Editor’s Letter
The holiday season is upon us, and it brings with it joy, travel, family gatherings, parties, frantic shopping, additional cooking, stress, depression, overeating, excessive drinking, preventable accidents, and illnesses. All of us at NurseRecruiter.com want to wish you a happy and safe holiday season whether you are at work or at play.
The main focus of this month’s newsletter is the flu and, subsequently, a survey of studies on hand washing follows. Outbreaks of influenza cause multiple problems for many types of nursing facilities and, after all, December 2nd through 8th is National Influenza Vaccination Week. Have you had your flu shot? Have you washed your hands recently? I have also included tips taken from the website of the Centers for Disease Control (CDC) on how to have a healthy safe holiday season.
As always, if you have a topic of interest that you would like to see included in our newsletter, or if you know someone who might like to receive our newsletter, please send your suggestions to newsletter@nurserecruiter.com.
Christine Thompson
Editor, NurseRecruiter.com Newsletter
Flu Season and Prevention
Flu season is in full swing. With careful monitoring and preventative measures the spread of the virus can be mitigated. Each year in the US there are between 3,000 to 50,000 deaths due to the flu.
This flu season the World Health Organization (WHO) has recommended that people living in the Northern Hemisphere’s use the influenza vaccine made from three vaccine viruses. The three viruses are an A/California/7/2009 (h3N1) pdm09-like virus; an A/Victoria/361/2011 (H3N2)-like virus; and a B/Wisconsin/1/2010-like virus (from the B/Yamagata lineage of viruses). The final choice is given to each country, and for the US, it is the FDA who will make the decision. Most flu vaccines are of the trivalent variety which means they are composed of three flu vaccines, though very recently a 4 component vaccine was approved by the FDA.
It takes 2 weeks for antibodies to build up in the human body, so it is a good idea to get the shot early in the season because outbreaks are unpredictable. The effectiveness of the flu vaccine depends on the age and health of the person being vaccinated, and whether the flu virus the person is exposed to is covered by the vaccine. The vaccine works best in healthier populations but everyone aged six months or older should be vaccinated.
The CDC reports weekly updates on the spread of the virus on their website (http://www.cdc.gov/flu/weekly/summary.htm). The states currently above baseline levels are Alabama, Louisiana, Mississippi, Tennessee and Texas. Both A and B influenza viruses have been identified in cases this season with the majority of them cases reported being type A.
To prevent the spread of the virus, wash your hands often with soap or use alcohol based gels, cover coughs and sneezes with a disposable tissue, don’t touch your eyes, nose, or mouth, and avoid extended contact with infected persons. If you become infected with the flu, see a doctor and take antiviral medications to reduce the impact and duration of the illness.
Everyone must do their part to prevent the spread of the flu virus. It is everyone’s responsibility not to spread the disease and to proactively utilize preventative measures.
A Look at Handwashing
Several relatively recent studies have come out addressing one simple preventative measure against diseases, hand washing. One study funded by the American Academy of Pediatrics CATCH Grant and the Children’s Memorial Advocacy Fund demonstrated that if children were shown that they were not effectively cleaning their hands that they would improve their hand washing skills. The study was conducted in a pediatric hospital waiting room. Participating children were asked to rub GloGerm Gel (http://www.glogerm.com/) on their hands then look at them under a black light. The gel causes dirty spots to glow under the black light. Based on how dirty the hands were each child was given a designation from 1 to 4 from very dirty to very clean. The kids were then asked to wash their hands with soap and water and then revisit the black light. The children were able to have instant feedback and grading on the effectiveness of their hand washing technique. Half of the kids were then taught how to properly wash their hands and the entire test group was asked to return 2-4 weeks later to retest. Findings showed that every returning child improved on the cleanliness scale regardless of whether or not they had received the additional training. But, what about health care workers?
Patients in health care settings know that physicians should wash their hands before and after care, but according to a recent study published in this month’s issue of Infection Control and Hospital Epidemiology only about half of them would feel comfortable asking their doctors to do so.
