slides-accompanying-training-films英文汇报材料

SlidesAccompanyingTrainingFilms

TouseinEducationSessionsforTrainers,ObserversandHealth-CareWorkersHANDHYGIENESCENARIOS

Userinstructions(1)The“Trainingfilm”isatoolincludedintheWHOMultimodalHandHygieneImprovementStrategytohelpconveytheconceptofthe“My5MomentsforHandHygiene”approachtohealth-careworkersTheseslidesaredesignedtoaccompanythefilmandtoexplainthecontentandeducationalmessageofthedifferentscenariosTheconceptsincludedinthefilmsarethesameasthosepresentedinthe“EducationSessionsforTrainers,ObserversandHealth-CareWorkers”,the“HandHygieneWhy,HowandWhenBrochure”andinthe“HandHygieneTechnicalReferenceManual”Thefilmsshouldbeshownonlyafterallotherpartsofthe“EducationSessionsforTrainers,ObserversandHealth-CareWorkers”havebeenpresentedHANDHYGIENESCENARIOS

Userinstructions(2)Thismaterialismeantto:givevisualexamplesofthe5moments(indications)forhandhygienetohealth-careworkersandobserverstrainobserversinthecompletionoftheObservationFormThematerialcanbeusedinasinglesession(atleast2hours)orinseveralshortersessionsScenarios1–5:areintendedtobeusedtotrainbothhealth-careworkersandobserverseachscenarioisdedicatedtooneofthe5moments(indications)forhandhygienesomescenariosexistindifferentversionstohighlightdifferentaspectsHANDHYGIENESCENARIOS

Userinstructions(2)Scenarios6–9:areintendedtobeusedmainlytotrainobserversshouldbeusedwhilecompletingtheObservationFormshowexamplesofsequencesofhealthcareduringwhichseveralindicationsforhandhygieneoccurmissedhandhygieneactionsareshowninsomescenariosbutaduplicateofeachofthemisprovidedshowing100%handhygienecomplianceHANDHYGIENESCENARIOS

Userinstructions(3)Thesection“Howtodohandhygiene”includesthecorrecttechniqueforhandwashingandhandrubbingaccordingtothestepsandtimerecommendedbyWHOInpractice,thescenariosshouldbewatchedonebyoneandtheobservershouldcompletetheobservationform.DiscussionshouldthentakeplaceandtheslideswiththeexplanationandtheobservationformcorrectlycompletedshouldbefinallyshownThemenubarallowstofreelyswitchfromonescenariotoanother,butpleasenotethatthecurrentorderhasbeenconstructedasalogicalmodulewithprogressivelearningcomplexitySCENARIO1:Beforetouchingapatient

1a–WhileenteringthepatientsurroundingsContentThenurseopensthedoor(lastcontactwiththehealth-careenvironment),enterstheroomandgoestowardsthepatientWhileentering,sheperformshandhygiene(handrubbing)Shemovesthenighttable(contactwithanobjectinpatientsurroundings)Shehelpsthepatienttobringouthisarmfromunderthesheets(firstpatientcontact)KeymessagesThenurseperformshandhygienewhileapproachingthepatient.Shehandrubsbeforetouchingsurfacesandobjects;sincethesearepartofthepatientzone,itisnotnecessarytoperformhandhygieneagainbeforetouchingthepatient.Theindicationremains“beforetouchingapatient”SCENARIO1:Beforetouchingapatient

1b–JustbeforepatientcontactContentThenurseopensthedoor(lastcontactwithcareenvironment),enterstheroomandgoestowardsthepatient.Shemovesthenighttable(contactwithobjectinpatientsurroundings)Sheperformshandhygiene(handrubbing)Shehelpsthepatienttobringhisarmfromunderthesheets(firstpatientcontact)KeymessagesHandhygieneisrequiredbeforepatientcontacttoprotectthepatientfromharmfulgermscarriedonhandsfromthehealth-careenvironmentoutsidethepatient’ssurroundings.Contactwithsurfacesandobjectsinthepatientzonedonotstrictlyimplytheneedforhandhygiene,whereascontactwiththepatient’sskindoes.SCENARIO1:Beforetouchingapatient

