Fighting infection at hospitals

Strategies for health care workers during cold and flu season

Strong Enough to Care Enough is the motto for Children's Healthcare of Atlanta. As manager of infection prevention/epidemiology, Renee Watson takes that personally.
Her job is to keep hospital staff and patients as free from infection and illness as possible. At this time of year, it's a challenge.

“In the fall and winter we battle respiratory viruses, especially. It’s cold and flu season,” said Watson, RNC, BSN, CPHQ, CIC. “Children get viruses by virtue of who they are — they touch everything and carry those germs to their faces. Parents catch those illnesses and force themselves to go to work anyway, so it spreads. It’s a vicious cycle and a work force challenge at this time of year.”

Since caring for the sick is their business, health care workers are at a greater risk of catching and spreading illnesses, especially during winter.

“Part of my job is to empower people with knowledge about how to care for themselves and others. Patient safety is everyone’s responsibility and my department takes every opportunity to remind people about the simple steps workers can take to protect themselves, their patients and their families,” Watson said.

Here are five strategies to help cut the spread of infection and illness.

1. Get a flu shot.

“The peak of the flu season varies from year to year, but it takes two weeks for the vaccine to protect your body, so get it early,” Watson said.

This is a condition of employment at CHOA and at many other hospitals.

“Research has shown that the more people are immunized against flu, the better it is for a community as a whole,” she said. “It’s especially important at CHOA because infants younger than 6-months-old cannot be immunized, and workers can infect others before they know that they are sick.”

Information is another helpful weapon to fight flu and flu-like illnesses. CHOA's website (www.choa.org/flu) offers parents guidelines in recognizing flu symptoms, how to treat the symptoms and deciding when to take family members to a doctor or emergency room.

2. Wash your hands frequently.

“Hand-washing with soap and water or alcohol-based sanitizers is at the foundation of all our efforts to prevent infection,” Watson said. “Poor hand hygiene is the most common way a child or anyone can get an infection.”

Because health care workers need to be especially vigilant, CHOA launched a hand-hygiene campaign in 2006, called Good Health is In Your Hands.

“We were hearing that hand-washing compliance was only at around 40 percent nationally in hospitals. The campaign was to remind health care workers of the importance of this practice and to make others aware of the need. We gave people permission to remind us and each other,” Watson said.

Seeing a bump in compliance numbers, CHOA stepped up the program with its Foam UP campaign in 2007 and 2008.

“We thought Foam UP was a nonthreatening way to remind every hospital worker to wash his hands upon entering patient rooms. We installed 4,000 soap and sanitizer dispensers in our facilities to make it easier, and the campaign proved very successful,” she said.

Today, CHOA’s hand-hygiene compliance rate is at 98.4 percent while the national rate is only 48 percent. Hand hygiene and other measures have also helped the health system greatly reduce the incidence of central line-associated bloodstream infections and ventilator-associated pneumonia.

3. Disinfect high-touch surfaces.

People think of bathrooms as the most germ-infected environment, but the workplace offers plenty of surfaces that can increase your risk of disease. Keyboards, phones, copiers and other office machinery, water fountains and elevator buttons can be germy. Using disinfect wipes to clean shared surfaces on a regular basis keeps everyone safer.

4. Use good respiratory hygiene.

Always cover your cough or a sneeze into a tissue. "If you don't have a tissue, use your elbow or sleeve rather than your hand, and wash your hands after coming into contact with secretions," Watson said.
Health care workers who come into close contact with patients who have respiratory illnesses may need to wear gloves and masks.

5. Stay home and get your rest.

“If you are sick with fever, you should distance yourself from patients and others as much as possible,” she said. “The rule of thumb is to stay home at least 24 hours after your fever has broken.”

Health care workers often think they must come to work no matter what, but most hospitals have mechanisms to handle staffing when an employee needs to stay home.

“Our central staffing office crosstrains workers to fill in when people call in sick and other workers are on call. That gives us back-up and helps ease the burden of absent workers,” Watson said. “So if you’re sick, stay home and rest. If you come to work, you could expose others to your illness and make yourself even sicker.”

When it comes to preventing infection, Watson borrows an approach from legendary football coach Vince Lombardi, who said, “Perfection is not attainable, but if we chase perfection, we can catch excellence.”

“Fighting infection in hospitals is a huge job,” she said. “We can’t stop everything, but if we keep exploring every avenue to keep our patients and our workers safe, we can improve care.”