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Archive for the ‘Hand Hygiene’ Category

Having returned from a lovely holiday, it’s been such an exciting week so far – two major headlines:

  1. I officially started my new role as Infection Prevention and Control Research Practitioner with the wonderful IPCT at UHCW. I had an UHCWamazing couple of days, sitting in on meetings, watching team members prepare to spread the love (#IPSWales) planning our summer of research activities, and taking part in my very first team schimee.  Cannot believe I get to do this every week now!
  2. We had our abstract accepted for #IP2014 – we’ll be there sharing our work on how ATP screening may help increase engagement with environmental cleaning… Look for the #TeamGreen poster.  The team have also been successful with other abstracts, but I’ll leave it to them to share that news over on their twitter feed….IP2014

 

 

Not sure what next week will bring, but tomorrow I have my final Warwick Women In Science (WIS) meeting before we announce our WIS A Day With…2014 plans, so I am sure there will be plenty more excitement to come…

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At the end of last month (January 31st) I had a wonderful time at my first IPS Audit and Surveillance SIG meeting, held in Birmingham.  I had the honour of being a guest speaker at their annual conference last year, held in collaboration with the IPS Ambulance Forum. This was my first “real” meeting though, and I have to admit my recent identity crisis had left me feeling a bit daunted…Would I really be welcome at a meeting of Infection Prevention professionals?

Great start to meeting!

Great start to meeting!

Fortunately, the IPS community spirit was as much in evidence at the meeting in Birmingham as I have found it to be at their national conferences.  Within seconds of entering the room I was made to feel welcome (the bacon roll definitely helped!!), and throughout the meeting and discussions over lunch I felt completely at ease.   I very much enjoyed hearing the group discuss the QIT tools, something I’d like to look at going forwards. Similarly there was great discussion about the potential for a network/directory/porthole/vault (I don’t think we ever hit on the correct word!) function on the Audit and Surveillance webpage. Such a tool would have really helped when I was carrying out my PhD research, and would certainly benefit anyone carrying out research within the measurement of infection prevention going forwards.  Three wonderful speakers contributed to the day, I’m sure copies of their presentations/details of their work are available from the groupFor me, it was a great opportunity to hear about other research going on outside of my specific focus, and also to consider further development of my research theme “meaningful data”.   

Here is just a summary of my thoughts and ideas generated during the speaker presentations:

During Lilian Chiewera’s engaging presentation “Does Post Discharge Telephone Surveys improve the accuracy of existing Caesarean Section SSI surveillance at local level” I was really interested to hear the familiar theme of “feedback” raised, in relation to research data collection.  During her research Lilian found that a key way of getting/increasing/maintaining support and collaboration from staff, required to contribute key surveillance data, was to ensure that everyone involved was informed about what the data was for, how it was to be used, and what the results of the surveillance were. In other words, she worked towards ensuring that the surveillance data would have meaning to those involved in the process.  By sharing information about the reasons for data collection with healthcare professionals, Lilian found that engagement with future data collection sessions was improved.   I was also delighted to hear her talk about the concept of “data” being only a number, and that too much focus on figures can lead to a loss of sight of the greater context.  As Lilian noted, even one infection, if it could have been prevented, is one too many.

Carole Hallam gave an enthusiastic presentation from which I also extracted themes of stakeholder engagement: here she stressed the need to communicate the need for standardised documentation, and how sometimes, perseverance was the key to “cracking” the hard job of engaging some clinical units in surveillance research.    Interestingly, she also hit on the concept of “using your instincts” whilst working within the rigorous area of surveillance data.   If something looks wrong, for example if infection rates seem too low, follow your gut!  There could be a simple calculation mistake, but similarly there could be a mistake in the whole data collection processes.  Don’t just report a figure if you don’t believe it.  

The way I see it is if you collect the data, and you understand the data, the data is meaningful to you. So use that meaning!     Now obviously I understand that this may sound idealistic, and additional investigation may be resource intensive…but ensuring that collected data is accurate is fundamental to the purpose of surveillance. Process redesign, or necessary recalculations are unlikely to be as disruptive as ploughing along regardless, and never actually understanding the true picture.

The final speaker of the day, Jane McNeish highlighted how meaningful data could be critical in future interventions extending out of the acute setting, and into care homes.  In her presentation, discussing Urinary Tract Infections (UTI) she highlighted that if time and thought is going to be put into designing surveillance tools, and indeed pathways and protocols,  then wider issues than simply being evidence-based may be crucial. For example, focus must surely be placed on how the information contained in the intervention is received by those who can deliver it?  Do carers understand carefully constructed tools? Does the data the tool produces mean anything to the staff, family or Patient it has been designed to help? What additional information, training or support is needed to ensure that tools are used, correctly, to improve Patient safety?

