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I’m pleased that February’s cover story on zero tolerance initiatives generated comments and questions from readers, because it deviated from our normal coverage of clinical issues in order to explore some of the underlying issues relating to human behavior—specifically that of healthcare professionals and why they may not be complying with perennial infection prevention issues such as handwashing. When I wrote the story, I wanted to get down to the crux of the matter—that human behavior is engrained over time, that intention is immutable, and that people will essentially not do anything that they do not believe in. This month, Kathy Dix looks at a related component of behavior modification—rewarding healthcare workers (HCWs) for doing the right thing. It’s more controversial than you might think—as you’ll read, one hospital CEO was the target of a torrent of negativity for rewarding HCWs for doing what is expected of them. Kathy shares with you several case studies that illustrate the various degrees of success that a rewards program can provide within the context of infection prevention compliance. Turn to page 16 to learn how doughnuts created quite a stir in Toronto.
I think there is great value in sharing information about various practices because one of the best ways to improve is to learn from others’ successes and failures. Kathleen A. McHugh, RN, BSN, CEO of the Association for Vascular Access, wrote me a letter about the "Zero Tolerance for Infections: A Winning Strategy" story (February 2008, ICT) in which she shares her experience: "With regard to catheter-related bloodstream infections (CRBSIs), at least one facility has convincingly demonstrated how to get to a zero infection rate. An article in the December 2007 issue of the Journal of the Association for Vascular Access describes a very successful bundle developed at Sutter (Calif.) Roseville Medical Center. After the bundle was implemented, Sutter had no CRBSIs for 15 months. The bundle combined several evidence-based practices and products, as well as measures to ensure compliance by all healthcare workers. Readers will find a summary of the article linked on the home page of the Association for Vascular Access ( www.avainfo.org). While more research on preventing CRBSI is needed, elimination of these infections over such a prolonged period is a notable achievement."
Speaking of success stories, I want to encourage you to send me your tales of hand hygiene-related initiatives that have worked in your facility. I’d like to collect these anecdotes as part of a larger article on hand hygiene compliance for an upcoming issue of ICT. I need your participation, so please don’t be shy! Send your success stories—long or short—to me at firstname.lastname@example.org by April 30, and please include your daytime contact information. Together, we can address HCW behavior issues and swap stories that just might spark a great idea for your facility or infection prevention program.
Until next month, bust those bugs!
Kelly M. Pyrek
Group editor, Virgo Publishing Medical Group