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Posts Tagged ‘Human Behaviour’

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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hurdlesSo last week I managed to finish collecting the in-situ data for Study 3 which explores the link between Human Behaviour and Hand Hygiene – and has been a great opportunity to learn more about the day-to-day reality of life on an NHS Acute ward, which really brings context to the other elements of my work, about auditing, technology and Hand Hygiene compliance.

I now have no more data to formally collect, which is a strange feeling, as there are actually so many more questions to ask – however I am at the stage of the PhD process where discipline has to step in, and the doors have to close on further investigation in the interests of ensuring the thesis is written, conclusions are drawn, and a line is drawn in the sand. BUT THEN….then the future research can be planned! 

And that is where March comes in – as I have a number of exciting meetings set up then, to help guide the potential future threads which are starting to spin out of my thesis already and into the wider Infection Prevention community.  Will be great to talk about what has happened so far, to hear what other people have been up to, and to discuss what could happen next. There is so much still left to do in this field, but continued collaboration is of paramount importance to ensure we build on what has gone before, and prevent re-inventing the wheel. Things look bright…

For now, I have my thesis writing motivation plan – the day it is handed in, I am getting an entire cake to eat. Oh yes. You heard right. Because deep down, we all want to be Mary Berry when we grow up don’t we?

cakes

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This week has been a true representation of how varied a PhD experience can be, especially one like mine which has a number of different threads  being (carefully…) woven together.  The brief overview of my schedule below should give some insight into how all the topics within my research are currently being explored in parallel, turning me into something akin to a plate-spinner….plates

Monday: (Snow Day) Chapter writing for Thesis on the topic of Hand Hygiene Compliance; Factors Affecting Compliance (especially Intensity  of Patient Care, Ward Context and Patient Type) and Issues of Measurement of Hand Hygiene Compliance (which links with the work for my Study 1, which explores how Hand Hygiene is Audited at an NHS Acute Trust).

Tuesday: (Rescheduled from in-situ study day), instead Paper writing on the topic of Electronic Monitoring Technologies and Hand Hygiene, discussing  their Fit-For-Purpose rating according to established guidelines. This links in with the work for my Study 2, which explores the potential for Technology within the Audit Process at an NHS Acute Trust. Also had good Twitterchat and received support (and Thesis!) from great source of knowledge in Infection Prevention – Microbiology expert Jon Otter.

Wednesday: Very interesting meeting with Engineering company to hear all about Hand Hygiene system which can provide data to Healthcare Professionals about their Hand Hygiene compliance against scientifically sound ‘benchmarks’ (expected compliance rates) based on WHO 5 Moments. So much potential to explore….  Also an opportunity for exciting, motivating and woefully short catch-up with Claire Kilpatrick,  already working on outputs from that session!

Thursday: (Today) Back to collecting data in-situ for Study 3, looking at the effect of Human Behaviour on Hand Hygiene, and then back to writing the Thesis Chapter draft…

Tomorrow I shall be collecting more data, and then next week I am attending a networking event at my University, aiming to bring together Health Research from all departments and schools. Health @ Warwick3should be an interesting and vibrant day, and I am looking forward to sharing my “Why Do You Wash You Hands” poster from IFIC, to give a flavour of the work I have been doing over the past 3 or so years.  I’ll probably Tweet from the day, so if you’re there/interested, make sure you keep an eye out for @CHD05!

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Whilst I write-up notes for my background chapter, I am also planning my proposed Post-Doc work (Where Next…?) which will focus, along with looking at how we move forwards with assessing Electronic Monitoring for Hand Hygiene, on how we could use Human Behaviour to (better?) engage Healthcare Professionals with the WHO 5 Moments.

I gave my first talk touching on this topic last week (at the NHS Acute setting where I have been carrying out my work, at their IPCT Study Day), and it felt great to be gradually putting thoughts into actions, even if it was just discussing them.  I had some great chats at the breaks during the day, and some really interesting points of view to go away and think about – building further on the feedback I’d taken away from HPA,  IPS and IFIC earlier in Autumn (work can be seen here).

Very excited now about pulling together a couple of papers on this topic, to get the ball rolling.  The PhD clock is ticking, so writing there has to come first, but happily there is natural synergy between the two.  Also hoping to carry out Study 3 over these winter months, so will have empirical data to add weight to the material by the spring.  Will keep updating…

NB: Yesterday we had the IDH Conference during which I had a really interesting chat with a fellow delegate about the importance of not developing technology in isolation, always remembering that the Patient/Healthcare Professional must be able to understand innovations, use them and benefit from them…. Great to hear someone outside ‘my’ field saying the same things back to me – without prompting I must add!

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