1c–Handhygieneattherightmoment?ContentThenurseperformshandrubbinginthecorridor(handhygieneactionisuseless)Sheopensthedoor(lastcontactwiththeenvironmentinthehealth-carearea)andgoesintotheroomtowardsthepatientShehelpsthepatienttobringhisarmoutfromunderthesheets(handhygieneactionmissed)KeymessagesAfterperforminghandhygieneinthecorridor(additionalactionnotcorrespondingtoanyrecommendedindication),thenursetouchesthedoorhandleandthuspotentiallycontaminatesherhandwithgermsbelongingtothehealth-carearea.Shethenmissestheactionbeforetouchingthepatient,potentiallycontaminatinghimwiththosegerms.SCENARIO1:Beforetouchingapatient

1d–RepeatedpatientcontactsContentThenurseopensthedoor(lastcontactwithenvironmentinthehealth-carearea),enterstheroomandgoestowardsthepatientWhileentering,sheperformshandhygiene(handrubbing)

Shehelpsthepatienttobringhisarmoutfromunderthesheetsandmeasureshisbloodpressure(firstpatientcontact)Shemovestotheothersideof

thebedShemovesthenighttable(contactwithpatientsurroundings)Shetakesthepatient’srightarmandassessesfingermobility(patientcontact)Shebendsdowntoexaminetheurinecontentinthebagandthentouchesthebedwhilestandingup(contactwithpatientsurroundings)Shepoursaglassofwaterforthepatient(contactwithpatientsurroundings)SCENARIO1:Beforetouchingapatient

1d–RepeatedpatientcontactsKeymessagesThesequenceshowsseveralcontactswiththepatientandhissurroundings,butwithnoclean/asepticprocedurenorbodyfluidexposurerisk.Handhygieneiscorrectlyperformedonlyonce,beforetouchingthepatientforthefirsttime.Thereisnoneedforfurtherhandhygieneactionsbecausethenurseisalwaysmovingwithinthepatientzone.Attheendofthesequence,shehandrubsbuttheactionshouldnotberecordedastheobserverhasnoideawhetherthenurseactuallyleftthepatientandhiszone.SCENARIO2:Beforeclean/asepticprocedure

2a–Clean/asepticprocedurewithincaresequenceContentThenurseenterstheroomandplacestheinstrumenttraywiththeitemsreadyforinjectiononthenighttable(lastcontactwiththeenvironmentinthehealth-carearea)Sheperformshandhygienebyhandrubbing(indication:beforetouchingapatient)Shehelpsthepatienttobringhisarmoutfromunderthesheets(firstpatientcontact)Shemovesthenighttable

(contactwithpatientsurroundings)ShepoursantisepticontotheswabsSheperformshandhygienebyhandrubbing(indication:beforeclean/asepticprocedure)Sheopensthetapontheperipheralvenouscatheter,givestheinjectionandclosesthetapagain(aseptictask)KeymessagesThenursehasafirstdirectcontactwiththepatient(sheperformshandhygieneasindicated)andthepatientsurroundings;shethenrepeatsthehandhygieneactionbeforetheclean/asepticproceduretoprotectthepatientfromhisowngerms.SCENARIO2:Beforeclean/asepticprocedure

2b–Clean/asepticprocedureonlyContentThenurseenterstheroomandplacestheinstrumenttraywiththeitemsreadyforinjectiononthenighttable(lastcontactwiththeenvironmentinthehealth-carearea)ThepatientislyinginbedasleepwithaperipheralvenouscatheteronhisarmdirectlyaccessibletothenurseShepourstheantisepticontotheswabsSheperformshandhygienebyhandrubbing(indication:beforeclean/asepticprocedure)Sheopensthetapontheperipheralvenouscatheter,givestheinjectionandclosesthetapagain(clean/asepticprocedurewithoutdirectpatientcontact)KeymessagesTheclean/asepticprocedure

istheveryfirstanduniqueindicationinthisscenario.Thenursehasnodirectcontactwiththepatient.SCENARIO3:Afterbodyfluidexposurerisk

