irritant contact dermatitis .mcguckin and govednik pptx
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Irritant Contact Dermatitis
A Survey of Healthcare Worker Knowledge, Perceptions and Actions
Maryanne McGuckin, Dr. ScEd, MT (ASCP) President, McGuckin Methods International
John Govednik, M.S.Co-Principal Investigator, McGuckin Methods International
Funded by an unrestricted grant from Georgia-Pacific LLC. The authors have nothing to disclose.
Barrier or Missing Link?
• Irritant Contact Dermatitis (ICD) symptoms (dryness, itching, redness, swelling, chapped skin) are often cited as barriers to compliance.
• The reported incidence of ICD in healthcare workers (HCWs) attributed to hygiene has increased steadily from 1996 to 2012.
• 4.5 times more likely to suffer from dermatitis in 2012 than in 1996
Br J Dermatol. 2015 Jul;173(1):165-71. doi: 10.1111/bjd.13719. Epub 2015 Jun 2.
Barriers Supported by Research and Guidelines• Interventions/ Education• Hand Hygiene (HH) Compliance Measurements • Patient Empowerment• Public Reporting
Irritant Contact Dermatitis (ICD) Barrier 2016 • Literature supports causes of ICD• ICD effects patient care practices• Lack of measures published on HCW
knowledge, decisions, and support for addressing this barrier to compliance
• Practices not supported by guidelines
Objectives
• Identify sources for HCW knowledge of ICD on hands
• Identify HH behavior changes when HCWs experience ICD symptoms on hands
• Assess role of facility policy in HCW decisions to monitor and treat ICD on hands
Methods
• Society for Healthcare Epidemiology in America Research Network internet survey
• November/December 2015• Four components:
• Knowledge• Procedures to monitor and treat ICD• Organizational HH policies addressing ICD• Demographics of respondents
• Responses analyzed as percentage of total responses
Results
• 62 surveys completed (28% response rate)• 40 USA, 3 India, 2 Canada, 1 all others each
Results – HCW KnowledgeKnowledge Source Percent of RespondentsScholarly Journals 63%Colleagues 42%Medical Websites 34%HH Product Vendor Websites 26%
Results – HCW ActionAction Steps Percent of RespondentsConsult Employee Health 58%Use lotion/moisturizing products
53%
Use approved alternate soap/sanitizer
40%
Use personal, non-approved HH products
39%
• 15 % of respondents said ICD symptoms impaired their ability to perform patient services
• When you start to experience symptoms of irritated skin on your hands, what change in behavior do you make in regards to the following hand hygiene practices?
Use of… Much less often
Somewhat less often
The same Somewhat more often
Much more often
Soap and water 16% 15% 34% 13% 0%
Sanitizer 2% 19% 39% 13% 5%
Alternative soap product
0% 6% 19% 8% 6%
Alternative sanitizer product
2% 3% 23% 5% 6%
Hand drying with paper towel
5% 10% 34% 11% 3%
Hand drying with air dryer
8% 3% 16% 6% 2%
Moisturizing lotions
2% 0% 6% 21% 60%
Results – Policy Support
• 47% consulted their facility’s ICD policy• 8% said they don’t have, or are unaware of, any
policy to address ICD• 13% were unsure how symptoms of ICD were
monitored, 29% said no procedure exists to monitor symptoms
• 65% used self-reporting method to assess symptoms and make treatment decisions
Conclusion
• How we address ICD maybe one of the missing links to improving HH compliance
• No common guideline or action plan across facilities
• Lotions and moisturizers are clear choice• Must be seen as part of facility’s HH procedure
and not individual choice• Empower HCWs with proper knowledge, best
actions, and a supportive environment!