Another study called a Feedback Intervention Trial (FIT) done by University College London (UCL) in connection with Health Protection Agency in the United Kingdom in 16 hospitals across 60 departments found that an intervention that included one on one feedback and a personalized action plan with health care workers was shown to improve their hand washing 18% on intensive care units and 13% on elderly acute care units and overall soap use increased by 30%. The study was done in part due to the sad statistics on health care worker’s hand washing compliance which according to the study were reported at 25% to 40% compliance levels in health care settings. This study was also done in conjunction with The World Health Organization’s WHO SAVES LIVES: Clean Your Hands (http://www.who.int/gpsc/5may/en/index.html) campaign which is a global campaign for clean care and patient safety in an effort to prevent the spread of diseases and reduce the spread of potentially life threatening infections in health care settings all over the world.
In a study of hand washing in emergency healthcare settings done by Dr. Arjun Venkatesh, an emergency medicine resident at Brigham and Women’s hospital in Boston, it was reported that bed location and health care worker type played a role in whether or not the worker washed their hands before treating patients. The study demonstrated that workers will often use gloves in place of hand washing, and that workers who move patients to new departments or rooms are unlikely to wash their hands. The study did find that 90% of the time proper hand washing techniques were used by staff and the study was to highlight areas where improvements could be made to prevent the spread of germs.
Using psychology to improve hand washing in a hospital was the focus of a study done by Adam Grant, a psychological scientist at The Wharton School, University of Pennsylvania and David Hofmann of the University of North Carolina at Chapel Hill. They noticed that the changing the language in hand washing signs from self interested language to patient centered language improved hand washing. One sign read, “Hand hygiene prevents you from catching diseases.” the other sign read, “Hand hygiene prevents patients from catching diseases.” They posted the two different signs above different hand washing stations and had trained co-researchers watch and document hand washing at the different stations. The stations with patient centered language signs went through 33% more soap and alcohol gel than the other stations, and workers were 10% more likely to wash their hands at stations with patient centered language signs than at stations with self interest signs.
Using shame to increase hand washing was the subject of a study by London School of Hygiene & Tropical Medicine and published in the American Journal of Public Health. The study used electronic signs in the entrance to bathrooms in public service stations to effect a change in hand washing behaviors. A quarter of a million subjects were in the study. Their use of soap was monitored using online sensors. The study found that 32% of men and 64% of women washed their hands using soap. Women responded to gentle reminders where as men needed a little more prompting and responded best to gross verbiage. The study varied the messages of the electronic signs with “Is the person next to you washing with soap?” being the most effective for both groups overall, and “soap it off or eat it later” being the most effective sign for the men.
Society for Healthcare Epidemiology of America. “‘Glowing hands’ in the waiting room improves kids’ handwashing.” ScienceDaily, 16 Jun. 2011. Web. 10 Dec. 2012.
University College London – UCL. “Personalized feedback makes healthcare workers twice as likely to clean their hands.” ScienceDaily, 23 Oct. 2012. Web. 10 Dec. 2012.
Society for Healthcare Epidemiology of America. “Study reports predictors of poor hand hygiene in an emergency department.” ScienceDaily, 3 Oct. 2011. Web. 10 Dec. 2012.
Association for Psychological Science. “Patients’ health motivates workers to wash their hands.”ScienceDaily, 30 Aug. 2011. Web. 10 Dec. 2012.
London School of Hygiene & Tropical Medicine. “Is The Person Next To You Washing Their Hands With Soap?.” ScienceDaily, 16 Oct. 2009. Web. 10 Dec. 2012.
Common Sense Health and Safety Tips for the Holidays
- Wash hands often with soap and clean running water for at least 20 seconds or use an alcohol based gel.
- Stay dry and warm by wearing weather appropriate clothing.
- Manage stress.
- Don’t drink and drive or let others drink and drive.
- Be smoke-free.
- Fasten seat belts.
- Get exams and screenings.
- Get your vaccinations.
- Monitor the children.
- Practice fire safety.
- Prepare food safely.
- Eat healthy and exercise.