adult learning principles applied to teach hand washing

1. Adult Learning Principles Applied to Teach Hand Washing September 14, 2010 Marisa Bunning Teaching something to adults that they have done every day for years, that is so routine it has become automatic, is not easy! Teaching something that does not have visible indicators is challenging � you can�t tell by looking if you did a good job or not. Teaching something to adults that they have done every day for years, that is so routine it has become automatic, is not easy! Teaching something that does not have visible indicators is challenging � you can�t tell by looking if you did a good job or not.

2. Theoretical and practical approach. Important to start with a theory, use that information to develop practical approaches for change. Theoretical and practical approach. Important to start with a theory, use that information to develop practical approaches for change.

3. Characteristics of Adult Learners Adults continuously grow and learn. Adult learning is often self-initiated and aimed at an immediate goal. Adults learn and process materials in a variety of ways. People have learning and activity preferences in subject matter or skills. Adults use only part of their intellectual potential during their lives. No adult is the same as any other adult because each has a unique past and a unique perception of that past. Characteristics lay the foundation. Number 3 is put to use in using a variety of methods of teaching adults � verbal, visual � text, illustrations, demonstration, related stories�Characteristics lay the foundation. Number 3 is put to use in using a variety of methods of teaching adults � verbal, visual � text, illustrations, demonstration, related stories�

4. Characteristics of Adult Learners An adult�s self-concept is the product of past experiences. Through experiences and past decisions, adults narrow the possibilities open to them in the future. Adults belong to many groups and play many roles during a single day and during a lifetime. The motivational needs of adults change in different roles with different developmental tasks. These needs affect relationships. Adults have relationship preferences that influence their sense of self and affect decisions and actions. Those that group up in poverty or homes in which English is a second language tend to be oral listeners. Number 9 & 10 can be used in teaching adults � wash hands well because it is a rule, wash hands well to prevent illness in family members.Those that group up in poverty or homes in which English is a second language tend to be oral listeners. Number 9 & 10 can be used in teaching adults � wash hands well because it is a rule, wash hands well to prevent illness in family members.

5. Tools for Teaching Adults Demonstration Hands-on Visual methods Humor Teach each other Engage the learner � interact Use variety of methods Reading and teaching least effective for oral listener; frequent breakdown, not understanding the consequences Important to use the right words/language Words of wisdom � use different methodologies: handouts, online modules, one-on-one, stand-up meetings, use them all Reading and teaching least effective for oral listener; frequent breakdown, not understanding the consequences Important to use the right words/language Words of wisdom � use different methodologies: handouts, online modules, one-on-one, stand-up meetings, use them all

6. FDA Webcast Using Employee Health and Personal Hygiene Measures 3-hour Webcast CDC, FDA, State Health Departments, Industry, Attorney Archived, available from: http://fda.yorkcast.com/webcast/Viewer/?peid=7ae0347ab01a4fac99ff1011b60f2a80 Continuing Education Credits Available Best Practices Nice to hear experts from across the country discuss the importance of what we do. Folks outside of health areas don�t always understand this focus. Focus groups, marketing, identified barriers, and other assessments were used in the approach to develop these programs.Nice to hear experts from across the country discuss the importance of what we do. Folks outside of health areas don�t always understand this focus. Focus groups, marketing, identified barriers, and other assessments were used in the approach to develop these programs.

7. Hand Washing How long? Use soap and clean, running warm water. Rub hands together to make a lather. Vigorous friction on areas of lathered fingers, fingertips, areas between the fingers, hands and arms for at least 15 seconds. Use a scrub brush to clean under and around finger nails. Rinse thoroughly under warm water. Dry hands with a paper towel or hot air hand dryer. Strong emphasis on hand washing, major source of problemsStrong emphasis on hand washing, major source of problems

8. Personal Hygiene

9. When to Wash Hands Before starting work After using the restroom and break time After coughing, sneezing, smoking, eating, or drinking After blowing or touching your nose After touching raw poultry, meat, fish Between handling money or food After touching dirty dishes, equipment, and utensils After touching trash, floors, soiled linens After using cleaners or chemicals After handling fish/shellfish in aquariums or display tanks Before handling single use items (i.e. cups, utensils, etc.) There are many situations (11 listed here) that require hand washing�the list illustrates why this becomes a difficult practice to implement.There are many situations (11 listed here) that require hand washing�the list illustrates why this becomes a difficult practice to implement.

10. Scripts Hospital Talking to all new employees Peers Button campaign Separate work activity from non-work activity Use all forms of media � verbal, visual, put message in different venues After time, signs become invisible; calendar better Important for managers to be role models Recognition for good practices Hospital environments have special issues with hand washing, include food handling. Calendar is geared toward food service.Hospital environments have special issues with hand washing, include food handling. Calendar is geared toward food service.

