Monday, 10 February 2020

“Nurses and Midwives: clean care is in your hands”: The 5th May 2020 World Health Organization SAVE LIVES: Clean Your Hands campaign


Alexandra Peters1, Nasim Lotfinejad2, ChloĆ© Guitart1, Alice Simniceanu2, Maria Clara Padoveze2, Tcheun Borzykowski1, Benedetta 
Allegranzi2, Didier Pittet 1
1Infection Control Program, University of Geneva Hospitals and Faculty of Medicine
2Department of Research, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
3Infection Prevention and Control Global Unit, Department of Service Delivery and Safety, World Health Organization, Geneva, Switzerland

In honor of Florence Nightingale’s 200th birthday, the World Health Organization (WHO) has declared 2020 the “Year of the Nurse and Midwife”. In addition to championing the nursing profession, Nightingale’s role was also fundamental for the recognition of the importance of infection prevention and control (IPC), as she was among the first to recognize that a caregiver could transmit germs, and thus cause patient harm. Nurses and midwives make up nearly 50% of the global health workforce,1 and are the group of healthcare workers that have the most frequent contact with patients. This makes them pivotal figures in the fight against healthcare-associated infections (HAI) as well as neonatal and maternal sepsis.
On the 5th May 2020, for the annual celebration of the SAVE LIVES: Clean Your Hands campaign, WHO will focus on the essential role that nurses and midwives play in contributing to saving millions of lives each year by championing clean care. Despite many improvements around the world, rates of HAI remain unacceptably high, and the majority of them are transmitted by healthcare workers’ hands. Therefore, hand hygiene promotion strategies must be constantly reinforced and improved. Clean healthcare has recently been recognized by WHO as one of the most urgent challenges to be tackled by the global community over the next ten year.2 Actively engaging the expertise of nurses and midwives in the development, implementation and evaluation of hand hygiene promotion contributes to clean healthcare.
Along with recognizing the critical importance of nurses and midwives to patient care, the aim of the “Year of the Nurse and Midwife” is also to highlight that there is a major global shortage of healthcare workers, and that more than half of the shortage is of nurses and midwives.1 WHO estimates that for countries to succeed in reaching the Sustainable Development Goal # 3 on health and well-being, the world will need an additional 9 million nurses and midwives by the year 2030.1 It has been proven that investing in education and job creation in the health and social sectors will result in improved health outcomes, global health security, and economic growth.1  Having adequate healthcare worker staffing reduces the risk of HAI and antimicrobial resistance, and is thus recommended by WHO as a core component of effective IPC programmes.3
It is crucial to recognize both the work and the immense responsibility that nurses and midwives carry: we cannot achieve Universal Health Coverage without investing in them. Everyone- including policy makers, healthcare workers, and patients themselves- can contribute to improving hand hygiene and preventing infections (Table 1).
Table 1.

The 5 May 2020 World Health Organization SAVE LIVES: Clean Your Hands Campaign Calls to Action
Campaign Participants 
Call to Action 


Nurses 
Clean and safe care starts with you.”


Midwives
Your hands make all the difference for mothers and babies.”


IPC leaders 
Empower nurses and midwives in providing clean care.”


Policy makers 

Increase nurse staffing levels to prevent infections and improve quality of care. Create the means to empower nurses and midwives.”


Patients and families
Safer care for you, with you.”  



Abbreviations: IPC, infection prevention and control; WHO, World Health Organization.                                  

Please join us in celebrating this vital and often underappreciated group of HCW; “Nurses and Midwives: CLEAN CARE is in YOUR HANDS”!
References
1“Nursing and midwifery”. Fact sheets. World Health Organization. 9 January 2020. https://www.who.int/news-room/fact-sheets/detail/nursing-and-midwifery
2“Decade of Action” Geneva: World Health Organization. Accessed January 27, 2020. https://www.un.org/sustainabledevelopment/decade-of-action/
3“Guidelines on core components of infection prevention and control programmes at the national and acute health care facility level”. Geneva: World Health Organization; 2016. https://www.who.int/gpsc/ipc-components-guidelines/en/

Disclaimer: The views expressed in this article are those of the authors alone and do not necessarily represent the views, decisions, or policies of the institutions with which the authors are affiliated. The World Health Organization (WHO) takes no responsibility for the information provided or the views expressed in this article.

Financial support: This work is supported by WHO, Geneva, Switzerland, and the Infection Control Program, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland; hand hygiene research activities at the SPCI/WCC are also supported by the Swiss National Science Foundation (grant number 32003B_163262). Potential conflicts of interest. 

All authors: No reported conflicts of interest. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Conflicts that the editors consider relevant to the content of the manuscript have been disclosed

Editorial note: entries to JAN interactive are not reviewed and are published at the discretion of the Editor-in-Chief and may be subject to editing or removal by Wiley. We welcome replies, rejoinders, comments and debate on all entries provided they are not offensive or personal.

Sunday, 9 February 2020

Effects of a telehealth educational intervention on medication adherence in rheumatoid arthritis patients

Roger Watson, Editor-in-Chief

Telehealth is an attractive alternative to having patients visit hospital from home or having busy health professionals visit patients' homes from hospital. It offers economies of scale, the technologies involved are always improving and more people have access to those technologies. It is especially attractive in managing long-term conditions as these require regular maintenance but not, usually, direct intervention by health professionals. But, does it work?

A recent study from China by Song et al (2020) titled: 'A randomized controlled trial of the Effects of a telehealth educational intervention on medication adherence and disease activity in rheumatoid arthritis patients' and published in JAN aimed to: 'examine the effects of a tailored telehealth educational intervention on medication adherence and disease activity in discharged patients with rheumatoid arthritis'. The study involved nearly 100 patients and the intervention group received: 'four educational sessions delivered through a telephone across a 12‐week intervention' and the control group received instructions on discharge.

The patients were followed up at 12 and 24 weeks after the intervention and the intervention group 'had significantly higher medication adherence compared with the control group'; there was no effect on disease activity. The authors concluded: 'This study demonstrated that the tailored telehealth educational intervention by nurses could improve medication adherence. Based on our results, further studies should explore the long-term effects of patient education on medication adherence and disease activity.

You can listen to this as a podcast.

Reference

Song, Y., Reifsnider, E., Zhao, S., Xie, X. and Chen, H. (2020), A randomized controlled trial of the Effects of a telehealth educational intervention on medication adherence and disease activity in rheumatoid arthritis patients. J Adv Nurs. doi:10.1111/jan.14319

Editorial note: entries to JAN interactive are not reviewed and are published at the discretion of the Editor-in-Chief and may be subject to editing or removal by Wiley. We welcome replies, rejoinders, comments and debate on all entries provided they are not offensive or personal.