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Infections halved when staff co-created their own hygiene routines in award winning GPCC project


Safe Hands at the Sharp End, a GPCC-financed research project which was led by Annette Erichsen Andersson, let staff create their own hygiene routines based on a person-centred approach, where they were seen as partners and experts during the implementation process. The project resulted in wound infections being halved and urinary tract infections being substantially reduced. The project was recently awarded two Swedish health care improvement prizes.

Annette Erichsen Andersson

An unusual interdisciplinary collaboration project was recently led by Annette Erichsen Andersson, Senior Lecturer at The Institute for Health and Care Sciences at Sahlgrenska Academy at the University of Gothenburg. The project, which was partly financed by GPCC, and was based on a person-centred approach, led to a reduction of wound infections and urinary tract infections in elderly patients undergoing hip fracture surgery. Wound infections were halved and urinary tract infections were reduced from 25.2 to 14.3 per cent.

The project has recently been given two Swedish health care improvement awards; the Sahlgrenska University Hospital Quality Prize 2018 and the Swedish Hygiene Award, which is awarded by the Swedish Association for Health Care Hygiene. The project was a collaboration between Sahlgrenska Academy at the University of Gothenburg and The Sahlgrenska University Hospital departments Anesthetics/Surgery, Orthopedics and Geratrics.

The project was awarded the Quality Prize for “focusing on how infections could be prevented by introducing individualized protection measures in fracture surgery. The study systematically contributed to a real change, reducing injuries and providing a high level of patient benefit.”

In summary, the project consisted of:

1. An evaluation a new implementation method, which was based on partnership, dialogue and co-creation of novel solutions for a safer health care in connection with invasive care procedures during surgery.

2. An evaluation of the effects of the intervention on postoperative infections.

The project is now in phaze three, where the ownership of the continued work has been handed over to the clinic.
- You never really complete the work, but as with everything else you need to work with organizational learning in everyday practice, Annette Erichssen Andersson explains. And just as in person-centred care you need to see the health care professionals as competent, able and active partners in change management. That is absolutely key to creating safe working practices which are meaningful in relation to the staff’s own context.

Annette believes that many health care environments have made attempts to improve ”compliance to hygiene routines”, yet haven’t managed to achieve this fully. Change methods used have often been seminars, revision and feedback, and the health care professionals have been viewed as recipients of information with the aim of following guidelines. Not as active partners and experts, whose experience is needed to co-create relevant solutions with regards to their own context.

Read the article "Iterative co-creation for improved hand hygiene and aseptic techniques in the operating room: experiences from the safe hands study", which was published in BMC Health Services Research here.