WURK Public Health Initiative | C. Dubois Matson

Hi, my name is Christine Dubois-Madsen and I will be presenting an initiative for the Introduction to Public Health course with instructor Dr. Chanoa Williams at Haasen University. This initiative will strive to reduce health care associated infections in adults 65 years or older seeking care at any health care facility in Maine through a multiplicity of actions. Thank you for watching. Health care associated infections are infections caused by a wide variety of common and unusual bacteria, fungi, and viruses while receiving medical care. The elderly population is particularly vulnerable to health care associated infections due to factors like impaired immune system, chronic disease, and frequent health care interactions. This concern is not new. For centuries we've known about health care associated infections. In mid-19th century, Ignaz Samuels groundbreaking discovery where he observed higher fevers in laboring mother due to the contaminated hands of medical students. This led to the foundation of infection control practices. For my research, I aim to identify what intervention strategies could be implemented by health care professionals including registered nurses, infection prevention and control staff, environmental services. One study used a mixed methodology of a survey in a focus group where they discovered that surveillance was not a priority for staff and that staff only reported the infection and antimicrobial reports 75.4 percent of the time to a committee to be reviewed. Additionally, in a quantitative study out of Trabones, Turkey is that seniors are 15.1 percent more likely to acquire a health care associated infection than those below the age of 60. Other research showed that using a hydrogen peroxide-based disinfectant to clean surfaces were not very effective with multi-drug resistant organisms and that a multi-modal approach is needed. And the multi-modal approach looks at sanitation using five key strategies, product and approach, technique, education, training, audit and feedback, and communication. The multi-modal approach incorporates new technologies and products in its sanitation procedures. In a cross-sectional study on multi-drug resistant organisms, they found that including electrostatic spraying, a hydrogen peroxide vapor, or UV lights were much more effective in removing more individual invisible microbes found in the room after a patient with multi-drug resistant organisms has left the room. Health care associated infections are a public health issue that affects communities worldwide and has a particular devastating effect on residents throughout our communities here in Maine. This campaign is created to address easy solutions that can have a huge impact on reducing unnecessary deaths in Maine. And if that doesn't persuade you, it will also save us money. They discovered that in 2023, these invisible microbes were the cause of approximately 1.7 million health care associated infections, which led to about 99,000 associated deaths in the United States. This resulted in roughly 30 billion in excess costs to the health care sector, money we could have better spent. With 55 percent of these adverse health outcomes potentially avoidable, the role of stakeholders in improving these outcomes is crucial. In fact, more crucial than ever. So what I propose is for the state of Maine to embark on an environmentally conscious initiative called the Maine Environmental Conscious Coalition, called MECC. This initiative, driven by the coalition of different health care facilities, creates a coalition where stakeholders can share the best ideas and technology. This collective effort with stakeholders at its core can significantly reduce health care associated infections across the health care facilities in Maine. This coalition in conjunction with Maine's already existing program, the Health Care Associated Infection and Antibiotic Resistant Program, known as HI-R program, could create a check and balance system for health care associated infections throughout Maine health care facilities. You see, the HI-R program already exists as a public health agency in Maine that collects and analyzes data on health care associated infections. The HI-R program then responds to any disease surveillance transmission threats that may pop up throughout Maine. Therefore, one organization, Maine Environmental Conscious Coalition, or MECC, aims to create unity and collaboration among health care facilities by using innovative technology and input from medical experts. In contrast with the other organization, the HI-R program will then test the results. Collectively, they will be looking to reduce the number of health care associated infections throughout the state of Maine. So, how does MECC plan to do that? First, through the establishment of the coalition, we will ensure collaboration and uniformity throughout the state. This will be facilitated by introducing a new data system, a crucial component that will provide 100% participation in health care associated infection reporting. Then, we will move on to standardizing infection control practices across all trial hospitals within the first year. Our goal for the following year is to achieve at least 30% reduction in health care associated infections within those facilities and a 95% or better compliance with the new infection prevention measures amongst the staff. After that, we plan to launch the WORK, as in W-U-R-K, Health Care Associated Infection Prevention Initiative for all health care workers in Maine. We set the success metric to educate 70% of Maine's facilities, aiming for a 30% increase in awareness and knowledge for those who have taken the course. Lastly, before we take this initiative public, we will first engage with colleagues and universities throughout Maine to educate 100% of the students entering into the health care profession and increase their awareness and knowledge of health care associated infections by 50%. This is an extensive initiative with a lot of funding needed for us to save thousands of lives. Therefore, to ensure that this initiative is effective and that our education is current, we will have already done the trial run in mid-Maine. In the pilot test, the MACC pulled from these few hospitals from both Waldo County and Hancock County. Some of these health care facilities received the WORK initiative, but the controlled facilities did not, and they went about business as usual. In this trial study, we evaluated health care workers' adherence to the current infection prevention control practices and all incidents of health associated infections. And what the MACC found was that health care professionals were washing their hands more often in these hospitals with the WORK initiative actively going on. In fact, those facilities met their target when being monitored, and those facilities are now running at a 95% compliance with health care associated infection protocols. Also, knowledge and skills have increased