An open admission…

So here it is.

As we know, I have now safely navigated through the PhD journey, and can officially say I have qualified as a Doctor of Engineering. My thesis, which examines future systems of hand hygiene measurement in healthcare, will soon be available for anyone to read.  Amazing.

Image from: http://manpreetdhuffar.files.wordpress.com/2013/04/photo1.jpg

Even more exciting (not sure I ever thought anything would top that…which shows you how much a PhD can change you!), we also know that I have now started working for the NHS – with the phenomenal IPCT at UHCW. 

Now two weeks into my role as IPC Research Practitioner and I have been blown away by how much I am enjoying myself, how diverse the workload and challenges that face the team are, and crucially how overwhelmingly welcoming the team have been.  I never doubted that for a second, but they have surpassed even my high expectations. I have LOVED every moment I have been there, and am so excited about the plans we have been making.  One thing I know for sure…we’re going to be BUSY!

And my admission?

I am SMUG.

I cannot help it. I have tried to battle it, but to no avail.  I just cannot help randomly smiling whenever I think about how much I am enjoying my new post-doc freedom, the ability to offer an “expert” opinion on real world, patient safety matters, and to be given the opportunity to develop research ideas that could make a difference to the way we think in the IP community.  It’s fantastic, and the picture below sums it up beautifully.

Whilst I enjoyed my PhD journey immensely, there is an element of being “caged” – when all is said and done, the main purpose is to develop as a researcher, and ensure you display skills required to earn the qualification.  Once this has been achieved, the freedom is granted to really focus on the research area…and this feels immense!

Image from: http://www.wayofcats.com/blog/wp-content/uploads/2011/04/Smug.jpg

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Another Hurdle passed…

So 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?

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Encouragement to Push On….

So this is 2013.  The year I will submit my PhD.

7 words that are rather easy to write. It’s the other 70,000 that make up the dissertation that pose the tricky bit….   Over Christmas and New Year, in between the standard giving, receiving, eating and being merry, and not-so-standard but absolute top quality use of NHS services, I had the big old think about what to do next as discussed previously – and came down hard on the side of carrying the research forward.  Always the decision in my heart, it was just the head that needed the additional encouragement, knowing how hard it can be to get research funding and positions, however well-intentioned, planned and necessary future research may be.  Yet despite all this, I decided that I want to try. I have to try. I need to try.  I have had so much interest and encouragement in this topic, from both those working in the field, and those who experience Healthcare from the ‘other side’, that it seems a waste not to try to take it forwards, to see just what we could do next.

So I emailed (a very, very long email….) my champion Claire (Kilpatrick) – Infection Prevention and Hand Hygiene Legend – on Christmas Eve, as you do, and received the most wonderful and encouraging email back within days, which has swept me through the first dark week of January, and literally dragged me out of bed and back to the computer. I have so many future plans, but need the discipline to write-up this work before I can go any further, and that is where the encouragement of others comes in. And it’s brilliant!  Hopefully I will be able to meet up with Claire soon and chat over some ideas, but before that I have promised (to myself) that I will commit another few thousand words to draft, and produce the article abstract which has been haunting me for about a month now. PLAN!

I also had a great email of encouragement from NursingTimes, after contacting them re: writing an article for them about the work we’ve been doing at my Case Study Site. I think it would be great to share this with the Nursing Community, and they’ve been really supportive, and also added that Hand Hygiene will be a topic they want to look at a lot this year – which is great for everyone. Another nod of encouragement!  I must also add a note to a great IPC Healthcare Professional ‏@Mimsiebel at this point who always gives me lots of motivation for my work via Twitter, and has added her voice to the encouragement for an NT article – thank you!

Finally I also have a meeting with the Chief Nurse at the Case Study site later this month to update him on my research, and explore potential areas for future work. As a fellow academic as well as clinical expert I am very much looking forward to gaining insight from both ‘sides’ of his expertise, and am really excited to hear his views on ideas for ways in which we could translate this research into practical, measurable, and Patient Safety conscious practice.

The plan, therefore, is now to write this week – and then start the practical aspect of Study 3 on-site next week – which I will blog about once it is up and running. Got an email through about IFIC applications at the back-end of last week too, and that has given me a massive boost of encouragement….definitely, definitely want to be presenting my work in Buenos Aires in October!

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Just write something…..

On Wednesday I have my second Thesis Writing Group session – for which I have been preparing my ‘Background Section’…which currently goes like this…:

• Healthcare Associated Infections (HCAI) – An Evolving Definition
• Prevalence and Burden of HCAI
• Contributory Factors to HCAI
• Strategies to Counter HCAI
• Thesis Overview

…with writing under the headings, I should add…. 😉

What I have tried to do is give a background to why someone would spend 4 years researching Hand Hygiene – and hopefully the content of this section will provide the groundwork to this argument, by introducing the reader to the all too pressing issue of HCAI, and bringing the focus towards the fundamental role that Hand Hygiene plays in both the Prevention and Control of such infections.

