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February 20, 2017/Nursing/Innovations

Sore Hands Lead to a Sound Idea

A team of nurses and others creates a hand hygiene tool


Many of the best practices in healthcare have humble beginnings and involve teamwork. That’s the case with a simple, yet innovative solution at Cleveland Clinic’s main campus that began with an assistant nurse manager and now involves the health system’s Medicine Institute – and others.


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A project spearheaded by nurses on two internal medicine units is helping Cleveland Clinic work toward its goal of 100 percent hand hygiene compliance.

Swapping out hand-sanitizing products

In January 2016, Nita Kollar, BSN, RN, assistant nurse manager on an internal medicine unit at main campus, noticed that a PCNA who had only worked on the unit for two days had bleeding, cracked and peeling hands from frequently using the foam hand sanitizer. Kollar began looking at the hands of other caregivers and realized many of them were experiencing the same problems.

Clearly, sore hands were a barrier to hand hygiene. Kollar and Jared Leal, BSN, RN, nurse manager on the unit, began considering alternatives to the foam. They talked to a nurse who carried her own personal 4-ounce bottle of Cal Stat® Plus antiseptic hand rub. She began sharing the product with other nurses, who all agreed it was gentler on their hands.

But finding a replacement hand-sanitizing product was only part of the solution. Another barrier to hand hygiene identified by the nurses was inconvenient placement of hand sanitizers. “Things that are out of sight tend to be out of mind,” says Leal. “If we wanted to make hand hygiene a priority, we had to put the hand rub in a convenient place – on our workstations on wheels (WOWs). If you look at nursing workflows, that’s the tool we use all the time.”


Making hand hygiene more convenient

Kollar and Leal presented the problem and idea at a leadership event for inpatient medicine nursing managers. Attendees considered options, such as placing a basket on the WOW to hold the antiseptic hand rub. “We realized that wouldn’t work because if you put a basket on a WOW, nurses will just fill it with junk,” says Leal. “We needed a specific holder.”

That’s when Rochelle Smith, BSN, RN, nurse manager on another internal medicine unit, had an idea. She presented the challenge to Travis Scott, an equipment technician at Cleveland Clinic. He, in turn, discussed the problem with Robby Varga, who works in the machine shop. Within days, Varga created a stainless steel holder for the hand sanitizer that attaches to either the WOW desktop or the side handle via double-sided tape. “It was perfect!” says Leal.

In mid-February 2016, Smith ordered enough holders for her entire unit. By the end of the week, all the internal medicine units ordered them. “We thought that’s where it was going to end, then people on other units and at other Cleveland Clinic hospitals kept asking for them,” says Leal.

By the beginning of 2017, Varga had made more than 800 holders for use across the Cleveland Clinic healthcare system. Leal is currently working with Cleveland Clinic Innovations on options for commercializing the solution. He’s also in contact with WOW manufacturers about redesigning workstations to incorporate tools such as the hand sanitizer holder.

Leal is proud of the nursing team for leading this innovation. “We’re the ones working with tools each day, so we need to speak up and share our innovations in order to improve nursing practice,” he says. But he readily admits that nurses couldn’t have done this alone.

“This was a team effort,” says Leal. “This wasn’t just one nurse – or all of nursing. It included our leadership, equipment technicians and the machine shop. How cool is that? When you get people with different specialties in one room, look what you can achieve!”

Nursing innovation can revolutionize healthcare by improving patient outcomes, streamlining processes and reducing healthcare costs. The 6th Annual Nursing Innovation Summit will highlight successful invention experiences, provide education on the cultivation of ideas, offer resources to create solutions and much more. Join us on Friday, Oct. 19 in Warrensville Heights, Ohio. Click HERE to register!


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