Nursing

Hand-in-hand on hygiene in a hospital setting

Tim Landers, RN, PhD, from Ohio State’s College of Nursing and Nora Mohammed, MSc, from University of Gondar -- an infection prevention hero!

Tim Landers, RN, PhD, from Ohio State’s College of Nursing and Nora Mohammed, MSc, from University of Gondar — an infection prevention hero!

By Tim Landers, RN, PhD
Ohio State College of Nursing

“Are you from Ohio? Will you talk to me?”

Nura stopped me in the courtyard of the University of Gondar hospital. She was waving my business card that had been given to her from a School of Nursing instructor who knew that my work centers on infection prevention.

She had just defended her Master’s thesis on hand hygiene at the University of Gondar in which she completed an audit of hand hygiene practices by nurses and other health care workers at a local hospital. When she told me about her project, I was very excited to learn more, so we met the next day to review her findings.

Improving hand hygiene saves lives. Reducing transmission of germs on the hands of health care workers is the most important means of preventing infections.  A recent article of mine on patient-centered hand hygiene is here. Another important article on the subject is here.

Effective hand hygiene programs use a multimodal approach, including strong administrative support, education, training, monitoring of hand-washing and feedback. A critical element of hand hygiene programs is providing products and supplies in the health care setting, and I’ve worked on the best approach for years.

But I had forgotten how critical the provision of products is in our hand hygiene efforts. Without a sink, running water, soap, or alcohol-based hand rubs, hand hygiene is simply not possible.

Quite frankly, I had come to take this for granted.

Until I met Nora.

In her study, Ms. Mohammed showed that in more than half of the “hand hygiene opportunities” – times when workers should perform hand hygiene – no soap, running water, or alcohol-based hand-rubs were available at this hospital. As a former nursing matron, or director of nursing, she saw the impact this had on patient outcomes.

By demonstrating the need to improve access, her study provides an important first step in improving hand hygiene practices.

I was really excited to meet someone who shares a passion for infection prevention and hand hygiene. She really is making a difference at her hospital and helping to save lives in Gondar. In the U.S., we call them “heroes!”

Yes, I am from Ohio, and I would love to talk to you!

O – H – I – O ! Ohio State students arrive in Ethiopia

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We were very excited to welcome four Ohio State students to Gondar yesterday.  They are beginning their work on the needs assessment for a rabies prevention/elimination project.

Last night over a traditional Ethiopian dinner, the group met with University of Gondar Veterinary Medicine Dean Dr. Mersha Chanie, Chair of Sociology Molalign Belay, guest Dr. Judd Walson from the University of Washington’s Department of Global Health, and Ohio Staters including Veterinary Medicine Professor Baye Molla, College of Nursing Vice Dean Usha Menon and other College of Nursing faculty.

One thing that struck me was the diversity and intensity of the group.  These four students represent the breadth of programs at Ohio State and how interdisciplinary work can bring creative and innovative perspectives to important problems.

Third-year veterinary student Karissa Magnuson is interested in wildlife veterinary medicine.  Ally Sterman is a third-year veterinary student with an interest in shelter medicine and public health approaches to veterinary problems.  Korbin Smith, BS ’13, was inspired by Dr. Randall Harris in the College of Public Health to consider opportunities in public health.  Heading up the team is graduate student Laura Binkley, who is working on a Master’s degrees in public health and wildlife ecology.

Absolutely striking was the passion that each student brought to their particular interests and the lively discussion about where interests overlap and intersect.  This is the kind of collaboration that we can build only at a major academic institution like Ohio State.

Go Bucks!

Making Animal Inquiries in Addis Ababa

I took this picture outside of the Jupiter Hotel in Addis Ababa. This is kind of how I felt trying to navigate a busy street with an unfamiliar language.

I took this picture of a stray dog outside the Jupiter Hotel in Addis Ababa. This is kind of how I felt trying to navigate a busy street with unfamiliar language and surroundings.

By Tim Landers
Ohio State College of Nursing

One of the first people we met when we arrived in Addis Ababa was Daniel, our driver who took us around some of the sights.

