Meet GUS, also known by many as Uncle GUS. GUS is a frequent visitor at the Iroquois Lodge, a 50-bed long-term care facility in Oshweken, Ontario. GUS, short for Germs United in Sickness, is the brainchild of Wendy MacDougal, Staff Development Nurse at Iroquois Lodge, who uses costumes and props to advance learning for staff and residents. GUS often visits the Lodge, schools and other healthcare facilities on the Six Nations reserve to promote hand hygiene practices. Last fall, when GUS visited the Lodge to endorse the influenza vaccination, 100 per cent of staff and residents complied.
“People learn better when they have fun,” says Wendy. “Germs are invisible and it is so easy to forget they are there. When I appear in a costume, it makes a connection and inspires people to do the right thing.”
The Iroquois Lodge has alcohol hand rub dispenses at all points of care and Wendy wanted to find out if they were being used. She utilized the Canadian Hand Hygiene Audit tool to gather and analyze the data. Wendy observed interactions between caregivers and residents, and with dietary staff, a physiotherapy assistant, environmental staff, and activity aide and a manager during the audit.
In preparation for the audit, Wendy told the staff that she wanted to observe lifts and how transfers were being made. She showed up at 7:00 am and once the residents were dressed and ready to be transferred to a wheelchair, Wendy entered the resident’s room. She offered no feedback as the lifts were used to transfer the residents, but a held a debriefing later in the morning, once the resident’s care was done. The staff were devastated by their results.
Wendy talked to the staff about communication – with their colleagues, as well as with residents. She addressed infection control to debrief on hand hygiene practices and cleaning of shared equipment between residents. Wendy says that although the staff did poorly on hand hygiene with only 63 per cent compliance, the follow-up discussion brought forth some great ideas on how they could improve.
“We talked about how important reminders are in a busy day and agreed that all members of the team should feel free, and in fact obligated, to remind each other about hand hygiene,” says Wendy.
Since the audit, baskets have been mounted on all lifts so that dispensers of rub and wipes for the lift are readily available. More laundry carts have been added and conveniently located so that staff do not have to carry laundry against their uniforms. Wendy has made up a poster to show staff their results and share their ideas on challenges and solutions to improve hand hygiene.
Every Manager at Iroquois Lodge takes a turn one day a week to help residents use alcohol hand rub before each meal, a practice that has been in place at Iroquois Lodge for more than two years. Wendy says that it is the favorite part of her job as she can connect with each resident and do a mini-assessment at the same time.
Wendy is always looking for innovative ways to educate the staff. She has a tickle trunk full of costumes that she has made. Although she has fun as GUS, her favorite is to dress up as Florence Nightingale, who was her heroine as a child.
The Canadian Hand Hygiene Audit Tool is available at www.patientsafetymetrics.com