11. Chick-fil-A Switched to no bare hand contact in 2008 Food for Thought campaign Novel approach helps people retain information Color coded gloves; yellow=raw chicken, clear = RTE Paradigm changed; clear gloves = clean Team members notice wrong use of gloves Training visual + classic classroom training

12. CDC Hand Washing Data Bare hand contact factor in 25% of FBIs Infected person factor in 20% of FBIs Workers need to wash average of 9 times/hr Hands washed about 1/3 of the times needed Norovirus - #1 cause of foodborne illness Good hygiene is principal method of control Hand sink in sight improved rate of washing Lack of time required for low compliance Reorganization can help improve Worker handling is significant cause of foodborne illness outbreaks. Reorganize line so different workers handle raw meat and ready to eat foods 20% admitted 72 times per shift! 20% admitted 20% workers admitted working with vomiting or diarrhea, 20% admitted Establishment that has on-call worker improved rate of workers calling in sick Hand sink in sight improved rate of washing Lack of time required for low compliance Reorganization can help improve Worker handling is significant cause of foodborne illness outbreaks. Reorganize line so different workers handle raw meat and ready to eat foods 20% admitted 72 times per shift! 20% admitted 20% workers admitted working with vomiting or diarrhea, 20% admitted Establishment that has on-call worker improved rate of workers calling in sick

13. CDC Hand Washing Data Working while ill found to be common Better compliance in restaurants with Policy in place Less busy On-call workers Interesting information available on webcast regarding workers rights to work vs. not allowing ill workers to work with food Policy could include working non-food related jobs while ill, would not fit small operations. Workers more likely to call in sick if they know someone is available to work for them. Interesting information available on webcast regarding workers rights to work vs. not allowing ill workers to work with food Policy could include working non-food related jobs while ill, would not fit small operations. Workers more likely to call in sick if they know someone is available to work for them.

14. Hand Washing Legends Project Oregon, 2007, state-wide effort Illustrations posted during annual inspections Available in English and Spanish True stories of foodborne illness outbreaks After 1 year, measure rate of hand washing Link http://www.oregon.gov/DHS/ph/foodsafety/hlp.shtml Hand washing #1 state-wide out-of-compliance item during the Oregon base-value decided to make hand washing an active part of their goals.Hand washing #1 state-wide out-of-compliance item during the Oregon base-value decided to make hand washing an active part of their goals.

15. Hand Washing Skillathon Olympic model; 4-man teams Competition starts with demonstration of knowledge; 24 questions Kitchen: Glo Germ� on hands � rate of removal and time closest to 20 seconds Front of the house better than back

16. Not clear on slide, link listed in referencesNot clear on slide, link listed in references

17. Did get feedback that this was culturally insensitive but it was a true story so it was used.Did get feedback that this was culturally insensitive but it was a true story so it was used.

18. Reported Cases of Enteric Pathogens � Colorado, 2006-8

19. Promoting & Monitoring Inventory of soap and paper towels Periodic reminders � bells Timed faucets RFID � badges Automated Hand dryers Vapa Wash Signs/Calendar 6 hand washing illustrations; in 4 languages http://www.mass.gov/Eeohhs2/docs/dph/cdc/handwashing/calendar.pdf RFID - Radio Frequency Identification Technology Health care: Radio Frequency Identification Technology Vapawash � introduction Feb. 15, 2010 Calendar � illustrates positive and negative scenarios � how an employee can make customers ill, make themselves ill, lose customersRFID - Radio Frequency Identification Technology Health care: Radio Frequency Identification Technology Vapawash � introduction Feb. 15, 2010 Calendar � illustrates positive and negative scenarios � how an employee can make customers ill, make themselves ill, lose customers

20. Automated Units Portable units Start automatically, Time can be varied Requires no fixed water or drainage supply, all that is required is a standard electricity supply. Water and soap are applied when the user places their hands into the cleaning chamber. Once the hand washing is complete the dryer automatically starts. Water and soap are applied when the user places their hands into the cleaning chamber. Once the hand washing is complete the dryer automatically starts.

21. Yuck Photos from Iowa State Image also available showing no growth from sanitized cutting board.Image also available showing no growth from sanitized cutting board.

22. References Smith, D. Advances in hand hygiene: Reducing contamination to food people and the work environment. New Food: the Quarterly Business Review of new Technology for European food & Drink Manufacturers FDA/HHS, 2010, Using Employee Health and Personal Hygiene Measure, Available from: http://fda.yorkcast.com/webcast/Viewer/?peid=7ae0347ab01a4fac99ff1011b60f2a80 Iowa State University Yuck Photos, available from: http://www.extension.iastate.edu/foodsafety/consumers/index.cfm?parent=289