IN THE HEALTHCARE ENVIRONMENT
by Jason Tetro
Microbiologist, Columnist and Author of the Science Bestseller The Germ Code
Hand hygiene compliance
continues to be a problem in healthcare environments despite
the introduction of sophisticated monitoring systems.
The solution is simple but effective — a small foldable shelf — used
in combination with hand sanitizer,
and installed in a variety of healthcare environments.
In addition to providing hand hygiene, the sanitizing station
offers co-workers the opportunity
to interact in the work environment.
in the benefits of hygiene.
Historically hygiene, both physical and social, was something performed in small, public locations where people gathered. The practice began with the Ancient Greeks, who developed the Asclepia1, named after Asclepius, the Greek God of Medicine and Doctors. Asclepia were structures that not only served as a place to escape the rigors of daily life, but they were also place to heal.2 These environments offered both healers and patients a place where they could join together in small numbers and share their mutual interest in learning about, and improving, overall health. Often, these structures were located close to fountains and pools, thus providing access to fresh water. Through the powerful combination of thought and opportunity, the Ancients found a way to improve personal hygiene.
The use of open and public spaces for public gatherings expanded over time to include the development of the Roman piazza. These community squares became not only places where people could congregate at will, but they were also places that gave the citizens the opportunity to express themselves, thus sanitizing their minds, if you will. This form of social hygiene resulted in a happier and healthier society. Not surprisingly, the concept of the public square is an enduring one and it continues to be used today, contributing to the improvement3 of the overall health of those who live in urban environments. Granted, our modern work environments cannot accommodate piazzas in every ward or office, however the possibility does exist to combine a meeting place with the already established methodology for hand hygiene. The installation of small foldable shelves, used in conjunction with hand sanitizer, everywhere in the healthcare environment can offer the same opportunities as the piazzas of old.
The concept has proven its efficacy in the recent past. At the turn of the 20th Century, the folding shelf was a standard piece of equipment on hospital ships in the United States Navy.4 These compact shelves were used for a plethora of functions, from serving food to providing a resting place for objects to free up the hands. But, more importantly, they served much like the Asclepia, a meeting place for both patients and doctors to discuss health.
In the modern healthcare facility, the folding shelf offers the perfect opportunity to go back to the future and re-establish the physical
hygiene-improving principles of Asclepius, and the social hygiene functions of the piazza. In the context of today’s necessity for infection prevention and control, a merger between the shelf and hand hygiene may offer the best of both worlds. A healtHcentric Utility Shelf can provide the opportunity for people to gather, take a few moments to set down whatever is in their hands, engage in discussion, and perform hand hygiene more effectively as peers rather than as individuals.
The water-fountain piazza may be long gone,
but we can still use their concepts to improve
our overall health.
In this regard, over the last decade, a handful of studies have shown that an improvement in hand hygiene compliance has improved infection prevention and control. From huddles5, to executive walk-arounds6, to group contests7 the key to success is the grouping of staff members both formally and informally. The foldable shelf, placed in patient rooms or hallways, offers a spur of the moment opportunity to engage, share information and improve work flow, as well as improve hand hygiene. The shelf allows workers to take a few moments to talk with patients and visitors while passively demonstrating good hand hygiene. Moreover, practical education can be shared passively through engagement and enrichment. As studies have revealed, hand hygiene is an effective way to de-stress and deal with challenging decision making.8/9
The days of the Asclepia and the water-fountain piazza may be long gone, but we can still use their concepts to improve our overall health. From improved hand hygiene to improved job satisfaction, the folding healtHcentric Utility Shelf can provide the perfect opportunity for passive preparedness and improved overall physical and social health.
The healtHcentric Utility Shelf is a folding, multi-purpose utility shelf. It’s simple, easily cleaned and affordable. The unit has a non-slip surface and is ideal for patient rooms, laboratories and hallways, or anywhere a temporary surface is required. This convenient surface allows healthcare practitioners to set down items and apply hand sanitizer. It folds to a low profile that does not protrude past the standard handrail, posing no risk to patients or staff.
The healtHcentric Utility Shelf, in combination with a measure of hygiene such
as hand sanitizer, provides opportunities for healthcare practitioners to
interact with one another, patients and visitors, while engaging in proper hygiene practices.
1 – Roland, G., Curtain, M. D. Aesculapian Temples of Health Compared with our Modern Resorts.
2 – History of Medicine Division National Library of Medicine National Institutes of Health.
Greek Medicine “I Swear by Apollo Physisan…”: Greek Medicine from the Gods to Galen.
3 – Semenza, Jan, G., March, Tanya, L., and Bontempo, Brain, D. Community-Initiated
Urban Development: An Ecological Intervention. (2007).
4 – Stevenson, Beatrice Van. H. A Visit to the “Solace,” the Hospital Ship of the
United States Navy. The American Journal of Nursing, Vol. 11, No. 3 (Dec., 1910).
5 – Dunn-Navarra, Ann-Margaret., Cohen, Bevin., Stone, Patricia W., Pogorzelska, Monika.,
Jordan, Sarah., Larson, Elaine. Relationship between Systems-Level Factors and Hand Hygiene Adherence. Journal of Nursing Care Quality. January/March 2011. Vol 26, Issue 1. P 30-38.
6 – Whitby, Michael., McLaws, Mary-Louise., Slater, Karen., Tong, Edward., and Johnson, Barbara. Three successful interventions in health care workers the improve compliance with hygiene:
Is sustained replication possible? (2008). Association for Professionals in Infection Control
and Epidemiology, Inc.
7 – Marra, Alexandre R., Guastelli, Luciana Reis., Pereira de Araújo, Carla Manuela., Saraiva
dos Santos, Jorge L., Filho, Miguel Almeida O., Silva, Claudia Vallone., Kawagoe, Julia Yaeko.,
Neto, Miguel Cendoroglo., dos Santos, Oscar Fernando Pava ̃o., Edmond, Michael B. Positive deviance: A program for sustained improvement in hand hygiene compliance. (2011). American Journal of Infection Control.
8 – Chen-Bo, Zhong., Liljenquist, Katie. Washing Away Your Sins: Threatened Morality
and Physical Cleansing. Science 8. September 2006. Vol. 313, No. 5792. P. 1451-1452.
9 – Lee, W. S. Spike., Schwarz, Norbet. Washing Away Postdecisional Dissonance. Science 7.
May 2010. Vol. 328, No. 5979. P 709.