- For hospitals: the WIPES Program
- For clinics and ambulatory settings: the Ambulatory Care Hand Hygiene Program
The WIPES Infection Prevention Program was developed at The Johns Hopkins Hospital to help prevent patients and health care workers from acquiring infections. The acronym WIPES abbreviates the program’s infection prevention strategy:
|I||Identify and isolate early|
|P||Precautions use (gowns, gloves and masks)|
|E||Environments kept clean|
|S||Share the commitment, raise your hand|
WIPES has made a huge impact in our hospital. Since the program’s inception in October 2007, we have observed a more than three-fold increase in hand hygiene compliance rates, across all units and among all types of health care workers at The Johns Hopkins Hospital. Read more. The WIPES program can help your hospital improve its infection-control strategy through education, communication materials and Web-based tools that target and support behavior changes.
The program consists of five components that reinforce and complement each other to ensure success:
Leadership Engagement: The WIPES program uses multiple strategies to ensure ongoing leadership engagement in hand hygiene. By including institutional leaders in the development of the communication campaign materials, regularly discussing infection prevention in hospital leadership meetings and regularly reviewing the results of hand hygiene monitoring, WIPES helps focus leaders’ attention on infection prevention. The program also offers a leadership guide to hand hygiene promotion and a leader’s checklist for leadership behaviors that will improve health care workers’ infection-prevention practices.
Contact us to learn more about the leadership tools.
The WIPES campaign disseminates information calling for a comprehensive approach to infection prevention. Its messages depict individuals and teams of workers from many health care disciplines and with varying levels of authority stating their commitment to follow WIPES’ five steps to prevent hospital infections. The primary audience for the campaign is health care workers of all disciplines and hospital leaders. But patients, families and hospital visitors are also exposed to the campaign and are likely to respond to its message.
The WIPES program contains a brief video designed for all health care workers on how infections are transmitted and what to do to prevent them. It is very important to ensure that all staff members are educated on key infection-prevention strategies.
To maximize a hospital staff’s ability to follow the WIPES strategy, it is important to optimize the hospital or clinic environment. Making hand sanitizer dispensers, masks and gloves easily available at strategic locations, for instance, helps enable all staff members to follow the WIPES strategy despite their busy schedules and a hectic patient-care environment. Visual tools with easy-to-follow instructions on various types of isolation precautions are particularly important for non-clinical health care workers, patients, family members and visitors.
Contact us to learn more about the environment optimization tool.
Because feedback is necessary to reinforce behavior changes and keep infection-prevention an institutional priority, the WIPES program requires regular feedback for teams of health care workers, individuals and institutional leaders. That feedback focuses on ongoing monitoring of hand hygiene behaviors and periodic audits of adherence to isolation precautions. Hand hygiene monitoring is performed using direct observations of entry and exit to the patient environment.
Watch a preview of our standardized training for hand hygiene observers. The full version video tests competency before observers can start data collection. If you are interested in purchasing the CD, please contact us, cost is $99 plus shipping charges.
The WIPES online data analysis and reporting tool allows data to be collected and entered in real time by observers using hand-held electronic devices or web-based forms. The program then automatically generates charts that can be viewed by any leader or health care worker at the institution.
Contact us if you’d like help setting up a similar program at your hospital.
The Johns Hopkins Outpatient Center (JHOPC) also initiated an outpatient hand hygiene monitoring process using the “patient-as-observer” process. The program involves asking patients at check-in time if they are willing to participate in the program as a hand hygiene observer.
We considered two main criteria in adapting this model of hand hygiene monitoring to the ambulatory setting: keeping costs low and minimizing the disruption of clinical activity. It was very important to develop a cost-efficient model of compliance monitoring. But in the JHOPC the hand sanitizer dispenser and sink are inside the patient exam room. Relocating either or both resources outside the room to enable officials to monitor their use would have been much too expensive. Having clinical staff enter the patient exam room during clinical encounters to observe whether hand hygiene protocols were followed would have required an enormous commitment of staff time, disrupted the patient care process and compromised patients’ privacy.
Upholding our second criteria, minimal disruption to the flow of clinical activity, required that the process of monitoring hand hygiene compliance should not detract from or impede clinical encounters. Relying on self-reporting from health care workers about whether they followed the protocols and used hand hygiene products would have met the low-cost criterion. But assuring the validity of the data would have been a constant challenge requiring frequent audits to confirm the reported results. These audits would have increased overall costs.
We considered the traditional models of monitoring compliance. But all were readily dismissed as too expense, too cumbersome or not capable of providing reliable data. The notion of involving the patient in the monitoring process was intriguing and we elected to develop a pilot project that included a turn-key description of process implementation.
In this process, the patients who agree to act as observers file cards as they check out of the clinic that report whether they observed the doctors and clinic workers who treated them washing or sanitizing their hands. We use this data to generate monthly charts that show the hand hygiene compliance of our health care workers by clinic. This is widely distributed in the clinics and improvement is tracked overtime.
In ambulatory procedural areas that are open or where patients may be sedated, this program uses the same methodology the WIPES Program employs.
Contact us if you’d like help setting up a similar program at your clinic or ambulatory setting.