I look forward to seeing where the Audit and Surveillance group heads, and what comes of many of the discussions held on that very rainy day in Birmingham.  It has definitely helped me put context around how I could develop my work going forwards, and certainly encouraged me to attend future IPS meetings.

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Image credit:  Jameson Gagnepain via Flickr

Image credit: Jameson Gagnepain via Flickr

Due to my current “limbo” status previously discussed, I find myself increasingly “plate spinning” at the moment, enjoying the luxury (challenge!) of being able to dive into a number of activities, rather than having to focus solely on one goal, as had been the requirement over autumn/winter last year.   Therefore I am currently spending time reflecting on my own research, through writing up my findings and methods for various journal articles, and also working with existing and new partners to plan potential avenues for future research.

These future avenues include:

  • exploring hand hygiene technologies
  • behavioural aspects of infection prevention
  • education and engagement of medical professionals with both hand hygiene and wider infection prevention goals
  • generating meaningful data for use in enabling change within infection prevention practices

Whilst these topics are listed as separate bullet points, the wonderful aspect of both my reflective work recently, and the exciting discussions had so far, is the acknowledgement of how much overlap there is between each area. For example:

Can hand hygiene technologies produce meaningful data?
How can we enhance the infection prevention education of medical professionals through understanding behaviour? 
What is the importance of engaging healthcare professionals when discussing hand hygiene technologies…and meaningful data…?

It is definitely an exciting time to be working and researching in infection prevention, and I am very lucky to be surrounded by a motivated and passionate community.  I have been particularly supported and encouraged by those below, although this list is certainly not exhaustive, and I look forward to adding many more names as we move forwards in the months and years to come!

Overdue thanks to:

UHCW Infection Prevention and Control Team,    Claire Kilpatrick,    Julie Storr,    Martin Kiernan,    Jon Otter,    Gary Thirkell,    Neil Wigglesworth,    Mark Radford,    The Infection Prevention Society (IPS),      #WeNurses,    Jamie Mackrill,    Kate Seers,    Jeremy Wyatt,    Christopher James

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As it is currently International Infection Prevention Week (IIPW) I thought I would write a quick post about hand hygiene promotion today – as it ties in with a lot of recent activities I have been involved in alongside tweaking the (almost complete!) PhD dissertation.

In addition to IIPW, earlier this month saw Global Handwashing Day (UK site here) whilst on May the 5th we celebrated SAVE LIVES: Clean Your Hands, the WHO annual Hand Hygiene awareness day.   Each of these carefully planned and well supported events allows the topic of Infection Prevention (and importantly for me, hand hygiene) to be promoted and discussed at perhaps a wider level than during the rest of the year.  One of the activities I have been involved in is writing a separate blog on human behaviour, technology and the WHO 5 Moments, which has been a great source of feedback and discussion.

Anyone visiting their local hospitals or health centres during these periods has probably noticed promotional material regarding hand hygiene, or seen information about the activities of the IPCT at that particular location.  A few photos from Twitter this week allowed a glimpse at the effort the Countess of Chester Hospitals NHS Foundation Trust IPCT have been putting in to promoting their work (captions their own)….

We’re keeping it clean… reducing MRSA and C.Diff #InfectionPreventionWeek

We’re keeping it clean… reducing MRSA and C.Diff #InfectionPreventionWeek

 

It’s Infection Control Week, keep your hands clean #InfectionPreventionWeek

It’s Infection Control Week, keep your hands clean #InfectionPreventionWeek

 

By keeping your hands clean, you are helping your local hospital to stay infection free #InfectionPreventionWeek

By keeping your hands clean, you are helping your local hospital to stay infection free #InfectionPreventionWeek

 

UHCW IPCT also used Twitter to promote their activities during IIPW.  Every Wednesday they #WIPEWednesday – standing for Wash Hands – Isolate promptly – Prudent Antibiotic prescribing – Environmental Cleaning.  This week they launched their new #WIPE stickers, and followed a board-to-ward strategy to ensure everyone got the message.  Here are just a few of their photos (captions their own):

It's #WIPEWednesday for #IIPCW today!

It’s #WIPEWednesday for #IIPCW today!

