The two-headed monster at #IP2014

After a busy few weeks of holiday followed by personal quarantine, I thought it was time I put pen to paper and shared some of the thoughts I’ve been having whilst reflecting upon my time at Infection Prevention 2014…(#IP2014).

Being an “academic” in a “real-world” situation is a great privilege, it allows you to get a real sense of the current state – something which can be missed if you only rely on feedback from academic papers and conference discussions.

My new role within a medical setting has changed the way I interpret information. It is not that I am no longer optimistic – far from it, I am, and always will be, an optimist – but now I have a wider appreciation for the reality of infection prevention “as it is”. Day to day. On the front line. And this is not a negative, difficult reality view. Or one filtered through an anti-research, anti-forward thinking environment. On the contrary, as I have the pleasure of working with the 2013 IPS Team of the Year, noted for their continuous focus on engagement activities and involvement with research and development, both with IPS and the RCN.

However, it is certainly a different position to be in.  And it made my experience of #IP2014 very different from my previous ones.  Let me explain…

In 2012 and 2013 I experienced the IPS conference through the eyes of a “pure” researcher, eager to know what was “out there” in terms of new data, new approaches and concepts, and potential new technologies to appraise.  I felt optimistic because infection prevention seemed to be moving at such a pace, swept along by incredible passion, determination and enthusiasm.  The wealth of information produced, through conference papers, journal articles, webinars and seminars was mind-blowing, yet incredibly welcome to a researcher “new” to the field.  Now, having completed my thesis and with more experience under my belt, I am much more concerned about what impact all this information could have on the way we work within healthcare. As I see it, from paper to practice.

image from http://www.coloringcrew.com

So I felt very much like a two-headed monster through most of the conference sessions I attended – one brain very excited about recent findings, theoretical discussions and endless potential, whilst my “other” brain was much more pragmatic, continually asking the questions “how would this impact healthcare professionals on any given Tuesday?”, “is this feasible”, and sometimes just a rather pointed “Really?!”.

Team inf_con at #IP2014 (image from @allisoncbradley)

 

The saving grace (that prevented one or both of my heads exploding) was the delightful new experience of attending the IPS conference as part of a team. Each session we attended, together or individually, was followed by the opportunity to discuss implications for our Trust, our staff and our patients. This directly addressed my “paper to practice” dilemma, and kept the two headed monster calm.

Darren sharing one of our posters

As a team we were very excited to be presenting three posters (.pdf here: 1, 2, 3) outlining a diverse selection of our current activities, and also providing an oral presentation on how we won the inaugural IPS Team of the Year award (abstracts available here).  I could not have been more proud of the enthusiasm, excitement and energy displayed by my colleagues; something which I am sure did not go unnoticed by the rest of the #IP2014 community. 

A key aim of my role within the team is to ensure that research is conducted which not only involves healthcare professionals, but which is driven by them. Therefore I was particularly proud to be involved in delivering our posters which outlined research instigated, and conducted, by current active healthcare professionals. It’s exciting to know that this is just the start…

Wonderful memories of #IP2014 (image from @darrenwheldon)

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Reflections from #IPSAudit_Surv

At the end of last month (January 31^st) 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!

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 group.  For 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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Checking In….

When I last blogged, way back in mid-April I was in need of a holiday, and was experiencing a mixed bag of events, although on the whole things were turning more positive, with enjoyable times being had with both Women In Science (#WISAnEveningWith) and the #GetStoolSmart campaign at UHCW.

So what has happened since?

Well, I managed to get away on the eagerly anticipated holiday! As with all such things, it seems a very long time ago now, but it was a wonderful break, and a great opportunity to spend some time outdoors (in all elements…!).  This isn’t a “Postcard From…” blog, but honourable mentions must go to (Dyfi Osprey Project, Welsh Cakes, MOMA Wales, Cadair Idris, and A Nets Catch).  Whilst I cannot say that I switched off from work completely (probably never possible for anyone), it was certainly much more pleasurable to be going through my presentations (Doctoral/IPS)  in my head whilst faced with scenery like this…

Doctoral Work – Getting it “Out There”

I hit the ground running when I got back from holiday, with the WMG Doctoral Conference (Healthcare) on the 29^th April, a positive chance to not only share my PhD progress with peers and WMG, but also to catch up with what other Doctoral students have been up to in the last 12 months. A PhD can be an isolating experience, especially when (like me) you are researching something “different” so spend most of your time working independently – so events like this are a welcome chance to gain feedback both professionally and personally. Fortunately the presentation seemed to be well received, and discussions over lunch were all positive, with great use of the word ‘rigour’…always a good thing to hear about your work when you’ve reached the ‘only writing up now’ stage I think…!

The 9^th May saw a second opportunity to share my work, this time as an Invited Speaker at the IPS Ambulance Forum and Audit and Surveillance Forum Conference (“Every Bug Counts!)” in Birmingham.  This was my first IPS meeting (outside of presenting my Poster at IPS 2012 last year), and I was absolutely blown away by the welcoming, supportive and truly friendly atmosphere; could not have been a more positive experience. Speaking after the ‘event’ that is Martin Kiernan, and with IPS President (not to mention Hand Hygiene legend!) Julie Storr mere meters away I think the word nervous barely covers it, but the excitement of being able to talk about my work, and knowing I was (in a way) representing the brilliant participants at my case study site helped me focus. And I think I got away with it…

Finally, I also found out I’ve been accepted to present my Poster summarising Studies 1 and 2 at ICPIC 2013 in Geneva at the end of June. Excited?  I believe I may have jumped a bit when I read the email. Fortunately I wasn’t in public…  Anyhow, bearing in mind the sheer scale of ICPIC 2013 with the speaker list looking like it has been copied right from my thesis reference section, I think a small amount of bouncing is allowed.

