Why Don't We Wash Our Hands?

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WHY don’t we WASH OUR HANDS?

Chris Nickson The Alfred ICU

h"p://lifeinthefastlane.com/ccc/hand-­‐hygiene/  

No financial disclosures

The Problem

Image  by  Tom  Adriaenssen    h"p://www.flickr.com/photos/inferis/110652572/  

“made me so miserable that life seemed

worthless”

Image  by  Rafael  Anderson  Gonzales  Mendoza  h"ps://www.flickr.com/photos/andercismo/2349098787  

Source:  h"p://en.wikipedia.org/wiki/File:Streptococcus_pyogenes.jpg  

CADAVEROUS PARTICLES

The Problem Today…

HAI Healthcare Associated Infection

10% of hospitalised patients

1 in 4 Are ICU patients

100,000 Deaths per year (USA)

$5 BILLION in costs per year (USA)

UTI Wound infections

BSI VAP

Image  by  Vic  (Flickr)  

OUR HANDS ARE MEANT TO HEAL,

NOT KILL

FIRST, DO NO HARM

The Solution

The Solution Today…

Image  from  the  WHO  “5  Moments  of  Hand  Hygiene”  

Timing is Everything

Hand Hygiene

Hand wash

Hand rub

We still do not wash our hands

Why don’t we wash our hands?

NOT A HAPPY MAN!

“You Herr Professor have been a partner in

this massacre!”

“I declare before God and the world that you

are a murderer!”

Photo  by  Darwin  Bell  

COMPLEX BARRIERS

LACK OF EVIDENCE?

POOR DESIGN

LACK OF FOCUS

OBSESSION WITH AUDIT

LACK OF FEEDBACK

“I forgot”

“I forgot” “I’m busy”

“I forgot” “I’m busy”

“I didn’t use my hands”

WHAT IS DIRTY?

Image  by  Vic  (Flickr)  

BAD CULTURE

CULTURE MATTERS

ROLE MODELS

Image  by  Tasha  Sturm  

Final Words…

h"p://lifeinthefastlane.com/ccc/hand-­‐hygiene/  

CULTURE MATTERS

h"p://lifeinthefastlane.com/ccc/hand-­‐hygiene/  

h"p://lifeinthefastlane.com/2009/04/laws-­‐for-­‐the-­‐naviga^on-­‐of-­‐life/  

The  22nd  of  Peter  Safar’s    Laws  for  the  Naviga^on  of  Life  

It is up to us to save the

world!

All images used for non-commercial educational purposes under a Creative Commons license from the following sources (exceptions noted where possible; see slide number below):��4. https://en.wikipedia.org/wiki/Ignaz_Semmelweis#/media/File:Ignaz_Semmelweis_1860.jpg�5. http://www.flickr.com/photos/inferis/110652572/    6. https://en.wikipedia.org/wiki/File:Yearly_mortality_rates_1841-1846_two_clinics.png 18 and 50. https://www.flickr.com/photos/59632563@N04/6104068209 23. https://en.wikipedia.org/wiki/File:Monthly_mortality_rates_1841-1849.png 25. http://www.hha.org.au/home/5-moments-for-hand-hygiene.aspx 28. http://www.freestockphotos.biz/stockphoto/15288 29. https://commons.wikimedia.org/wiki/File:Ethanol-3D-balls.png 30 and 45. http://www.medicaldaily.com/hand-washing-antibacterial-soap-isnt-any-more-effective-clearing-bacteria-plain-old-352968 31. https://commons.wikimedia.org/wiki/File:USMC-101008-M-1558F-390.jpg 33 to 35. https://commons.wikimedia.org/wiki/File:Ignaz_Semmelweis_1863_last_image.jpg 36. Unknown 37. https://en.wikipedia.org/wiki/Straitjacket 38. https://www.flickr.com/photos/darwinbell/ 39. https://commons.wikimedia.org/wiki/File:FBI_Evidence_Response_Team.jpg�40. https://commons.wikimedia.org/wiki/File:Bad_Sink_Design_LA.JPG 41. https://pixabay.com/en/bokeh-lights-blurry-blur-effect-336478/ 42. https://blog.bikersden.com/wp-content/uploads/2014/05/Mexico_City_motorcycle_police_officer_writing_a_ticket.jpg 48. https://commons.wikimedia.org/wiki/File:Yorkshire_pigs_at_animal_sanctuary.jpg 49. Unknown 50. https://commons.wikimedia.org/wiki/File:Michelle_and_Barack_Obama_fist_bump_DNC_2008.jpg 52. https://www.flickr.com/photos/jamescridland/613445810 53. https://commons.wikimedia.org/wiki/File:From_left,_U.S._Air_Force_Lt._Col._Richard_Degrosa,_an_emergency_room_doctor;_Lt._Col._Gerald_Fortuna,_a_trauma_surgeon;_and_Master_Sgt._Jose_Arias-Patino,_an_operating_room_surgical_technician,_all_with_140117-F-RW714-754.jpg 55. Credit CSA/NASA; http://www.asc-csa.gc.ca/eng/astronauts/living-hygiene.asp 56 and 57. Credit Chris Nickson 58. Credit Tasha Sturm; http://twistedsifter.com/2015/06/microbiologist-takes-sons-handprint-and-incubates-the-results/ 59. https://commons.wikimedia.org/wiki/File:Shame_grafitti.jpg 60. https://commons.wikimedia.org/wiki/File:US_Navy_090606-N-9988F-814_Brigadier_General_Harry_Polumbo_adjusts_his_seat_belt_before_his_familiarization_flight.jpg Video clip of feedback given to little boy washing hands; credit Chris Nickson (all rights reserved)

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