3a–Afterbodyfluidexposureriskwithin

acaresequence(missed)ContentThenurseisdrawingabloodsample(bloodexposurerisk)Whenshefinishes,sheremovesthetourniquet,putsaplasteronthepuncturesiteandputstheequipmenttogetheronthetray(continuingbloodexposurerisk)Shetakesoffherglovesandthrowsthemintothebin(continuingbloodexposurerisk)Handhygieneactionmissed(indication:afterbodyfluidexposurerisk)Shetakesthepatient'spulse

(nextpatientcontact)KeymessagesHandhygienemustbeperformedimmediatelyafterbodyfluidexposurerisk,beforetouchingeitherthepatientagainoranysurfaceandobjectwithinthepatient’ssurroundingsorcareenvironment,topreventpotentialdisseminationofgerms.Anycareactivityimplyingcontactwithbodyfluidsconstitutesariskbecauseexposuremaynotbevisiblebutmayhavehappened.SCENARIO3:Afterbodyfluidexposurerisk

3b–Afterbodyfluidexposureriskwithin

acaresequence(100%compliance)ContentThenurseisdrawingabloodsample(bloodexposurerisk)Whenshefinishes,sheremovesthetourniquet,putsaplasteronthepuncturesiteandputstheequipmenttogetheronthetray(continuingbloodexposurerisk)Shetakesoffherglovesandthrowsthemintothebin(continuingbloodexposurerisk)Sheperformshandhygiene(handrubbing)

Shetakesthepatient'spulse

(nextpatientcontact)KeymessagesThenurseperformscorrectandtimelyhandrubbingimmediatelyafterbodyfluidexposurerisk;herhandsarenotvisiblysoiledandshedoesnotneedtohandwashSCENARIO3:Afterbodyfluidexposurerisk

3c–Afterbodyfluidexposurerisk(handwashing)ContentThenurseisdrawingabloodsample(bloodexposurerisk)Whenshefinishes,sheremovesthetourniquetandputsaplasteronthepuncturesite(continuingbloodexposurerisk)Shegathersuptheequipment,goestothewashbasinandthrowsthewasteitemsintothebin(continuingbloodexposurerisk)Sheremovesherglovesandthrowsthemintothebin(continuingbloodexposurerisk)Shewashesherhandswithsoapandwater(afterbodyfluidriskexposureandaftertouchingapatient)KeymessagesThenurseperformscorrectandtimelyhandhygieneafterbodyfluidexposureriskandafterthelastpatientcontact(twoindicationswhichcorrespondtoonesingleopportunitythatrequiresonesinglehandhygieneaction).Sheperformshandhygienebyhandwashing.Handwashingwithsoapandwaterisrecommendedwhenhandsarevisiblysoiled.SCENARIO4:Aftertouchingapatient

ContentThenursetakesthepatient'sbloodpressure(lastpatientcontact)Sheleavesthepatientandgoestoatrolleywiththepatientchart(nocontact)Sheperformshandhygiene(handrubbing)

Shewritesinthefileonthetrolleyandthenleavestheroomwiththetrolley(firstcontactwiththeenvironmentinthehealth-carearea)KeymessagesThetrolleyisnotpartofthepatientsurroundings,thereforehandhygieneisperformedafterpatientcontact,beforetouchingthechartandthetrolley.SCENARIO5:Aftertouchingpatientsurroundings

