Health Policy Analysis on Hand Hygiene - Coursework Example

Health Policy Analysis on Hand Hygiene Health Policy Analysis on Hand Hygiene Introduction Having been recently appointed as an analyst for our communities health department, it is my objective to implement a new healthcare policy requirement related to hand hygiene in all city buildings and dwellings. The need to improve hand hygiene throughout our community is critical to the overall health and well being of our residents. In my role as a healthcare worker, I have been intimately involved in recent years to improve hand washing protocols throughout the hospital setting where I am currently employed. It is amazing to observe how many healthcare providers that I come into contact with on a daily basis feel that it is acceptable to enter a patients room without first washing their hands, or some other form of hand sanitizer. Even if the medical staff in question does not actually physically touch the patient, everyone should still wash their hands before enter a room, as one never knows what any individual patient might require prior to entering a room. This need is also evident throughout our community, as we all come into contact with various settings on a regular basis that are germ filled and require sanitization on our part in order to remain healthy and safe. Many hospital and healthcare facilities make the claim that any alcohol based hand cleaner can be effectively used in place of the traditional washing of hands with soap and water. The common consensus is that one only needs to wash their hands after using a hand cleaner ten consecutive time, or if there is a buildup of cleaner on the hands or the hands become completely dry (Abraham, 2008). Recent research has revealed, however, that hand sanitizer is not entirely effective against all bacteria, so washing with warm water and sap is the primary method to effectively wash away and sanitize the hands from bacteria. Problem Statement The problem is that too many healthcare providers today do not take seriously enough the importance of washing their hands before entering any area of the hospital where a patient might be. The process of washing one’s hands is one of the primary ways available to all of us to stop the spreading of germs from one person or location to another (Anderson, 2011). It is actually considered to be the single most effective way to prevent the transmission of infections. In the course of daily life, the simple washing of hands can help to stop the spread of bacteria and viruses from person to person, including the common flu and other easily transmitted diseases and infections. This concept is a vital and potentially lifesaving patient safety measure that must be taken very seriously. Hand hygienic is something that is rather simple to accomplish, but the problem is exacerbated by the reality that way too many health care providers and caregivers still do not consider the washing of their hands between patient visits to be a priority (Anderson, 2011). This is leading to a potential situation where patients that are coming in for routine treatments and procedures are having to prolong their stays at the hospital or health care facility as a result of the spread of viruses, much of which could possibly be avoided by implementing a stringent to hand hygiene and washing policy. It is important to note that infection such as Streptococci, Escherichia coli, P. aeruginosa, Enterobacter spa., and Klebsiella pneumonia, which have been problematic in our community for years, will become even more of a problem should we continue to be lax in our approach to hand washing (Pittet, 2010). This rise may be attributed to several factors including the shift to more outpatient care, an aging population, overall population growth, and an increase in international travel. Another, even more likely contributor, is that many health care organizations are short of staff, which may result in a subsequent rise in rates of infection because individual employees are rushing from patient to patient without properly washing their hands or cleaning and sanitizing the room properly (Pittet, 2010). Background As a recently hired analyst for our local government office in Austin, Texas, my services have been retained to help design and implement a new healthcare policy requirement related to hand hygiene and proper washing practices. This new hand hygiene policy, once implemented, will serve as a mechanism to enforce proper hand washing procedures throughout all local healthcare facilities. Currently on the market today, there is a new system referred to as the Hand Hygiene Compliance Monitor (HHCM). This system actually works in conduction with Wi-Fi Internet based technology. As soon as any medical staff or related personnel walks either in or out of a patient room within the facility, the system will record whether or not they used the hand sanitizer. In addition to this feature, the new policy is designed to measure when a health care worker steps into a zone that is covered by a patient bed. In so doing, the monitor will recognize if the badger is green, which indicates that the worker has washed his or her hands. The time, location, and the identification number of the worker will be immediately transmitted to an internal database for subsequent review and analysis. If a health care worker does forget to wash his or her hands, the monitor near the bed will begin to vibrate, serving as a gentle reminder that hand washing is necessary (Lorenzi & Neal, 2014). This particular type of system and policy should be implemented throughout all healthcare organizations and facilities in the Austin area in an effort to improve the level of hand hygiene throughout the the community. The policy and system will enable administrators within each facility to track that data compiled by the HHCM and work to enforce proper hand hygiene amongst all medical staff, particularly those that do not currently take the washing of their hands very seriously at all. Landscape Identification There are numerous key stakeholders and factors to be considered as the basis for implementing this heath care policy. One of the primary legal factors to consider is the efficacy of mandating a hand washing policy for all personnel in a health care setting. Such a policy may carry stipulations that are relative to the reprimanding of any employee who fails to adequately wash their hands, or perform some type of approved hand hygiene process, before entering any area where a patient might lie (Pittet, 2014). Because the risks of failing to do so are so high, the legal standing of the health care organization to insist on such a policy is not only sound and just, but have previously been upheld in the judicial system. In addition, patients could possibly bring litigation against any health care facility where they either fall ill, or their existing illness or infection is compounded by encountering health care workers that have not washed their hands. If the hospital is found to be negligent in this area, the legal implications could be severe (Lomolino, 2014). The primary stakeholder, and beneficiary, of this policy is the individual patient within a health care facility. Most times, the average patient has no control over who visits them in their room and doctor’s office. If we are referring to a person actually admitted to the hospital overnight, or for a stay of a longer duration, it is almost frightening to consider the number of individuals that come and out of the average patient room on a daily basis. Not all of these individuals are health care workers, as there are maintenance and cleaning crew, to just to a new few types of other key personnel in a typical health care facility, to consider as well. Each of these individuals, if they fail to properly wash their hands after each and every visit, are potentially bringing in numerous types of germs into an environment that is already occupied by a person who is either sick or suffering from some type of infection (Lomolino, 2014). As a result, patients must depend on the integrity of the health care facility to implementing proper hand washing hygienic policies throughout the confines of the building in order to protect them from harmful, even deadly, bacteria. The next logical stakeholder to benefit from this policy would be facility personnel, be them medical or logistical staff. As previously mentioned, these individuals visit countless patient rooms and offices on a routine basis, coming into contact with a myriad of different bacteria and other germs that can affect their overall health and well being (Eriksen & Iversen, 2013). If even one employees fails to properly wash his or hands upon being in a patient’s room, it affects the health of every other staff person who enters that room until it is properly sanitized. If multiple people in a row do not practice prudent hand hygiene, then this phenomenon is compounded further. As such, for the health and well being of every individual staff person working in a hospital or health care facility, the implementation of this health policy is both necessary and timely (Eriksen & Iversen, 2013). A final stockholder worth mentioning is the healthcare facility and community themselves. The community depends on the health care facility to provide quality and safe medical treatment to the general populace of an area. The facility, in return, depends on a healthy workforce to meet the increasingly stressful demands of a population that is both growing and aging. Studies reveal that improper hand washing techniques and frequency can lead to illness. Many illnesses, even minor, will require health care works to stay home in order to not risk passing on harmful germs to already sick and infected patients in the facility itself. In addition, when key personnel are required to miss work, it often results in a situation where the hospital or facility finds themselves short of staff. It is exactly this type of scenario that this policy aims to resolve. A hospital is already a stressful environment with a lot of demands placed upon the employees. When there is a staffing shortage, the potential to become quick is all too prevalent, causing many employees to neglect stopping to take the time to properly wash their hands (Grimshaw, 2014). Alternative Section In considering possible options that will make this new health policy work, and dramatically improve the hand hygiene throughout Austin area health care facilities, it was prudent to consider three alternatives that could solve the problem and meet the needs of stakeholders and the community, in addition to meet any legal requirements that might existent as well. After a comprehensive review of research currently published in this area, the following three alternatives were considered: 1) Education and Promotion of the importance of hand washing and proper procedures; 2) Offering more facilities around the hospital in the form of automated sinks and moisturized soap dispensers in more