As many, if not all, fellow PhD students will have found at some point or other I’m sure – I have been battling the standard ‘stumbling’ issue of not being able to allow myself to write, for fear of it not being any good… I think we are all so used to talking about our research, discussing it, defending it, debating it – that sitting somewhere quiet and just being responsible for writing about it unchallenged is actually quite daunting…that’s when the real doubt starts to creep in….   And the best advice I keep on being given (and really, really have to listen to on a loop!!) is just write something!!! 

So that’s what I’ve done now – I’ve put pen to paper (quite literally most of the time, I do like the old-fashioned way to kick-start a writing session…), and churned out Draft 1.  And I’m not precious about it.  I’m quite sure that most, if not all, of what I’ve produced (about 4,000 words) for this draft won’t appear in the final version.  But that is fine – because now I’ve got something, I can start to get it out there for feedback, and that’s huge.

Now, it’s on to the Literature Review – a 3 parter of Hand Hygiene, Auditing, and Hand Hygiene Technologies….  Perhaps not Waterstone’s Number 1 Christmas Trilogy, but I promise, it all makes sense….  Will keep you updated 🙂

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Hand Hygiene Technology – Quick Notes on Innovation

Today pages of notes swirl in my head like autumn leaves

 

Just a quick post whilst I let my head work out what to do with the pages of notes I’ve amassed whilst working on the structure of my PhD Dissertation ‘Background’ chapter….  I decided thinking about something else may allow it time to settle before I start adding in the next layer…

One of the key themes of my research is the potential for technology within the field of Healthcare Hand Hygiene, primarily to aid accurate monitoring, measurement and feedback – but through researching for such examples, all kinds of innovations have surfaced.  My interest lies in how these technologies are perceived by the Healthcare Professionals themselves, from a ‘fit for purpose’ aspect, and also how they may inspire different types of innovations or interventions themselves.  Thus, for a start, whilst examples shown to some participants in my research were judged not to be ‘fit for purpose’ they did inspire great discussion about how Hand Hygiene could be improved through better education, using a combination of technology and training.  The technology itself was seen as a tool for something entirely different from it was being marketed, yet the end goal – improving Hand Hygiene – may be the same.  A great example of the importance of the context, and allowing a wide range of thinking prior to implementing innovations.  sometimes, perhaps, it may be better to ignore what it says on the tin….

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‘Potentially’ interesting

Haven’t written a post for a while, as it has been somewhat difficult to think of what to write….half of me is very excited about the direction my research is potentially taking, whilst the other half is so hung up on the ‘potentially’ aspect, that I find myself getting tied up in knots and fighting waves of panic…..  And no one wants to read a blog post about that (but they might want to look at a picture….)

SO, a brief update as to all things research, to help me clear the mind, and reassure those who are asking that work is still continuing.

• Study 3 – the revised version – is currently in the recruitment stage.  This will be investigating Inherent and Elective Hand Hygiene in an NHS setting, and will be on a pilot scale, hopefully giving me the grounds for future Post-Doc development, exploring themes of training and technology/process development all centred around the WHO 5 Moments.
• Studies 1 and 2 – the data collected from these studies are being analysed, using thematic coding (for interviews) with a mixture of both inductive and deductive analysis.  A process map, based on how Auditing works within the Case Study site has been produced, showing areas of perceived ‘confusion’, and it is here that analysis is being concentrated – is there a potential role for technology to help reduce this confusion?
• I am now looking forwards to the time after my PhD (only 8 months left) and have had some great conversations about the potential to extend the PhD work, to develop the emergent themes. A number of NHS sites have potentially shown an interest in collaborating, which is excellent, and I believe we have in place some excellent (relatively short-term) study designs that could help us explore issues surrounding the understanding and use of the WHO 5 Moments further.  My main decisions to make are how to fund (applying for an independent Fellowship…?) and where to base myself (Academic Institution…?).  These are big decisions to make, and always harder at a time when trying to finish a PhD. A recognised and shared worry I’m sure.

What else is happening?