5a–PatientsurroundingsContentThenurseauxiliaryenterstheroomwithatrolleyShetidiesupthenighttable(picksupemptybottleandglass)andcleansthetabletopSheplacesabottleofwaterandacleanglassonthetable(patientsurroundings)Sheperformshandhygiene(handrubbing)Sheleavestheroomwith

thetrolleyKeymessagesThereisnocontactwiththepatient,buthandhygienemuststillbeperformedaftercontactwithobjectsandsurfaces

inthepatient’ssurroundings.SCENARIO5:Aftertouchingpatientsurroundings

5b–Notpatientsurroundings!ContentThenurseauxiliaryenterstheroomwithatrolleyThepatientasksforaglassofwaterandthenurseauxiliarypourswaterintotheglass(patientsurroundings)Sheperformshandhygiene(handrubbing;indication:beforetouchingapatient)Shehelpsthepatienttositupinbed(firstpatientcontact)ShegivestheglasstothepatientwhodrinkssomewaterandthenhandstheglassbackThenurseauxiliarytidiesupthenighttable(picksupemptybottleandglass)Shecleansthetabletopand

putsabottleandacleanglass

onthetableSheperformshandhygiene(handrubbing;indication:aftertouchingapatient)SheleavestheroomwithtrolleySCENARIO5:Aftertouchingpatientsurroundings

5b–Notpatientsurroundings!KeymessagesThescenarioissimilarto5a.However,evenifthenurseauxiliaryhasnoinitialintentiontotouchthepatient,shemustperformhandhygienewhenthesituationimpliesadirectcontact.Sincethenurseauxiliaryhadacontactwiththepatient,thenextindicationisnolongeraftertouchingpatientsurroundings,butaftertouchingthepatient.SCENARIO6:Caresequencebreak

6a–Caresequencebreak(missed)ContentThedoctorenterstheroomandgoestowardsthepatientWhileentering,sheperformshandhygiene(handrubbing;indication:beforetouching

apatient)Sheshakesthepatient'shandandexamineshiskneeThepagerbeeps,thedoctorexcusesherselfandleavestheroomtoanswerthephoneinthecorridor(handhygieneactionmissed;indication:aftertouchingapatient)ThedoctorcomesbackthroughtheopendoorShecarriesonwiththephysicalexamination(handhygieneactionmissed;indication:beforetouchingapatient)SCENARIO6:Caresequencebreak

6a–Caresequencebreak(missed)KeymessagesAcaresequencebreakoccurs(thedoctoransweringthephoneinthecorridor,outsidethepatient’ssurroundings).Therefore,sheshouldperformhandhygieneafterleavingthepatient(topreventtransmissionofgermsfromthepatienttothehealth-careenvironment)andbeforetouchingthepatientagain(topreventtransmissionofgermsfromtheenvironmentinthehealth-careareatothepatient).Thesecarebreaksshouldbeavoidedasmuchaspossible.SCENARIO6:Caresequencebreak

6b–Caresequencebreak(100%compliance)ContentThedoctorenterstheroomandgoestowardsthepatientWhileenteringsheperformshandhygienebyhandrubbing(indication:beforetouchingapatient)Sheshakesthepatient'shandandexamineshiskneeThepagerbeeps,thedoctorexcusesherselftoanswerthephoneSheleavestheroomwhileperforminghandhygieneby handrubbing(indication:aftertouchingapatient)Thedoctorcomesbackthroughtheopendoorwhileperforminghandhygienebyhandrubbing(indication:beforetouchingapatient)ShecarriesonwiththephysicalexaminationKeymessagesSamesequenceas6a,butwithcorrectlyperformedhandhygiene(100%compliance)SCENARIO7:Betweenpatients

7a–Betweenpatients(missed)ContentThedoctorexaminespatientXWhenfinished,heleavesthepatientandshakeshishandHandhygieneactionmissed

(indications:aftertouching

apatientandbeforetouchingapatient)HeapproachespatientYandgreetsherbyshakingherhandKeymessagesTwoindicationsoccur(aftertouchingapatientandbeforetouchingapatient)andcorrespondtoonesingleopportunitythatrequiresonesinglehandhygieneaction.SCENARIO7:Betweenpatients

