The document discusses why hand hygiene is important in healthcare settings but is often not properly practiced. It provides background on healthcare-associated infections, noting they affect 10% of hospitalized patients and are a major cause of death. Poor hand hygiene allows harmful bacteria like Streptococcus pyogenes to spread. While handwashing guidelines exist, complex barriers like lack of evidence, poor design of facilities, and lack of focus and feedback prevent adherence. A major factor is culture - role models who prioritize hand hygiene can influence others to make it a consistent practice and save lives.

1. WHY don’t we
WASH OUR HANDS?
Chris Nickson
The Alfred ICUh"p://lifeinthefastlane.com/ccc/hand-­‐hygiene/

2. No financial disclosures

3. The Problem

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

7. “made me so miserable
that life seemed
worthless”

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

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

10. CADAVEROUS
PARTICLES

11. The Problem
Today…

12. HAI
Healthcare Associated Infection

13. 10%
of hospitalised patients

14. 1 in 4
Are ICU patients

15. 100,000
Deaths per year (USA)

16. $5 BILLION
in costs per year (USA)

17. UTI
Wound infections
BSI
VAP

19. OUR HANDS ARE
MEANT TO HEAL,
NOT KILL

20. FIRST, DO NO HARM

21. The Solution

24. The Solution
Today…

25. Image
from
the
WHO
“5
Moments
of
Hand
Hygiene”

26. Timing is
Everything

27. Hand Hygiene
Hand
wash
Hand
rub

31. We still do not wash
our hands

32. Why don’t we
wash our hands?

33. NOT A
HAPPY
MAN!

34. “You Herr Professor
have been a partner in
this massacre!”

35. “I declare before God
and the world that you
are a murderer!”

38. Photo
by
Darwin
Bell
COMPLEX BARRIERS

39. LACK OF
EVIDENCE?

40. POOR DESIGN

41. LACK OF FOCUS

42. OBSESSION
WITH AUDIT

43. LACK OF FEEDBACK

46. “I forgot”

47. “I forgot”
“I’m busy”

48. “I forgot”
“I’m busy”
“I didn’t use my hands”

49. WHAT IS DIRTY?

51. Image
by
Vic
(Flickr)

53. BAD CULTURE

55. CULTURE
MATTERS

56. ROLE MODELS

59. Image
by
Tasha
Sturm

62. Final Words…
h"p://lifeinthefastlane.com/ccc/hand-­‐hygiene/

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

64. 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!

66. 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_Ma
ster_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)