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Patient empowerment tools used to remind MDs to wash

However just more than half of physicians felt that patients should be reminding healthcare providers of their obligation to wash their hands. Healthcare-associated infections (HAIs) are important contributors to rates of illness and mortality with five to ten percent of patients admitted to acute care hospitals in the US acquiring such infections while hospitalized. Most HAI’s are preventable and the most effective preventive measure is hand hygiene.

HAIs are quite costly and often deadly as this article citing Canadian statistics shows: “Each year, about 8,000 Canadians die from hospital-acquired infections; 220,000 others get infected. Treatment is more costly than prevention; estimated costs for 2004 were $82 million. Costs are estimated at $129 million for 2010.”

The importance of hand-washing was emphasized back in 1850 by Ignaz Semmelweis in Vienna. Semmelweis noticed that when doctors rather than midwives working in the best maternity hospitals in the area made deliveries the maternal death rate was often 10 to 20 times higher. Medical students and their professors in elite hospitals would start their day by doing barehanded autopsies on women who had died earlier. Next they went to the wards to deliver babies. Semmelweis thought quite correctly that proper hygiene including hand-washing would greatly reduce the rate of infection. His advice to doctors was to wash your hands.

Allison Lastinger an MD at the West Virginia University School of Medicine(WVU) led a research team that conducted a cross-sectional survey of parents of hospitalized children, adult patients, and primary care physicians at the WVU J.W. Ruby Memorial Hospital. He used a self-administered questionnaire to examine attitudes to a new patient empowerment tool (PET) at the hospital. Some of the digital tools for patient empowerment are discussed in this article.

Linda Greene a nurse and the president of the Association for Professionals in Infection Control and Epidemiology (APIC) said: “Patient involvement is increasingly recognized as an important component of hand hygiene improvement strategies. Organizations must realize that patients and families are an important part of the healthcare team, and their involvement in hand hygiene campaigns should be encouraged.” The PET tools are shown in these photographs. They are various slogans and reminders mounted on the end of tongue depressor sticks some with cartoon-like faces.

In the study a total of 222 adult patients and parents completed the survey of which 108 were adult patients and 114 parents. 64 percent of patients and 70 percent of parents said the PET made them feel more in control of their care. Researchers noted that parents were nearly 20 percent more likely than adult patients to speak up if a physician failed to perform hand hygiene.

The Ruby Memorial Hospital’s multi-pronged initiative to increase their hand hygiene rates had dramatic results. The rate rose from just 48 percent in 2015 to 75 percent in 2016. According to Dr. Lastinger the 48 percent is fairly standard.

Healthcare provider responses were less positive than those of patients and parents with only 54.9 percent of the 89 responders indicating that they felt that patients should be involved in reminding providers to perform hand hygiene. Overall they preferred that a patient would make such a request verbally rather than using the PET devices. 37 percent of physicians thought that it was not the patient’s responsibility to remind them to perform hand washing. Another 16 percent found the reminder embarrassing to the doctor. 13 percent even thought that the reminder could have a negative impact on the doctor-patient relationship. Lastinger notes: “Based on the results of this study, patient empowerment appears to be an effective strategy to facilitate healthcare workers’ adherence to hand hygiene, but acceptance of the PET by providers remains a challenge. Barriers to hand hygiene adherence among healthcare providers should be identified and addressed.”

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