Minh Nguyen has just returned from a summer trip to Vietnam that was part of the UNC-Chapel Hill School of Nursing’s . He was the recipient of the Cronenwett Global Study Award, created by a private gift to honor Dean Emerita Linda H. Cronenwett. Read about his experience:
Prior to the trip, I knew there was a big gap between the health care systems of Vietnam and the US. Among the differences, the lack of infection control posed the biggest threat to the health and safety of the patients. The hospitals in Vietnam are overcrowded and lack resources, and overuse of antibiotics has increased infection rates.
Because of these problems I wanted to do a project to reduce the infection rate by increasing hand washing compliance since hand washing has proved to be the most effective, and simplest, method. My plan was to spend a week observing at a hospital in Vinh city, another week for planning the interventions and the rest of the time implementing and evaluating those interventions.
I began by observing the hospital’s infection control policies, hand washing compliance and nursing care. I noticed that the relationship between the patients and healthcare workers in Vietnam was much different than in the US. Patients and family members feared the healthcare workers. In the US, our patients are our clients, and they have the right to demand the best care. However, in Vietnam, that right seemed to not exist.
During the week of observing, I noticed that the hand washing compliance was not high. Many physicians and nurses did not wash their hands before touching the patients or between patients. Family members were the biggest sources of infection since they were the main caregivers and had the most contact with the patients.
Through research, I learned that no single intervention was effective in increasing the hand washing compliance. I needed a series of interventions including education, feedback, supervision, motivation and reminders. I discussed my plan with the head nurse, and after several modifications, we started the project in the NICU and Resuscitation Unit.
Before implementing the interventions, we surveyed the attitudes and knowledge of the staff on hand washing and infection control and their perceived barriers to hand washing. Most of staff understood the importance of hand washing and the correct techniques. I started with classes on cross infection, the importance and techniques of hand washing. With the staff, I created a video using the techniques recommended by the Ministry of Health. I also used a Glo-germ hand washing kit to make the class more interactive and interesting. This was the first time that I was able to utilize what I learned in class to in a real world setting.
After this summer, I can see that my confidence has increased. I was able to work independently in a new working environment. My leadership and communication skills were sharpened, and I carried out my project successfully. I hope that I will be able to keep a professional relationship with the hospital and continue to help them to increase hand washing compliance. I also realized that infection control is a great field because it is one of the most important aspects in patient safety. By controlling the infection rate, we are reducing the mortality rate.