7b–Betweenpatients(100%compliance)ContentThedoctorexaminespatientXWhenfinished,heleavesthepatientandshakeshishandHeperformshandhygienebyhandrubbing(indications:aftertouchingapatientandbeforetouchingapatient)HeapproachespatientYandgreetsherbyshakingherhandKeymessagesSamesequenceas7a,butwith

properlyperformedhandhygiene(100%compliance).SCENARIO8:Physicalexamination

8a–Physicalexamination(missed)ContentThedoctorisbesidethepatientandlistenstohisheartbeatThenursecomesintotheroomwithatrolleySheperformshandhygienebyhandrubbing(indication:“beforetouchingapatient”)

ThenursehelpsthedoctortopropthepatientupinbedThedoctorexaminesthepatient'slungsThedoctorasksthenursetohandhertheexaminationequipmentHandhygieneactionmissed(indication:“beforeclean/asepticprocedure”)

Sheputsonglovestoexaminethepatient'smouthusingaspatulaandapentorchShehelpsthepatienttoopenhismouthandexaminesthemucousmembrane(contactwithmucousmembrane)SCENARIO8:Physicalexamination

8a–Physicalexamination(missed)ContentSomesalivadripsandthedoctorwipesawaythesaliva(bodyfluidexposure)Thenurseperformshandhygienebyhandrubbing(additionalhandhygieneaction,unnecessary)ThedoctorcompletesherexaminationShethrowsthewipesandspatulaintoabagandtakesoffherglovesandthrowsthemintothesamebagHandhygieneactionmissed(indication:“afterbodyfluidexposurerisk”)ThenurselowerstheheadofthebedThedoctorpalpatesthepatient'sabdomenThedoctorperformshandhygienebyhandrubbing(indication:aftertouchingapatient)SheleavesthepatientThenursetidiesupthepatient'ssheetsandremovestheinstrumenttraySheputsitdownbythewashbasinthenleavesroomHandhygieneactionmissed(indication:“after

touchingapatient”)Keymessage:thecareprocedureshowninthisscenariotakesplaceinasingleroom;thuswhenleaving,bothhealth-careworkersaremovingfromthepatientzonetothehealth-carearea.SCENARIO8:Physicalexamination

8b–Physicalexamination(100%compliance)ContentThedoctorisbesidethepatientandlistenstohisheartbeatThenursecomesintotheroomwithatrolleySheperformshandhygienebyhandrubbing(indication:beforetouchingapatient)ThenursehelpsthedoctortopropthepatientupinbedThedoctorexaminesthepatient'slungsThedoctorasksthenursetohandhertheexaminationequipmentSheperformshandhygienebyhandrubbing(indication:beforeclean/asepticprocedure)

Sheputsonglovestoexaminethepatient'smouthusingaspatulaandapentorchShehelpsthepatienttoopenhismouthandexaminesthemucousmembrane(contactwithmucousmembrane)Somesalivadripsandthedoctorwipesawaythesaliva(bodyfluidexposure)ShecompletesherexaminationShethrowsthewipesandspatulaintoabagandtakesoffherglovesandthrowsthemintothesamebagSheperformshandhygienebyhandrubbing(indication:afterbodyfluidexposurerisk)SCENARIO8:Physicalexamination

8b–Physicalexamination(100%compliance)ContentThenurselowerstheheadofthebedThedoctorpalpatesthepatient'sabdomenThedoctorperformshandhygienebyhandrubbing(indication:aftertouchingapatient)SheleavesthepatientThenursetidiesupthepatient'ssheetsandremovestheinstrumenttraySheputsitdownnearthewashbasinSheperformshandhygienebyhandrubbing(indication:aftertouchingapatient)SheleavestheroomKeymessagesSamesequenceas8a,butwithcorrectlyperformedhandhygiene(100%compliance)Keymessage:thecareprocedureshowninthisscenariotakesplaceinasingle-room;thuswhenleavingbothhealth-careworkersaremovingfromthepatient