prominent locations; and 3) the implementation of a hand hygienic policy system. The first option consists of implementing required professional development workshops aimed at educating the entire workforce on the importance of proper hand hygiene each time a patient’s room or office is entered. This would include literature at strategically placed locations around the facility in order to serve as a constant reminder about the important of taking regular care to perform this action. The theory behind this found in research that indicates that strategies aimed directly and education and motivating about the importance of hand washing and hygiene have proven effective (Klevens & Edwards, 2013). This includes the distribution of written educational materials, reminders to staff, and continuous feedback from supervisors about observed performance. A second alternative that given serious consideration was to offer more hand washing facilities strategically located throughout the hospital or health care related facility. These facilities would be in the form of automated sinks or moisturized soap dispensers. An independent consultant would be contracted by the city to go into each facility and make recommendations about any existing deficiencies in this area and propose where sinks and dispensers should be added. The hope would be that either a sink or lotion dispenser would be located no more than a few steps from anyplace where contact might be made with a patient zone. Automating the sink not only speeds up the hand washing process, but it contributes to a more germ free environment as dirty hands would not be touching the sink at any time more than necessary (Klevens & Edwards, 2013). A third and final option that was seriously considered is the implementation of a modern hand hygienic policy system. Currently on the market today, there is a new system referred to as the Hand Hygiene Compliance Monitor (HHCM). This system actually works in conduction with Wi-Fi Internet based technology. As soon as any medical staff or related personnel walks either in or out of a patient room within the facility, the system will record whether or not they used the hand sanitizer. In addition to this feature, the new policy is designed to measure when a health care worker steps into a zone that is covered by a patient bed. In so doing, the monitor will recognize if the badger is green, which indicates that the worker has washed his or her hands. The time, location, and the identification number of the worker will be immediately transmitted to an internal database for subsequent review and analysis. If a health care worker does forget to wash his or her hands, the monitor near the bed will begin to vibrate, serving as a gentle reminder that hand washing is necessary. Side-by-Side Tables of the Alternatives Table 1: Analytic Table of the Alternatives Alternative Description Education and Training This would include literature at strategically placed locations around the facility in order to serve as a constant reminder about the important of taking regular care to perform this action. The theory behind this found in research that indicates that strategies aimed directly and education and motivating about the importance of hand washing and hygiene have proven effective. This includes the distribution of written educational materials, reminders to staff, and continuous feedback from supervisors about observed performance. The advantage of this policy would be the highlighting of the importance of this issue on a constant basis. The downside might be the reality that working professionals, particularly those that already make a practice of regularly washing their hands, are having the skills denigrated by being force to attend trainings and seeing educational materials as a daily reminder. More Hand Washing Facilities and Dispensers These facilities would be in the form of automated sinks or moisturized soap dispensers. An independent consultant would be contracted by the city to go into each facility and make recommendations about any existing deficiencies in this area and propose where sinks and dispensers should be added. The hope would be that either a sink or lotion dispenser would be located no more than a few steps from anyplace where contact might be made with a patient zone. Automating the sink not only speeds up the hand washing process, but it contributes to a more germ free environment as dirty hands would not be touching the sink at any time more than necessary.The advantage of this would come in the form of every employee having ready and available access to the equipment they need to properly take care of hand hygiene each and every time a patient zone is entered. The downside will be the expense of developing an automated sink system throughout every hospital and healthcare facility. In addition, it would be difficult to monitor such a system and ensure that all employees are doing their part to properly wash their hands, which could simply result in the same situation we are facing today throughout the Austin area. Hand Hygiene Compliance Monitor Currently on the market today, there is a new system referred to as the Hand Hygiene Compliance Monitor (HHCM). This system actually works in conduction with Wi-Fi Internet based technology. As soon as any medical staff or related personnel walks either in or out of a patient room within the facility, the system will record whether or not they used the hand sanitizer. In addition to this feature, the new policy