1. How in the real world are wemeasuring PPE compliance?

2. WHO guidelines for Handhygiene http://www.who.int/gpsc/5may/background/5moments/en/inde x.html

3. Perceived barriers to adherence withhand hygiene.... skin irritation caused by hand hygiene agents inaccessible hand hygiene supplies interference with HCWpatient relationships patient needs perceived as a priority over hand hygiene wearing of gloves forgetfulness lack of knowledge of guidelines insufficient time for hand hygiene high workload and understaffing lack of scientific information showing a definitive

4. So from our Fishbone Data....

5. Personnel Incident reports Surveys Education and training Communication

6. Environment Use of signage Counting the amount of PPE equipment being used Determining perceived comfort Changing hospital policy Making sure the equipment is available and in good supply Ease of access

7. Patients Education in the form of posters, signage, advertisements Use of an assessment scale And the use of surveys

8. How successful is PPEcompliance in the real world?This is what I found....

9. The Joint Commission.... The Association for Professionals in Infection Control and Epidemiology, Inc. The Centres for Disease Control and Prevention The Institute for Healthcare Improvement The National Foundation for Infectious Diseases The Society for Healthcare Epidemiology of America The World Health Organization World Alliance for Patient Safety

10. According to the JointCommission... Observation Product measurement Surveys

11. Using multiple methods to measurehand hygiene... Triangulation, or the use of more than one approach to study the same phenomenon. multiple perspectives can provide more and different information

12. Another example from the JointCommission.... Direct observation by frontline health care workers and training others to do the same Gathering of information about patients perceptions of health care worker hand hygiene practices, using a patient satisfaction survey. Monitoring of hand hygiene product usage system wide

13. Deciding on which aspects toobserve Type of product or agent used Thoroughness of cleaning Glove use

14. Determining who to observe Nurses, nursing assistants, orderlies, physicians, medical residents, pharmacists, and therapists Technicians/technologists Nonclinical staff Environmental staff Pastoral care, social workers, discharge planners Food service staff Transporters Vendors Students, visitors, patient sitters, parents/guardians

15. Determining who will conductobservations: Infection preventionists Other trained personnel Use of patients

16. Sample Observation Schedule