Campaign Critique: Save Lives - Literature review Example

Campaign Critique Campaign SAVE LIVES: Clean Your Hands Implementing organisation World Health Organization (WHO) Campaign website (if available) http://www.who.int/gpsc/5may/en/ Overall goal and Objectives (while you explain the goal, please mention briefly what the background problem is. For example: high HIV rate in the country; frequent human rights abuses; unregulated industry/sector, etc) “To galvanise action at the point of care to demonstrate that hand hygiene is the entrance door for reducing health-care associated infection and patient safety. It also aims to demonstrate the world’s commitment to this priority area of health care” (WHO, 2013). Background problem: the spread and increase of life threatening healthcare associated infections Geographical location (which are the countries where the campaign is implemented?) Global (48 countries have participated in this campaign) Target audience(s) Health care workers Approach (advocacy, social marketing, participatory, multi-pronged) Encouragement of health workers using the following tools: 1. System change tool: Alcohol-based handrub planning & costing tool 2. Training/education tool: Hand hygiene - why, how and when brochure 3. Evaluation and feedback tool: Observation form 4. Reminders in the workplace tool: Your five moments for hand hygiene poster 5. Institutional safety climate tool: Sustaining improvement-additional activities for consideration by health-care facilities Dissemination channels (please list the channels or materials) Government health agencies for each participating country. Critique: SAVE LIVES: Clean your hands The WHO campaign SAVE LIVES: Clean your hands targets basic health practices which seek to prevent the transfer of bacteria and of infection from patient to patient and from health worker to patient and vice versa (WHO, 2013). Health workers are always exposed to bacteria, viruses, and other contaminants which in some cases may be infectious and transferrable to other patients, to themselves, and to other health workers (Groll and Grimshaw, 2003). Washing hands has long been part of the health care process, however, there are times when health workers fail to adhere to its appropriate practice. Barriers to hand washing including limited and/contaminated water supply, especially in developing countries can prevent the health workers from actually carrying out their hand washing procedures before and after managing their patients (Mani, 2010). The lack of opportunity to carry out hand washing procedures also interferes with hand washing, especially where there are inadequate facilities for hand washing and where there are numerous patients requiring attention from the health workers (Kampf, 2004). Issues in the inadequate observation of hand washing techniques are seen mostly in developing countries where their health resources and facilities are inadequate, and where the number of patients often overwhelms health worker population (Kampf, 2004). The goals of the WHO campaign on highlighting the importance of hand washing for health workers is an important goal, as it helps refocus and revitalize a routine health care practice which can potentially bring about significant benefits for the patients and health workers (Larson, et.al., 2007). The goals of the project are also clearly linked to the WHO’s First Global Patient Safety Challenge, that clean care is safer care work (WHO, 2009). Through the campaign, the WHO has provided a necessary first step towards ensuring patient safety and welfare. Health care associated infections can easily transfer from one patient to another through the contaminated hands of healthcare workers. Improving the hand hygiene practices of health workers decreases infection in various settings (Curtis and Cairnscross, 2003). Public concerns on the increased levels of meticillin resistant Staphylococcus Aureus (MRSA), bacteremia, meticillin sensitive S aureus (MSSA) bacteraemia, as well as Clostridium difficile infection (CDR Weekly, 2003) are just some of the reasons why hand hygiene measures were highlighted within the healthcare settings. Although this is a global campaign by the WHO, not all countries have fully participated in this WHO campaign. Nevertheless, most countries have expressed their commitment to hand hygiene (Pessoa-Silva, et.al., 2007). Issues for participating countries are however very much apparent in areas where there is limited water supply. In developing countries like Africa and some parts of Asia clean water is difficult to access. Potable drinking water alone often has to be fetched from their sources, and when they are fetched, they are mostly contaminated and can only be secured at limited amounts (Allegranzi, et.al., 2010). Going through the aseptic techniques of hand washing before and after caring for each patient would be considered a major wastage of water. Flowing water is a luxury which is only available in the more developed areas of Africa (Allegranzi, et.al., 2010). For which reason, in these areas, healthcare associated infections are rampant and other infectious and transmissible diseases are also common. Under the above conditions, it is also important for the WHO to take an active campaign towards securing adequate water sources for these developing countries (Pengpid and Peltzer, 2012). This is a major challenge for some countries like