is designed to measure when a health care worker steps into a zone that is covered by a patient bed. In so doing, the monitor will recognize if the badger is green, which indicates that the worker has washed his or her hands. The time, location, and the identification number of the worker will be immediately transmitted to an internal database for subsequent review and analysis. If a health care worker does forget to wash his or her hands, the monitor near the bed will begin to vibrate, serving as a gentle reminder that hand washing is necessary. The advantage of this system would be that it is non-invasive to the point that employees who do regularly and properly wash their hands will need to nothing more than wear the badge. Those that do not wash their hands will be reminded privately and their actions recorded in a database for further follow up. The downside will be the initial expense of implementing the system throughout all Austin area health care facilities. Recommendations While there are certainly many great options available to implement a more sound and productive healthcare policy related to hand hygiene, it is my recommendation to adopt the Hand Hygiene Compliance Monitoring System (HHCM). The HHCM incorporates many of the principles related to the need to ensure proper hand washing procedures with the legalities of ensuring that it takes place in such a way the it is proven which employees simply are refusing to abide by the policy itself. The only noticeable drawback to the implementation of this policy is the expense, but this is a one time factor that is easily mitigated by the potential increase in healthy and safety procedures being in place throughout the health care facility. There will be a software maintenance package expense, in addition to procuring the badges and WiFi technology. Beyond this, however, there will be minimal man-hours required to read the data, as the software will do that quickly and make it readily accessible to the appropriate administrators throughout the facility. While the alternatives considered have shown effectiveness in certain settings, this alternative is deemed to be the least invasive, while being the most effective. At the end of the day, the individuals working in a health care facility are professionals and would like to be treated as such. This is the reason why educational materials and training about an issue such as hand washing might seem demeaning to this particular demographic group. At the same time, either out of sheer laziness or out of business, the reality is that many individuals in this group are simply choosing to not wash their hands nearly as often as they should. This policy will provide a way to remind each and every employee about the need to do so, and will provide a way to monitor electronically and follow up as needed. Implementation Strategy There will be a three step process incorporated into the implementation of this new health policy. The first will involve consulting with key administrators at each facility in the Austin area to inform them of the impending change and go over procedures for ordering and installing the devices. The second step will involve scheduling brief in-service trainings with all staff to brief them on the monitoring system and answer any questions that individuals might have (Hugonnet, 2013). The final step will be actually the devices, handing out the badges to all workers and begin the process of monitoring hand washing frequently. Implementation Planning The planning for the policy should be organized in order to insure that it is well received. Staff must first buy in to the concept that everyone needs to be monitored in terms of their hand hygiene in order to not only protect the patients, but themselves as well. In this regard, planning sessions should be held with healthcare administrators throughout the city in an effort to answer any questions that they might have, or that those employees under their charge might have already presented to them. In return, it will be helpful to first train these key personnel on the monitoring system in order that they fully understand how to navigate the system and monitor the data that is received (Grol, 2013). Conclusion The importance of proper hand washing techniques and protocol is both well known and misunderstood. In the end, it is an everyday activity that is almost taken for granted, even by the very medial professionals and staff that should understand its importance. Because of the critical function that hospital and healthcare facility staff play in maintain a healthy environment for patients, many of whom are already ill or suffering from various types of infection, it has become necessary to implement some type of system to ensure that hands are properly washed before entering into any patient zone (Stone, 2014). That is the focus of the new policy and I true believe that the implementation of the monitoring system will pay off with improve hygiene through the facilities in the Austin area. References Abraham, C. (2008). A taxonomy of behavior change techniques used in interventions. Health Psychology, 27, 379-387. Anderson, L. (2011). Improving patient and provider communication: A synthesis and review of communication interventions. Patient Education Counseling, 17, 99-134. Eriksen, H. and Iversen, B. (2013). Prevalence of nosocomial infections in hospitals in Norway. Journal of Hospital Infections, 60, 40-45. Grimshaw, J. (2014). 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