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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)