Africa as their access to water is limited. Moreover, facilities in these areas may also be inadequate, especially in terms of flowing water and handy hygiene resources (Pengpid and Peltzer, 2012). Hand hygiene resources include alcohol rubs at bedside, antibacterial soaps, and hand sanitizers. The challenge for the WHO is on ensuring that health service facilities, including hospitals and clinics are equipped with these resources (Pengpid and Peltzer, 2012). Alcohol rubs and hand sanitizers can also help manage the water resource problem for these facilities. The campaign is filled with challenges, especially in terms of compliance. The WHO indicated specific details on how hand hygiene can be promoted and ensured among patients (Whitby, 2007). These details are more or less engaging and applicable under ideal circumstances, especially in well-equipped health facilities. However, in areas where the resources are limited, the recommended methods of securing hand hygiene are impracticable (Whitby, 2007). Nevertheless, other tools which relate to evaluation and feedback tools and reminders in the workplace can be carried out in most facilities – in both developed and developing countries – with minimal cost. It is also one of the simplest methods which can be implemented by most healthcare facilities in ensuring and facilitating hand hygiene (Grol, 2007). Most facilities have implemented evaluation and feedback tools as well as reminders in the workplace, especially in terms of statistical tools reflecting on the incidents of healthcare associated infections. Posters have also become more apparent and visible in health facilities, serving as a reminder to health service workers on the tasks they need to undertake for each patient they are managing (Grol, 2007). The visibility of appropriate hand washing and hand hygiene practices are sometimes not included in these posters, and this is an aspect which the WHO needs to coordinate better with different health facilities. Posting the different steps to proper hand washing can serve to inform not just health workers, but patients as well. The training and education of health service workers on proper hand washing is also an essential aspect of this campaign. This aspect of the campaign needs to be coordinated with different health facilities, health agencies, and schools offering health related courses (Sax, 2007). The training process would have to include the nature of the infection process, what, why, and how infection can be transferred from one patient to another or from the patient to a health worker. Schools are considered basic training and education facilities for health workers especially as they provide a venue for theoretical learning; the clinical setting would then follow as a more practical training facility for these health workers (Sax, 2007). Compliance with the elements of the campaign has been difficult to assess, especially as the campaign is being implemented at the global level. Nevertheless, most countries in most health facilities understand and recognize the importance of hand hygiene among their health workers (Whitby, et.al., 2006). As such, efforts are being made to improve compliance with these measures. These efforts can be seen in the increased visibility of posters in health facilities reminding health workers to wash their hands or to use alcohol rubs and hand sanitizers before and after managing their patients (Whitby, et.al., 2006). Decrease in areas where strict and improved efforts towards hand washing and hand hygiene have been made strongly indicate a link between hand hygiene and reduced incidents of healthcare associated infections. These studies alone provide strong support for the importance of hand hygiene in healthcare facilities (Gould, 2008). It is therefore incumbent upon health workers and health administrators to ensure that the proper facilities and resources are available to promote infection control through hand hygiene practices. As was mentioned by the WHO, the support of private agencies and medical companies, the right tools and resources including antibacterial soaps, hand sanitizers, alcohol rubs and other hand hygiene resources can be provided for free or with minimal cost (Joint Commission Mission, 2009). Improving compliance with hand hygiene practices have also been discussed in terms of its habit-forming possibilities. Where adequate foundations for hand hygiene are established for health workers, it soon becomes routine for them (Whitby, et.al., 2006). Soon enough, reminders on posters would no longer be necessary to signal health workers that they need to wash their hands before and after each patient. This is the ultimate goal for the WHO campaign (Whitby, et.al., 2006). Although it may take a while to reach habit-forming levels for health workers, the foundations for the establishment of routine practices are already laid out through the WHO campaign. The WHO campaign SAVE LIVES: Clean your hands, is a campaign which seeks to prevent the transmission of healthcare associated infections from the point of care – meaning from the health workers themselves. The goals of the project are specific enough and are in accordance with the broader patient safety goals of the WHO (Backman, et.al., 2008). As far as securing patient safety is concerned, hand hygiene is indeed one of the most basic remedies which can be implemented. More countries are however