Department Focus--Quality: Come On In, Everyone

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Worried about the infection risks of family-centered care? Involving loved ones in care can actually help keep patients safe.

When someone is sick and in the hospital, it's the job of nurses and other caregivers to do everything they can to shield that person from infection. They wear gloves and gowns. They wash their hands every time they enter a patient room. They take care to keep hospital rooms sanitary, and in some cases, even limit the patient's exposure to visitors—and germs—from the outside world.

So it's easy to see why the concept of family-centered care could cause some concern with clinicians and caregivers. Allowing those who aren't medically trained to spend an unlimited amount of time at the hospital—in many cases sleeping right there in the room—doesn't seem like the best way to keep a patient's room infection-free.

But research shows that allowing family members to play a part in a patient's care can actually reduce length of stay and improve patient outcomes, says Cezanne Garcia, MPH, senior program and resource specialist for the Institute for Family Centered Care, a nonprofit organization in Bethesda, MD, that advocates for the use of family-centered care in hospitals. Family members are very different than visitors, Garcia says, and caregivers need to realize that families are just as interested—if not more so—in keeping the patient safe and free from infection.

"Too many times we lose perspective. We need to remember that for the majority of a patient's care needs, the family is the one taking care of them at home," she says. "Sure, they may not know the best of infection control practices, but who better than hospitals to educate them?"

Educating family members has been a key part of the successful family-centered care program at the Medical College of Georgia Health System in Augusta, says Bernard Roberson, director for family services development. MCG, which includes 478-bed MCGHealth Medical Center and 154-bed MCGHealth Children's Medical Center, has allowed families to stay in patient rooms in various departments since 1993.

"We talk to them about the importance of handwashing when they come into the room and leave the room, and we tell them to take note of physicians, nurses, and interdisciplinary caregivers washing their hands," Roberson says. "We have a program called ‘Ask,' where patients and families are encouraged to ask providers if they've washed their hands … We tell them, ‘If you don't see them do it, ask them.' We do have patients and families who ask, so it's working."

At the same time, MCG's caregivers are trained to watch out for visitors who may not have washed their hands, or a visitor who may show signs of having a cold or other infection, Roberson says. "We explain why it's important to be alert about the germs they may be carrying."

Families, once they are made aware of hospital infections and how to prevent them, will do everything they can to keep a loved one safe, he says.

"If you've got a family member staying with a patient, they're going to do everything they possibly can—if you educate them when they first come in—to keep that patient safe. They'll help you—they're your biggest advocate."

Both Roberson and Garcia emphasize that the success of family-centered care is a continuous process that involves constant communication between families and caregivers.

"It's a continuous process, and if we continue to work with families and continue to educate—not just patients and families, but faculty and staff…our patients and families can help us decrease infection numbers even more," Roberson says.

Maureen Larkin

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