Traffic is very bad, with pedestrians, loaded mules, stray animals and vehicles trying to share the same road.

Most of the dogs we saw were roaming the street, but as we wove through traffic, I asked Daniel if he had a dog.  He was happy to show us photos of “Jack.” We know that dogs are important parts of many peoples’ families, and this was true for Daniel as well.

We asked more about Jack – where did he find him, when did he go to the doctor, and what type of dog he was.  Expecting that he would tell us about Jack’s pedigree, Daniel seemed very puzzled by the this question.  “He’s a small dog, a nice dog.”

Daniel was concerned because Jack had some sort of infestation, and he did not know how to treat it.  Unfortunately, we had two nurses in the car and no veterinarians.  We did stop at a local pharmacy to see what treatments they might have.

While we were able to buy fairly high-end human antibiotics, but they did not carry veterinary medications.

During our tour of Gondar, we encountered this donkey, which in Ethiopia are seen as work animals.

I asked one of the veterinarians with our group about an ulcer on the back of this donkey.  He actually pointed me to a paper he had written about these “pack ulcers” –erosions caused by loading of the animal for transport of goods to the market.  They are generally non-infectious, but they look uncomfortable!

 

Ohio State Arrives in Gondar–Let One Health Begin!

By Tim Landers
Ohio State College of Nursing

We’ve arrived in Gondar!

Our traveling group from the College of Nursing arrived this morning and were greeted by officials from the University of Gondar and Baye Molla, PhD, clinical assistant professor in Ohio State’s College of Veterinary Medicine.

Dr. Molla is a native of Gondar and has been a wonderful guide and adviser as we have planned our trip to Ethiopia for the One Health Summer Institute.

Over the summer, we will be joined by 20 faculty and students from Ohio State, representing the colleges of Nursing, Veterinary Medicine, Medicine, Public Health, Optometry, and Food, Agricultural and Environmental Sciences, as well as faculty from Addis Ababa University and University of Gondar.

In addition, Robert Agunga, director of Ohio State’s Center for African Studies, will join us in presenting a series of short courses using the One Health framework.

The College of Nursing’s faculty contingent will begin the institute by offering a week-long course in research methods to students and faculty from the University of Gondar.

Meeting Our Partners

We have already met some amazing people as we get acclimated to Ethiopia. Here are some of our recent experiences:

We were welcomed to the University of Gondar by President Mengesha Admassu. With incence wafting through the room, we were served coffee and talked with senior leadership of the University. President Admassau expressed the great value that the University of Gondar placed on its collaboration with Ohio State.
We were welcomed to the University of Gondar by President Mengesha Admassu. With incense wafting through the room, we were served coffee and talked with senior leadership of the University. President Admassau expressed the great value that the University of Gondar placed on its collaboration with Ohio State.
Dr. Sisay Yifru, Dean of University of Gondar College of Medicine and Health Sciences demonstrates to me the use of a hand sanitizer dispenser on an inpatient unit at the University of Gondar Hospital. These dispensers are manufactured at a local plastics factory. The dispenser location and design demonstrate local adaptation of international “best practices” for hand hygiene in health care facilities, including placing hand sanitizer at the “point of care.” This technology was developed and deployed in cooperation with the Patient Safety Initiative, World Health Organization, but has been sustained by administrative support and leadership of the University of Gondar.
Dr. Sisay Yifru, Dean of University of Gondar College of Medicine and Health Sciences demonstrates to me the use of a hand sanitizer dispenser on an inpatient unit at the University of Gondar Hospital. These dispensers are manufactured at a local plastics factory. The dispenser location and design demonstrate local adaptation of international “best practices” for hand hygiene in health care facilities, including placing hand sanitizer at the “point of care.” This technology was developed and deployed in cooperation with the Patient Safety Initiative, World Health Organization, and has been sustained by administrative support and leadership of the University of Gondar.
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Drs. Jodi Ford and Usha Menon, College of Nursing, walk with the director of International Relations at the University of Gondar on a tour of the university’s new hospital under construction though a partnership with United States Centers for Disease Control and Prevention (CDC-Ethiopia), the Ministry of Health, and a private donor.