throughout those facilities, and this goal was easy to accomplish. We just had to have a few classes, and then the staff took it from there. It became quite the buzz conversation starter throughout the facilities that we tested it. And with so many health care professionals now interested, they continued to learn more information and discuss health care associated infections further with each other, really excelling on their awareness and education of health care associated infections. However, the most significant target was to achieve a 30% reduction in health care associated infections in patients, and MECC achieved this goal. So how, you ask, can we save people money? Well, it will require everyone to work together. First, stakeholders like health care administrators and public health leaders must manage and reduce the impact of existing infections. This prevention approach ensures that infection control policies are in place and that staff are well trained on the steps for which they are accountable for. For instance, a policy like the five moments of hand hygiene, where health care providers should be responsible for the cleanliness of their hands, should be implemented. This strategy encompasses a multi-layer approach to hand hygiene, including product and approach, needed for cleaning, technique, and education and training, audit and feedback, and communication. Other stakeholders include support staff like environmental cleaning services and infection prevention, who can be instrumental in reducing health care associated infections in our main health care system. The collaboration of these two departments is an excellent secondary approach to preventing the further spread of health care associated infections throughout the state of Maine. With infection prevention and environmental services working with new technology, sanitation could be more than just wiping hydrogen peroxide-based liquid disinfectant on surfaces. Collectively, they could introduce UVC transmission devices, pulsated Xeon UV lights, high-intensity narrow-spectrum lining, and aerosol or vaporized hydrogen peroxide disinfecting techniques throughout the state of Maine, further reducing health care associated infection. Now let's get to our primary stakeholder, the key to making this initiative work, the patient. They are the number one stakeholder and truly hold the key to making this initiative work. We will engage these stakeholders by launching the WURK, Work Health Care Associated Infection Prevention Initiative, throughout all health care facilities in Maine. By using the acronym URK, Work, our plan is to educate everyone on some key infection prevention practices. It is crucial that everyone takes part in the initiative as it is our collective action that we will reduce these numbers across the state. W, wash hands and hold others accountable for cleaning mirrors. U, use appropriate PPE as required. If you have a cold, mask up. If you're going to be around foreign agents, gown up, glove up appropriately so that you can help reduce the spread of infection. R, recognize signs of infection including redness, pain, swelling, fatigue, chills, fever, and organ dysfunction. And this leads me to K, keep your environment clean, specifically within hospital settings. Be aware of the surfaces that are most commonly spreading these infections and require that those surfaces be cleaned daily. We need to make it standard knowledge that anyone who seeks care at a health care facility in Maine knows that it's not only their right to a clean environment to get care, but is their obligation to keep it clean. And I'm not saying that it's up to them to be scrubbing toilets themselves, but they should not be acting like slobs. And if they see something dirty, say something, so that it can be addressed promptly. And this accountability to be mindful should extend to all those entering the patient care areas. This includes any visitors, family, friends, but honestly technicians, CNAs, nurses, providers, they all need to do their part as well. Being complacent of a dirty work environment in a health care setting puts their patients at risk. Isn't that non-maleficent if the surgeon continues to perform surgery after surgery, as he watches the teal dust bunnies grow in size each day and roll down these sterile halls? This is an example of a pamphlet or flyer in a provider's office or waiting room throughout all health care facilities. By providing educational information on the topics like the work initiative proposal, we are empowering patients to take an active role in their own health care. The fact is that educating patients is more likely to engage in discussions with their health care provider and make a more informed decision on their own treatment options. The ease and the accessibility of a quick grab and go pamphlet are perfect for allowing patients to read and absorb the information at their own pace without the pressure of feeling rushed. The work initiative hopes that by using these pamphlets and posters that we can improve patient education and contribute to better health outcomes. Therefore, if we look back at the 2023 health care associated infection statistic stating that in the United States 99,000 deaths were because of health care associated infections, then if this initiative was used during that time in 2023 throughout the United States, we could have potentially saved 29,700 lives and it could have saved us 525 million dollars. Thus, as the human population continues to age at an unprecedented rate, the challenges associated with a health care associated infections become increasingly urgent. In 1900, only one percent of the earth's population, that's about approximately 15 million people, were over the age of 65. However, by 1992 this number had increased to about six percent, roughly 342 million people. Currently, our projections for 2050, it is estimated that 20 percent of our global population will be seniors. That is 2.5 billion people. This demographic shift underscores the necessity of implementing robust infection prevention practices and implementing them fast. Let's face it, this is our future. If we're even lucky enough to make it over the age of 65, we need to address this issue and we need to do that. Health care and public health leaders must prioritize developing and implementing a comprehensive multi-layer approach to health care associated infection prevention, which is why the MECC is instrumental in getting this to work in reducing health care associated infections across the state. Much of this approach will help reduce morbidity and mortality rates among the most vulnerable populations in our health care system. Focusing on effective health care associated infection prevention measures can create significant positive change for all individuals utilizing the main health care system. Practices like these stop infections and save lives and work. So, to get this initiative to work, we need your support. 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