needed in order to secure wider application and dissemination of this campaign. With more countries and more health workers engaged in this campaign, compliance can be improved and healthcare associated infections can be decreased to an even more significant level (Backman, et.al., 2008). As far as developing countries are concerned where the access to water and hand hygiene resources are limited, the WHO needs to assist the concerned governments in improving water access and facilities as well as access to hand hygiene resources. These developing countries need the most assistance in implementing the goals of the campaign, mostly because their population is also highly vulnerable to health risks and complications (Pickering, et.al., 2010). In order to complete and effectively expand the coverage of the campaign, the campaign can also include patients and family members, mostly in terms of health education, teaching them the importance of regular hand washing and hand hygiene practices (Pickering, et.al., 2010). The WHO also mentions the participation of government agencies in implementing the goals of the campaign. Improved coordination with these agencies has been secured in most participating countries (Pittet and Donaldson, 2005). However, issues in the implementation of the advocacies and goals of the campaign have been apparent, especially as far as developing countries are concerned. These countries often experience difficulties in securing legislations and policies in relation to health (Pickering, et.al., 2010). These difficulties stem from the fact that most these policies would likely require additional financial allocations during implementation. These allocations would mean expansion of already strained budgets (Oswald, et.al., 2008). In effect, the lack of support from government agencies, especially in terms of health programs is limiting the extent of implementation of the WHO campaign. References Allegranzi, B., Sax, H., Bengaly, L., Minta, R.,et.al., 2010. Successful implementation of the World Health Organization hand hygiene improvement strategy in a referral hospital in Mali, Africa. Infect Control Hosp Epidemiol., 31(2), pp. 133-41. Backman, C., Zoutman, D., and Marck, P., 2008. An integrative review of the current evidence on the relationship between hand hygiene interventions and the incidence of health care-associated infections. Am J Infect Control 36, pp. 333–348. Boyce, J. and Pittet, D., 2002. Guideline for Hand Hygiene In Health- Care Settings: Recommendations of the Healthcare Infection Control Practices Advisory Committee and the HICPAC/SHEA/APIC/IDSA Hand Hygiene Task Force. Infect Control Hosp Epidemiol 23(Suppl.), pp. S3–S40. CDR Weekly, 2004. Staphylococcus aureus bacteraemia: England, Wales, and Northern Ireland: October to December 2003. Health Protection Agency [online]. Available at: www.hpa.org.uk/cdr/archives/2004/staph_1204.pdf [Accessed 25 March 2013]. Gould, D., 2008. Interventions to improve hand hygiene compliance in patient care. J Hosp Infect, 68, pp. 193–202. Grol, R. and Grimshaw, J. 2003. From best evidence to best practice: Effective implementation of change in patients’ care. Lancet, 362, pp. 1225–1230. Grol, R., 2007. Planning and studying improvement in patient care: The use of theoretical perspectives. Milbank Q, 85(1), pp. 93-138, Joint Commission Mission, 2009. Measuring hand hygiene adherence: Overcoming the challenges [online]. Available at: http://www.jointcommission.org/assets/1/18/hh_monograph.pdf [Accessed 25 March 2013]. Kampf, G., 2004. The six golden rules to improve compliance in hand hygiene. Journal of Hospital Infection, 56, S3–S5 Larson, E., Quiros, D., and Lin, S., 2007. Dissemination of the CDC’s hand hygiene guideline and impact on infection rates. Am J Infect Control, 35, pp. 666–675. Mani, A., Shubangi, A., and Saini, R., 2010. Hand hygiene among health care workers. Indian Journal of Dental Research, 21(1), pp. 115-118. Oswald, W., Hunter, G., Lescano, A., Cabrera, L., et.al., 2008. Direct observation of hygiene in a Peruvian shantytown: not enough handwashing and too little water. Trop Med Int Health, 13, p. 1421 Pessoa-Silva, C., Hugonnet, S., Pfister, R., Touveneau, S., et.al., 2007. Reduction of Health Care–Associated Infection Risk in Neonates by Successful Hand Hygiene Promotion. Pediatrics, 20(2), pp. e382 -e390 Pickering, A., Boehm, A., and Mwanja, M., 2010. Efficacy of Waterless Hand Hygiene Compared with Handwashing with Soap: A Field Study in Dar es Salaam, Tanzania. Am. J. Trop. Med. Hyg., 82(2), pp. 270–278. Pittet, D. and Donaldson, L., 2005. Clean care is safer care: The first global challenge of the WHO world alliance for patient safety. Infection Control and Hospital Epidemiology, 26(11). Whitby, M., 2007. Behavioural considerations for hand hygiene practices: The basic building blocks. J Hosp Infect, 65, pp. 1–8. Whitby, M., McLaws, M., and Ross, M., 2006. Why healthcare workers don’t wash their hands: A behavioral explanation. Infect Control Hosp Epidemiol, 27, pp. 484–492. WHO, 2013. CleanHandsNet - a network of campaigning countries [online]. Available at: http://www.who.int/gpsc/national_campaigns/en/ [Accessed 25 March 2013]. World Health Organization, 2009. SAVE LIVES: Clean Your Hands. A briefing kit to advocate for action [online]. Available at: http://www.who.int/gpsc/5may/resources/slcyh_briefing-kit_website.pdf [Accessed 25 March 2013]. Read More