What does the W in #WIPE stand for? #WIPEWednesday #AskTheTeam

What does the W in #WIPE stand for? #WIPEWednesday #AskTheTeam

Our Chief Operating Officer knows what the I is for in #WIPE - he's got a sticker & a card! #WIPEWednesday #IIPCW

Our Chief Operating Officer knows what the I is for in #WIPE – he’s got a sticker & a card! #WIPEWednesday #IIPCW

Who knows the P of #WIPE ? Our CEO might be the man to ask? His sticker invites you to! #WIPEWednesday #IIPCW

Who knows the P of #WIPE ? Our CEO might be the man to ask? His sticker invites you to! #WIPEWednesday #IIPCW

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

They have also been doing some great work with the Paediatric teams and Patients, using creative play to produce some beautiful hand hygiene promotional work:

They maybe our smallest patients, but they're big on getting involved! #IIPC2013 #ptsafety #handhygiene

They maybe our smallest patients, but they’re big on getting involved! #IIPC2013 #ptsafety #handhygiene

Finally they also launched their much awaited #HygieneHop video last week….a must see and share for all interested in Infection Prevention and Hand Hygiene: http://www.youtube.com/watch?v=eGCPPqGweNQ&sns=tw

Enjoy!!

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ExploringHandHygiene
When I started this blog, and thinking about how to discuss “my” area of research, I wanted to have an image that I could use to symbolise my work – perhaps a form of icon really – so that any related social media/dissemination outlets could follow the same theme.  Therefore both my Twitter feed, and all my presentations/posters have included the image (above), along with the phrase “exploringhandhygiene“.

Because that’s what I have been doing during my PhD really, exploring the concept of hand hygiene.

Whilst, due to the academic nature, I have had to be specific as to which areas I am particularly addressing (i.e. measurement, through researching auditing, technology, human behaviour), I have naturally been open to many other themes within the area during my research.  And that’s the point of today’s post.

One of the key additional themes that has come up time and time again, although not central to my current project, is the role of gloves within hand hygiene.   This was first pointed out to me during the interview phase of my Study 1, when participants were discussing their perceptions of barriers to hand hygiene.  Once it had been explained to me I was much more aware of it during my participatory observation sessions.  Further reading, and some excellent presentations at conferences, has shown me that this is a huge area of concern and research in the field of hand hygiene.  and aside from the clear implications for Patient Safety, it has left me more than a little uncomfortable about my originally chosen logo…..

Look at it again.

Indeed.  Why is the medical professional wearing gloves to touch the baby?  The infant has intact skin.  There appears to be no imminent bodily fluid risk.  It’s not a clinical setting where one would expect PPE to be required due to the infant being identified as being contaminated by some particular pathogen – indeed, the other hand we see holding them is not gloved….   So, barring the scenario that the medical professional is about to whip out a needle (possible) or other such ‘clutching-at-straws’ explanation, I have to say, I think this picture may be one for the archive now.

linkedin

I may keep it until submission day, and launch a new picture for the next phase of my research life though.  That feels appropriate.  It’s been a comforting image through some pretty big events, like my first international conference, and my foray into social media, and so I’m not quite ready to dump it unceremoniously.   And to mark its passing with some style, I’m using it to launch my LinkedIn page.

Let it have one last hurrah out there in cyberspace!  And if it causes discussion about glove use, then perhaps that is a good thing.  We really should be thinking about the appropriateness of their use more…

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Since coming back from #IP2013 I’ve been continuing to put the final touches to my thesis on the measurement of hand hygiene.

Final touches take a long time…that much I can definitely state with confidence!  But I’m happy that with each reading the chapters appear to take on more clarity, and confirm the over-arching links which I believe emerge from the work.

The thesis is bursting with ideas for future work....

The thesis is bursting with ideas for future work….

In parallel with finalising the thesis,  this month sees me developing further my plans for the research post-submission.  Indications from the findings are that they provide significant scope for development. Happily this is not just my opinion, and feedback from dissemination activities and discussions have encouraged my development plans.   My main focus will be in moving forward with work on hand hygiene measurement, ensuring that data generated from future systems provides meaning to those receiving it, to enable them to make improvements to Patient safety.  This proposed work will include exploring both technology and human behaviour, continuing and extending that already undertaken in my PhD, and looking to collaborate with experts within the field: both within healthcare and industry.

I’m very excited by the opportunity to combine both my academic and industrial experience, whilst remaining within a healthcare setting, the field I have come to feel so passionate and interested in over the past 5 years.  I am, as I have noted before, incredibly lucky to have been inspired by some wonderful people within this sector – with timely reference to the award-winning team who have hosted my research…you may also have heard about their success here…!

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ips 2013So I am back ready to work on my thesis today, but I have to admit that half my screen in taken up with Twitter feed…. Usually I am much more disciplined, trying to ensure that I “schedule” Twitter sessions in to my day – but I am making allowances for today/tomorrow so I can keep up with the exciting proceedings still going on at Infection Prevention 2013 (#IP2013).

