Getting teams invested in hygiene post-pandemic

Even with the World Health Organization recently declaring an end to the global COVID-19 public health emergency, many communities remain vulnerable to infection, especially long-term care residents in nursing homes or assisted living facilities. 

More than three years since the start of the pandemic, hygiene must remain a top concern in long-term care facilities to prevent the spread of infection from COVID-19 and other pathogens. Moreover, hand hygiene is one of the most effective ways to ensure significant improvements in infection control, resident safety and quality of life, and to preserve the dignity and independence of residents.

Barriers to proper hand hygiene 

Throughout the pandemic, the public was reminded of the importance of hand hygiene so often that it became ingrained in many people’s  minds. The lesson that hand hygiene is a simple but highly effective method to prevent the spread of infection circulated quickly. But how many people also quickly forgot those lessons learned about hand hygiene? Because it is easy to forget, hand hygiene requires reeducation and ongoing reinforcement to ensure it is done correctly and consistently.

In addition to direct contact with other people, long-term care employees and residents touch various surfaces in their environment throughout the day. These high-touch areas include doorknobs, bedrails, light switches, walls around the toilet in the resident’s room and privacy curtains. Without realizing it, everyone also touches their mouths, noses and eyes, so it’s easy to become infected with a pathogen amidst so many touchpoints. Therefore, the most effective way to prevent the spread of infection is hand hygiene. Proper hand-hygiene practices remove those pathogens from hands, thereby breaking the chain of infection.  

Although critical to long-term care facilities, hand hygiene can pose challenges, especially around education and compliance. For example, a long-term care giver may not understand that gloves do not negate the need to wash their hands. Hand hygiene is also comprised of relatively simple procedures, so staff can become complacent when it comes to valuing the importance of hand hygiene and hand-hygiene education. Additionally, amidst staffing challenges, increased severity of residents’ conditions and heavy workloads, staff may cut corners to complete their assigned tasks.

Hand hygiene meets virtual reality 

Training is the most impactful conduit of tackling barriers to proper hand hygiene, but it can sometimes be neglected in health care facilities. In fact, research conducted by Essity for its Tork professional hygiene brand found that eight out of 10 health care professionals would like to receive better hand-hygiene training, and they want it to be based on facts and research. 

Based on this finding, Tork incorporates the interactive and engaging nature of virtual reality (VR) technology into hand-hygiene training. The Tork Clean Hands training, a complimentary VR and desktop-accessible program, lets users (in this instance, long-term care staff) take on the role of a nurse or physician to navigate a series of realistic hand-hygiene situations. 

VR training allows nursing home and assisted living staff the flexibility and autonomy to conduct their training when it’s convenient for them, and it gives them feedback on ways to improve. And because VR training is interactive and engaging in nature, users are more likely to remember the resident care scenarios and learnings in real-life situations. VR training is also convenient for those who are administering the programs, like directors of infection prevention or nursing, because it enables them to implement consistent training in different languages across their facilities.  

Hand-hygiene training begins on Day 1 for new employees. During onboarding, managers should walk through hand-hygiene protocols and then have new employees demonstrate the process in real-time to ensure compliance. Managers should also keep an in-service record of trainings and demonstrations on a facility-approved skills checklist and ensure that the training is repeated on an annual basis. Throughout the year, managers can reinforce hand hygiene during monthly infection control updates, staff meetings, beginning-of-shift rounds, and as needed when health care-associated infections (HAIs) occur. 

Data-driven cleaning can help improve hand hygiene

Aside from improved hand-hygiene training and education, another component of ensuring infection prevention across health care facilities is making sure products utilized for hand hygiene are readily available to staff, residents and visitors. Soap, hand sanitizer and towel dispensers must be easily accessible and adequately stocked. An empty dispenser is an infection preventionist’s nightmare because one person’s inability to properly wash or sanitize their hands can create a chain reaction in the spread of infections. Empty dispensers also increase a facility’s risk of receiving citations from regulatory agencies. The most common reason that dispensers might be left unfilled is a shortage of environmental services (EVS) staff, which many facilities are currently experiencing. When cleaning professionals are overwhelmed with more work on their plates, they become unable to service dispensers as quickly as needed. 

Today, the power of data-driven cleaning enhances infection prevention norms in health care facilities. For example, Tork Vision Cleaning leverages sensors to gather real-time usage data to notify facility staff exactly where and when a refill is needed before a product runs out. Data-driven cleaning technology also helps monitor visitor traffic to make staffing more efficient and optimize cleaning frequency. This facilitates more time for EVS staff and directors, and infection preventionists to focus their attention on other hygiene critical priorities.

Putting it all together 

In addition to implementing VR training and data-driven cleaning, there are a few other practices long-term care facilities can do to build a comprehensive hand-hygiene strategy. Signage, for example, puts hand-hygiene reminders “in your face,” so staff are far more likely to remember to do the act. Hand-hygiene reminders should be placed in common areas frequented by staff, including entrances and exits, elevators, bathrooms, breakrooms and staff lounges.

Skills days are another opportunity to re-educate team members on hand hygiene. They include demonstrations of the correct way to perform hand hygiene, as well as return demonstrations of hand hygiene — allowing staff to show evidence of what they’ve learned.

For hand hygiene to be seamlessly implemented in elderly care, it must be ingrained in long-term care facilities’ culture. Facilitywide, all employees need to understand that hand hygiene is everyone’s responsibility. It’s important to create a culture in which team members can coach their peers when they observe improper hand-hygiene practices or provide positive reinforcement when they observe good hand-hygiene practices. They also need to share the responsibility of monitoring dispensers and reporting empty or nonfunctioning dispensers to the designated person as soon as possible so the dispenser is replenished or repaired quickly. 

Hand hygiene not only ensures the safety of long-term care residents, but it also plays a pivotal role in delivering dignified, person-centered care. Being able to perform one’s own hand hygiene reinforces feelings of independence, dignity and self-worth. No one dreams of having their personal care performed by another person. Being able to perform portions of their activities of daily living independently improves their self-esteem, but to do so, residents need products and tools (sanitizer, soap and towel dispensers) that are easily accessible and easy to use, thereby allowing them to achieve good hygiene and live their lives to the fullest while maintaining their independence.   

Learn more about how Tork can help improve outcomes within long-term care facilities by visiting their website. 

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Marika White, MSN, R.N., Tork hygiene advisor, Essity.