental Services Department at Sibley Memorial Hospital featuring employees’ painted handprints. For the artistic and educational project, staff put paint on their hands and then washed it off to show they would not enter or leave a room with germs on their hands.
- Third Place: A Shakespearean sonnet captured third place. Gary Pilarchik, psychiatry therapist from The Johns Hopkins Hospital’s Community Psychiatry Program, wrote the prose using true iambic pentameter, a Shakespearean staple.
Every year, the World Health Organization and the Centers for Disease Control and Prevention take a day to remind health care providers that keeping their hands clean saves lives. Every day, employees across Johns Hopkins Medicine practice proper hand hygiene to protect patients, visitors and colleagues from infection and the spread of germs. It’s been demonstrated at Johns Hopkins that as hand hygiene increases, infections such as MRSA and Vancomycin-resistant Enterococcus decrease.
Thanks to a successful effort to remind staff of the importance of hand-washing, The Johns Hopkins Hospital has extra cause for celebration this World Hand Hygiene Day. Since achieving 91 percent compliance in December 2012—the first time the hospital met or exceeded its goal of 90 percent—JHH has sustained its performance, scoring at or very near the goal for the past three months. Scores are based on data collected by “secret shoppers,” who monitor whether staff sanitize/wash their hands when entering and exiting patient rooms.
When Sibley Memorial Hospital adopted a program last July that assigns specially trained staff to secretly monitor whether or not clinicians use Purell or wash their hands when entering and exiting patient rooms, only slightly more than half of those observed met the strict rules.
One year later, however, their compliance rate is 94 percent—among the highest within Johns Hopkins Medicine.
Others across the system are striving to replicate these results through similar “secret shopper” programs. Although hand hygiene improvement programs vary by hospital and even by unit, an institution-wide task force is looking at ways to boost scores across the board to protect patients from hospital-acquired infections.
At Johns Hopkins Community Physicians, we analyze the Hand Hygiene habits of our Health Care providers annually during the cold and flu season of the winter months.
Our Hand Hygiene campaign is based on the “patient-as-observer” program that the Johns Hopkins Outpatient Center and the Hopkins Hospital utilize. The “patient-as-observer” model encourages the patient to mark on a ‘score card’ if they witness their provider, nurse, medical assistant or lab personnel wash their hands while they are at JHCP for their visit. Our ‘score cards’ have spaces for yes, no and unsure answers.
When it came to hand hygiene compliance, All Children’s Hospital seemed to be in an enviable position. Its inpatient rate was around 93 percent and its outpatient clinics were doing even better, with a near-perfect 99 percent.
But with such vulnerable patients as infants in the NICU and significant numbers of cancer, bone marrow transplant and heart transplant patients, the hospital wasn’t content with almost perfect.
Within the last two years, the roster of regional hospitals in the health system has gone from three—Hopkins Hospital, Johns Hopkins Bayview Medical Center and Howard County General Hospital—to five, with the addition of Suburban Hospital in Bethesda, Md., and Sibley Memorial Hospital in Washington, D.C. Also increasing the size of the health system have been new Johns Hopkins Community Physicians sites throughout the state.
In her new role as senior epidemiologist for the Johns Hopkins Health System, Trish Perl will draw on her long experience on all these fronts to help all the components of Johns Hopkins Medicine use best practices and share resources.
Two years ago, in a demonstration of how easily caregivers could acquire pathogens, Angela Feurer of the neurosciences critical care unit invited staff to slide their fingertips across a culture medium. Before doing the exercise, most had only touched keyboards or phones, rather than handling patients, since their previous hand cleaning. Yet, as if emphasizing her point, the funk growing in these cultures “actually made my office stink,” Feurer says.
Yet Feurer continued to face resistance from some caregivers who still didn’t see the connection. They asked, Where is the proof that cleaning hands so frequently truly prevents disease? She now has an answer.
Did you remember to wash your hands? We’ve all heard this from parents and other family members before, most likely starting at a young age. Around The Johns Hopkins Hospital, it’s a hard message to escape, and the constant reminders seem to be working.
The Johns Hopkins Hospital has become better and better at identifying factors that make it easier for health care workers to consistently wash their hands—and it’s planning to share its findings with hospitals around the country.
The Joint Commission has chosen Hopkins, along with seven other hospital systems, to develop methods to improve hand-hygiene compliance.
Early on during Nisa Maruthur’s internship at The Johns Hopkins Hospital, an outbreak of the Norwalk gastrointestinal virus in 2004 left most of the health care staff on Nelson 5 ill. Maruther ended up being one of a few physicians available to care for the critical care unit patients for days. “I believe that part of the reason I did not get sick,” says the internist, “was because I wash my hands religiously.”
Clean Hands, Dome, February 2009
Hand washing is a simple, common-sense policy. But making it as automatic as fastening a seat belt is not as easy as one might think. That’s why posters, prizes, bulletin boards and slogans have all been used to get people’s attention.
Hand hygiene is so important that 90 percent compliance is required by the Joint Commission. In fact, hand hygiene compliance is the hospital’s top quality and safety goal for the current fiscal year.