Lindsay Shaw

On the ward

1. An Infection Control Practitioner provides continuous monitoring on the ward for evidence of cross contamination. Environmental swabs are performed on a regular basis.

2. Individuals with CF do not share a room or bathroom with another individual that has CF. They may, however, share a room or bathroom with an individual that does not have cystic fibrosis.

3. Individuals with CF are assigned a shower based on the type of bacteria that they grow in their sputum (cepacia negative, Burkholderia positive, or cepacia positive). Showers are cleaned after each use. If desired, individuals may be given a day pass to go home and shower.

4. Staff are required to wash their hands and then put on a yellow gown and gloves upon entering your room and examining you. The gown and gloves are discarded upon leaving the room.

5. Nurses are assigned to patients based on what bacteria they have in their sputum; so that a nurse who is looking after someone who has Burkholderia cepacia complex does not also look after a cepacia negative patient. 

6. All rooms are cleaned and disinfected once an individual has been discharged

Monitoring of Hand Hygiene on the Ward

Hand hygiene is the responsibility of all individuals involved in health care.

Hand hygiene means removing or killing microorganisms (bacteria and viruses) on the hands

There are two methods of removing/killing microorganisms on hands: washing with soap and running water or using an alcohol-based hand rub.

Alcohol-based hand rub is the preferred method for decontaminating hands.
Using alcohol-based hand rub is better than washing hands (even with an antibacterial soap) when hands are not visibly dirty.

How to use the alcohol-based hand rub

Apply between 1 to 2 full pumps of product, or squirt a loonie-sized amount, onto one palm.
Spread product over all surfaces of hands, concentrating on finger tips, between fingers, back of hands, and base of thumbs. These are the most commonly missed areas.
Rub hands until product is dry. This will take a minimum of 15 to 20 seconds if sufficient product is used.

SmartPump

The CF ward is part of a pilot project to assess an automated hand hygiene monitoring system (SmartPump) to track how well staff follow hand hygiene guidelines.

The SmartPump system includes sensors for existing wall-mounted dispensers (soap and alcohol) in the ward including in patient rooms. These sensors record each time a dispenser is activated.
Data regarding how many patients are admitted on the ward, the type of unit and the severity of illness of the patients is fed into the system to create an estimate of how many hand washes in a 24-hour period should be occurring.

A hand hygiene compliance number is calculated as: number of actual hand washes per 24 hours ÷ extimated number of hand washes expectede in 24 hours X 100

Although the estimated number of hand washes may not be completely accurate, general calculations that we have done on the CF/Respirology ward suggest that this number is fairly accurate.

This system allows accurate monitoring around the clock and results are provided within 24 hours.

Weekly reports are created and posted on the ward and also on this website.

When this system is compared to audits where a person comes to the ward and watches the staff to see if they are washing their hands, the SmartPump system gives results that are much lower than the visual audit.

The audit of the CF/Respirology ward shows hand hygiene compliance of 85-90% whereas the SmartPump system shows compliance of 25-50%. These initial results show that we have room for improvement and initiatives are underway to increase the amount of hand washing that is done on our ward.