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Posts Tagged ‘Hand Hygiene and Technology’

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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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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  So, now I have had time to let my thoughts settle/ferment since I returned from IPS 2012 I can write a little update about how I got on, and try and give a flavour of just how inspiring the whole event was. 

Yes, inspiring. Having thought long and hard, I think that is the best word to use as an overall theme.  Having been through a difficult few months with the PhD with various set-backs, not to mention the episode of quarantine immediately prior to the conference, it is fair to say I was a somewhat jaded character on the train north to Liverpool. Not so on the train home! I was brimming with new ideas, running thoughts over in my head, and with a bag full of notebooks, hand-outs and, naturally, hand-gel samples….

So what inspired me?  The answer is probably best split into 2 categories – my fellow delegates and the information presented.  

Fellow Delegates

The former was a great comfort, and a timely reminder that Infection Control is an area where people are hugely motivated towards moving forwards, and that to do so they understand that team work, multi-disciplinary collaboration and mutual support are crucial elements for success.  Having travelled to the conference alone it was a joy to meet with new people, to share stories, receive feedback on my work, and generally feel welcome in a room full of strangers. I was particularly made to feel welcome by some wonderful ladies from Bournemouth NHS Trust, Plymouth NHS Trust, St John’s Ambulance Head Office, and a Private healthcare provider in Sussex. It was also a perfect co-incidence to bump into one of my host ICT attending a fellow delegate – I was proud to see them there, knowing how hard they work helped me really relate the formal presentations to real-life, and it was great to debrief after a few of these sessions; relating them directly to ‘our’ NHS Acute trust.  A perfect balance of theory, experience and practice.

Information Presented

The formal presentations then, to sum up, were varied yet all thought-provoking.  Because of my focus on Hand Hygiene and Research I tended to attend sessions focused around these – although the session aimed at those new to Infection Control was a lovely way to start the Conference experience, really helped me feel less alienated as a ‘solo’ attendee.  It felt like there was a great emphasis in all of the sessions (I attended) to encourage empowerment in the delegates, to encourage the belief that change was possible, and that it could come from anyone, regardless of position, background or experience. I found that inspiring, as often it can feel like only ‘top’ people can make a difference – both in the academic and medical sectors; I’ve heard this a lot from those I’ve met during my studies, as well as from within my academic circle.  Great examples from Professor Judith Tanner helped illustrate how crucial research has often been born from the ideas of those on the ‘front-line’, continually perplexed or frustrated by a problem, and who took the step beyond fire-fighting to look for a more long-term solution.

Fire-fighting vs. long-term solutions

This was such a key theme in my decision to undertake a PhD; I felt it deserved a quick mention. Having worked in the private sector for 6 years, I had a great team there which was focused on this very topic, looking for, and implementing, long-term solutions rather than continually reverting to emergency work-arounds to get through a deadline; and repeating this again and again.  Doing a PhD allows an in-depth review of a particular issue or problem (for me, Hand Hygiene Auditing), using rigorous methodology, to produce a ‘unique contribution to knowledge’.  In this way it is hoped that the field moves forwards, and that others can benefit from another building block; rather than continually being stuck in a loop of emergency ‘make-do’s’.  

What the IPS Conference did was remind me of this initial excitement, the fact that so many people are stuck doing ‘work arounds’, and yet through rigorous research there is the potential to improve the situation in Infection Control; and for me, Hand Hygiene Auditing.

 Ending on a high

This idea, of being able to make a long-term difference, was firmly cemented during my final session at IPS – “Set me free – letting go of hand hygiene” presented by Julie Storr, (the new IPS President, WHO Consultant, Imperial College London) and Claire Kilpatrick (Consultant, World Health Oganisation Patient Safety).

An amazing presentation (you always know it’s going to a bit different, when the lights go down and Coldplay fills the speakers….), featuring an interview style debate on the future of Hand Hygiene.  Too much to jot down here (and I’m sure there would be some rules about plagiarism….), but the 5 ‘things to take away’, as outlined by Claire, were summarised a bit like this:

 Key points:

  1. Hand Hygiene should be part of the natural workflow, embedded in daily tasks
  2. Hand Hygiene interventions should be multipronged
  3. We should all look for ‘one key step for tomorrow’ to improve Hand Hygiene where we are
  4. Hand Hygiene is not that simple (but is should be….?)
  5. We need to understand the complexities (to get back to the simple side….)

An interesting point mentioned was that we may be living under an illusion of a ‘Perception of Success’; infection rates have gone down, we have been used to hearing about Hand Hygiene campaigns, we have seen an increase in AHR use, and AHR dispensers seem abundant – but have we really moved forwards in helping people understand why Hand Hygiene is important? Do we believe it is too simple?  Jules had a great slide, demonstrating the journey from simple, through complex, back to simple – using a myriad of disciplines to navigate the complex stage; including psychology, neuroscience and ergonomics.  Thus, we need to move away from the belief that “It’s easy, everyone can wash their hands’, through to understanding why and how we can enable Hand Hygiene at the right moments, to a point where it really is easy for people to act appropriately and perform Hand Hygiene correctly.  Seriously, the slide explains this so much better….!

Finally, and of real interest to me, someone asked a question about the relevance of ‘Electronic Monitoring’ – a key theme of my research.  A stand in the exhibition (see image, right) was causing great interest; having a badge system that had the ability to track (some) Healthcare worker Hand Hygiene compliance within a set zone – still in a prototype stage, but worthy of investigation.  Issues such as price were definitely high on the agenda for delegates, and for me, issue relating to accuracy of data and, critically the relevance to the 5 Moments….  I was delighted to hear this was something that WHO was already taking active steps towards ensuring.

What I’ve taken away, and what next….

 Now my thoughts have settled, and I have almost finished deciphering my handwritten scrawl, I think my main output from the Conference is twofold.

Firstly, I am confident that the work I have been doing is worthwhile, that Hand Hygiene is still a crucial nut yet to be ‘cracked’ fully, and that the methods to complete this process is still hotly debated.

Secondly, though, I am confused, verging on worried. Where do I go from here?  I was really intrigued by the presentation by Julie and Claire, the concept of Simple/Complex/Simple, the involvement of Neuroscience, Psychology and Ergonomics (to name but a few elements), and the emerging field of electronic monitoring – but I feel I need further guidance as to where to apply my energies next.  My PhD is very ‘open’ at the moment, I feel it could still go in a number of directions, which is exciting, yet I need to start pulling it down, ready to write up into one cohesive ‘story’.  But I do not want it to be the only story. It doesn’t end at submission…!  So, I am now off to IFIC 2012 (Twelfth Congress of the International Federation of Infection Control) and what I’d really like to come away with is a clearer idea of how I could plan my Post-Doc future…..  Time will tell…..

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