Impressions of #IP2013

I was, again, overwhelmed by the amazing blend of scale and intimacy of this event, which first struck me last year in Liverpool.  At #IP2012 I was experiencing everything for the first time, including the whole concept of a “full conference”.  My only previous conference experience was the HPA conference, which was held at my own research institution (University of Warwick), therefore had not given me the same immersion opportunity as #IP2012.  So I wasn’t sure how this year’s event would feel – would it have lost some of its charm? Also, this year I had been accepted for oral presentation, giving me another new experience, but also an additional layer of nerves…

Happily #IP2013 more than fulfilled my expectations – from the moment I arrived I found I was rapidly taking notes, excitedly making links to my own work and seeing parallels I could draw between other people’s experiences and my future plans.

ConferenceI love that about conference. The sudden immersion into an environment where everyone shares a common sense of purpose, can understand experiences, and can debate ideas.  As I have – from an academic point of view – been working alone for the past four years, such opportunities are very welcome. 

It was also hugely exciting and a source of great pride to see how many of the key concepts highlighted by the experts in the morning session (more of which later) were reflected in work already been carried out by my IPC heroes.  They really are superstars, and it’s wonderful to know they’re getting to share some of that work at #IP2013 too.

Personal Highlights

As well as sharing my work on Study 3, which explored behavioural drivers to hand hygiene, I also had the opportunity to meet and hear from some leading experts in Infection Prevention.  Here are just a few highlights…

Professor Dale Fisher – offered really useful information about experience in successfully achieving organisational “buy-in”.  Very closely linked to my work and subsequent thoughts on “Meaningful Data”, and thought it was particularly useful to connect with the work of Human Factors (Ergonomics).  Definitely areas to follow up…

Dr Michael Gardam – presented the concept of Front Line Ownership (FLO) as part of a complexity science approach, with the message that solutions to problems may be very context specific. What works for one unit/team/setting may not work for another…  I’m interested in linking this to “Domain Knowledge”, which is a key theme throughout my thesis, so really pleased to see that evidence of successful practice using the FLO approach.

Professor Hugo Sax – provided a clear, logical background for why hand hygiene is vital, with particular emphasis on the role of endogenous infection, something I have discussed, but would like to look at in more depth.  I was particularly interested in the human factors approach, and thought the examples of innovations where error had seemingly been “designed in” through a failure to realise what was intuitive, were very persuasive.  Within hand hygiene I agree that understanding what is intuitive and what requires explicit learning would be of great benefit when designing interventions.

Martin Kiernan – delivering the EM Cottrell Lecture was a clear highlight, not just for me but for the audience as a whole.  Entertaining yet highly informative, “The life and times of the urinary catheter” was a talk spanning 2,000 years, examining (scant!) evidence, demanding action and research, and ending with a self-penned poem.  I don’t think you can ask any more of a speaker can you…except maybe a dance?  Roll on #IP2014…

Finally I also got to meet Pat Cattini and Jon Otter, both of whom made my day possible, and also helped ease my presentation nerves by being wonderfully welcoming, supportive and friendly.  I’m not sure I could have made it to the podium without their reassuring presence in the front row, and it was a fantastic example of the inclusive environment I appreciate from IPS.  Needless to say Jon then gave a flawless and superb talk on targeted MRSA screening – a presentation master class thrown in for free!  I also found out that Pat has an MSc which explored hand hygiene auditing, that she’s familiar with the key papers I’ve based Study 3 on, and that she’s involved in hand hygiene technology trials. In other words, she is my new superhero.

Now, back to the thesis………..the first step on my journey into Infection Prevention!

writing

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whirlwindThe last week has been a complete whirlwind, culminating in an early start tomorrow so I can share my work on Inherent and Elective hand hygiene (Study 3).

Having had my abstract for Infection Prevention 2013 accepted back in July, my planned funding was then delayed which meant I was left with no choice but to sadly pull out of the programme with only a few weeks to go. This was such a disappointment, as I had been really looking forward to Infection Prevention, having got so much out of the conference in Liverpool last year.  However, due to some amazing help from IPS (especially Claire Kilpatrick, Jon Otter and Pat Cattini) within hours of letting them know the news last Monday, I was offered funding support meaning I can join the event tomorrow (30th September). 

Really looking forward to sharing my work, and giving experts in the field the opportunity to comment/get in touch with regard to my plans for future developments!! 

Also have a HUGE sense of excitement building about the chance to hear from Hugo Sax again tomorrow. I was totally blown away by hearing him speak at ICPIC2013, so I’m sure tomorrow’s session will be worth the anticipation.  The programme is bursting with other gems, and I’m particularly looking forward to the EM Cottrell Lecture, given by Martin Kiernan.  Based on previous experience I’m sure this will be entertaining as well as informative…

Will be tweeting as much as possible, but with only one day at the conference, a huge exhibition, lots of posters I want to see, public transport to master, not to mention some #PoshMuffinsonTour to track down, I can’t be sure how much will be done…  Expect a blog in the next few days to wrap up thoughts!

ips 2013

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