Senin, 28 Juni 2010

Empowering patients to ask providers to wash their hands


"2000 miles
Is very far through the snow
I'll think of you
Wherever you go"
- Chrissie Hynde

We moved our family to Iowa City last week. There is something about being back in the Middle West that gets me singing old Pretenders' songs. I can't really explain it. One thing I've immediately noticed is that people say "hand washing" here and not "hand warshing" like I heard often back east.

Enough of that. There is a qualitative study out in the June issue of the Journal of Patient Safety by Amanda Garcia-Williams and colleagues from the CDC's DHQP that assessed the CDC video "Hand Hygiene Saves Lives" as a tool of patient empowerment. They conducted four focus groups using laypersons without hospital exposure in the past year, laypersons with hospital exposure, nurses and physicians. There are a lot of interesting findings within the study and many should be subject to further analysis.

The primary finding was that laypersons were much more likely to ask a nurse to wash his/her hands after watching the video, however, those with recent hospital exposure stated that they would still be "nervous" or "scared" to do so. Interestingly, laypersons with hospital exposure were more likely to ask physicians to wash their hands after watching the video but those without hospital exposure were not influenced by the video to ask physicians to wash their hands.

A very interesting finding was that laypersons with hospital exposure had lower levels of perceived risk for HAIs than persons who hadn't been in the hospital recently. Perhaps fear of the unknown is playing a role here. I suspect this fear could be used positively to get them to monitor compliance among their healthcare providers. Overall, I found the results of this study promising. Hopefully they will continue to analyze the impact of this video through quasi-experimental study or using other methods to see if this video intervention actually results in changed patient behavior, improved hand hygiene compliance, and dare I dream, reduced HAIs.

Article in the Journal of Patient Safety (here)

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