• I had an amazing conversation with Claire Kilpatrick and Jules Storr at IFIC 2012.  I cannot say too much about it (because I’ll sound far too over-excited), but suffice to say their encouragement and support about my work was immeasurable. Well timed and simply perfect.  As a researcher working without a ‘team’ (I am the only member of my department working on Infection Prevention) it is often a disappointment not to be able to become passionate about the work with other people; this conversation certainly gave me a strong shot of that passion!  Cannot thank them enough.
• Have also been asked to share my work at my host NHS site’s ICT study day (November 14th), which I’m really looking forward to.  I’ve been given free range to talk on anything related to the work we’ve been doing, and I’m really eager to share what we’ve been upto – especially as the ICT often (it seems) get a bit of a ‘bad press’ within hospital circles, by nature having to appear mainly at times of crises, and often being seen to be ‘telling people off’. Will be great to share the story of how the work on Hand Hygiene is preventative, looking to stop these crises happening, and how the new work (Study 3) is trying to explore an angle the audience may not have heard about before.  We can but see….
• In off topic news, I’ve also been testing out the NHS as a Patient, as I’m sporting a knee injury post-marathon. This has left me unable to run, and may be in someway linked to my ‘PhD blues’ state.  Fingers crossed I will be able to get some more answers tomorrow at the next check.  The only good thing is I get to play one of my favourtie games, where I see the Doctor’s face when I tell them what I do for a living……cue instant fear, and sudden Hand washing….!

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Standing Still – Time to Think

My last post, just over two weeks ago, marked a low point in the research project – where a ‘Buckaroo Moment’ was dangerously close due to a myriad of issues cropping up in close succession.  Today marks my first day back after a well needed fortnight away from all things research, and thus I am happy to report the donkey has all four hooves firmly on terra firma this morning. So far, so good…

Whilst I may have been away from the active research for 2 weeks, it would be wrong to say that my thoughts have not turned to the project during this time.  However, both the geographical and time distance away from the work has allowed for a period of reflection, a time to stand still (literally…on rocks, on a beach, on a hill watching the sea….) and try to unpick some of the ‘knot’ that seems to have occurred within the work.  Prior to my holiday this knot felt very much like an impenetrable mass, with no discernible way past.  Now, with my mind and body rested I understand that, in the words of the Bear Hunt – if you can’t get round it, and you can’t get over it, then you just have to go through it. So that’s what I’m about to start doing….

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Posters, Young Experts, Robot Mummies….

My Poster in the Sunshine (2nd left)

I had a great time yesterday, sharing my PhD research with over 70 other researchers at the 2012 Vitae Midlands Hub Poster Competition, held at The_Herbert Art Gallery in Coventry.  We managed to have the event on the (seemingly) only sunny day this month so far, and the venue was superb (see photos, taken from the lovely people at Warwickrssp!) – great space for all the Posters, an interesting taster session re: The Engaging Researcher, and time to visit the various exhibitions within the Gallery and the historic Cathedral opposite.  Delightfully there was also tea and cake. Twice. Need I say more….?

Speaking about my research was certainly an enjoyable experience, it is a strangely unusual chance to be able to share your work with ‘new’ audiences; often in research you speak with people in your own field, either experts you are asking for advice, participants you are engaging with during research, or peers you are sharing research experiences with.

New Audiences

At events such as this one, the audiences are hugely varied, I spoke with people with backgrounds in Biology, NHS administration, high-end Manufacturing, Retail, Catering and Rail Networks on the Island of Sodor. Admittedly the last person was 3 and highly knowledgeable on Thomas the Tank Engine; but as was pointed out earlier in the day, if you can explain your research to the under 9s, then you should have no problem explaining it to anyone else.This is a conversation I had earlier in the week with my own on-call Young Expert (5), when I told them what I was up to later in the week.

Young Expert: Why does that hand look funny?

Me: Because it needs washing.  Do you wash your hands?

Ye: Mmmm. Sometimes. When they’re muddy.

Me: That’s great. And does Mummy tell you to wash your hands lots of times? Even when they’re not muddy…?

YE: Mmm.

Me: Well that’s what I’m doing. I’m seeing when people need to be told to wash their hands, even when they’re not muddy!

YE: By Mummies…? 

Me: Well….maybe not by Mummies. They’re probably quite busy. But we’ll think of something, won’t we…?

YE: Robot Mummies!

So there you have it…out of the mouths of the young. Keep an eye out for Robot Mummies, coming to a Hospital near you…! 

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New Phase, New Page…

Taking a quick break from transcribing my last interview from Phase 1 of the research, it feels good to be making solid plans for Phase 2 (Can you join in?) by adding a new page on the menu bar-(UHCW Staff?….) although there is still quite a bit of work to do on Phase 1; the data may be collected, but the analysis is still on-going…!

Phase 2 (July-August) will see members of Staff from all over the Trust, being sought to share their views and experiences of the Hand Hygiene Audit process, Hand Hygiene Measurement, and the potential of Hand Hygiene technologies.  There are many topics that have come up already, so it will be interesting to see if any new ones are still to surface, or if there are clear distinctions between roles in the Audit process and views on how it works….  Time will tell!

Early results and feedback will start to come out in September, firstly at the HPA Conference and then hopefully at the IPS Conference  in October.

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