Hand Hygiene – Impressive NHS Activity

Some amazing ideas!

Also since I last blogged I also had a wonderful invite from the team at UHCW to come and judge their exciting Hand Hygiene poster competition, which involved both local primary school children and in-patients, all tasked with getting the vital “Hand Hygiene” message over.  These posters were displayed in the main entrance area of the hospital for over a week, generating much interest from Public and Staff alike, showing the worth of such apparently simple innovations.  Even some of the parents of the children came to see the handiwork of their offspring, and you could see the pride clearly – and also, interestingly, comments like “Oh yes, they’ve been on and on about when we should be washing our hands at home now…”. 

Baked Goodness for all!

Not just your standard poster competition then…!The judging panel found picking winners in each of the age categories nearly impossible, because each child seemed to have managed to put their own unique spin on the challenge, some going with the ‘Big and Bold’ strategy, others using ‘Devil in the Detail’, whilst others were just amazingly beautiful and colourful.  Naturally, we needed cake to help us with our discussions, and fortunately the IPCT office is a haven for such baked goodness….

In the end the winners reflect a real mixture, and the overall winner will be on display at UHCW soon – contact UHCW IPCT for more information.

Global Hand Hygiene Day – My Challenge

In preparation for May 5^th – Global Hand Hygiene Day – Professor Didier Pittet Tweeted a call asking what everyone would personally be doing to mark the event…which made me think about what I could do, specifically, on that date.  I decided, as my main activity in the sphere on Hand Hygiene at the moment is research, to set myself the target of trying to submit my first academic paper to a journal for review on May 5^th.  I chose the Journal of Infection Prevention (JIP), as it is the Journal of the Infection Prevention Society (IPS) who I have found an invaluable source of inspiration, information and support, and I felt that my research may be best suited to their audience at this stage.  Having contacted the Editor (the wonderful Dr Neil Wigglesworth, who I’d met briefly at IFIC 2012) and received a virtually immediate response to confirm that the topic would be fitting for JIP, I knuckled down and (with my co-author!!) managed to get this paper to a format suitable for submission…thus it found itself winging its way off to the reviewers on the 5^th May precisely.   Time will tell as to what feedback is returned, but we’re just looking forward to hearing what ‘outside eyes’ think of the topic, so we can take it from there. Don’t worry, I’ll keep you posted…

General PhD Progress

From a writing-up point of view progress is still being made; albeit a ‘non-linear, backwards/forwards, apparently quite normal’ PhD type way. I think it is best illustrated by the medium of cakes consumed recently, each representing either a breakthrough or breakdown in writing progress….

Fuel for IPS Talk run through…

The PG Hub turned 1!

Celebrating breakthrough in Study 1 writing

Dark times…not always bad…

Part of the PG Hub “Dissertation Station” season

Cake selection for Happy Monday!

And the eagle-eyed amongst you, if you haven’t been distracted by all that cake, may have spotted actual pages of thesis hidden in amongst those snap shots. Proof that amongst all those sugar hits, words are emerging….there’s even talk of “sense” and “logic”… But let’s not get too carried away yet…

Back to writing for today now – revisiting my Literature Review section at the moment to add-in a section on Effective Hand Hygiene, covering Soap and Water, ABHR, Technique and, of course, the 5 Moments…

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#HPA2012 Conference – Twitter and Poster….

The past two days saw me taking my research off to a wider audience via the Health Protection Agency annual conference which was held at the Warwick Arts Centre, located at my own University; very handy for me logistics wise…!

I had a great time, engaging in great discussions via Twitter – taking a guess at using #HPA2012 as a hashtag, as there was no official one being flagged up to start…I’m quite new to Twitter, so not sure if this is standard….but we got there in the end, and I made some wonderful contacts leading to very engaging face-to-face chats. A perfect blend of Social Media and Conference opportunity.

My Poster – The Potential Role of Technology to Improve Hand Hygiene Auditing and prevent Hospital Acquired Gastrointestinal Infections – can be seen here – and is a rather whirlwind tour of my PhD research from start to (almost) finish, with an angle focus on Clostridium Difficile (C.difficile), as the particular stream I was engaging with for this conference was Gastrointestinal Infection – however the PhD itself is not necessarily only focussing on the link between Hand Hygiene and C.difficile as a justification for the importance of the former.

Great interest was shown in all aspects of the work, with different people honing in on different aspects – some on the actual technology examples themselves, others on the topic of auditing as a whole, and many being particularly interested in the concept of “splitting” the “5 Moments” into different behavioural categories; Inherent and Elective.  This latter topic, the focus of my future work, is also featuring more heavily on my next poster, now ready for the Infection Prevention Society (IPS) conference at the beginning of October – and I am looking forward immensely to gathering more views and thoughts during those few days. And before then, it’s back to data collection and analysis…!

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