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Posts Tagged ‘Thesis’

SO, here I am back blogging at exploringhandhygiene – it’s wonderful to have the time and opportunity to share my recent activities within the research sphere of infection prevention. Therefore, without further ado, let’s crack on!
  • What’s happened to my PhD research?

ThesisFirst, the big news – since my last post I am happy to announce that I successfully defended my thesis in my viva examination!  I had a very enjoyable examination, aided by superb examiners and a moderator who kept the atmosphere friendly, helpful and conducive to meaningful discussion, rather than making it in anyway seem like an interrogation.  My overwhelming thanks must therefore go to Professor Judith Tanner (external examiner), Dr Tina Barnes (internal examiner) and Professor Paul Jennings (viva moderator).

I am now working on my minor modifications, and also working on the feedback from a number of peer reviewed papers stemming from this research.  I’ll update on the progress of these outputs here in due course.

  • How I marked May 5thmay 5th

Whilst I was not able to be online for May 5th – the WHO SAVE LIVES: Clean Your Hands campaign – I did write a guest blog for Deb Group, which you can read here. This explores the origins of the WHO 5 Moments, the role of hand hygiene in helping stop the rise of antimicrobial resistance (AMR), and the importance of producing meaningful data when measuring hand hygiene compliance if we want to change behaviour.

  • My latest research plans

Now that I have (almost!) completed my PhD I am working on plans to further key strands of the research in order to improve practice within Patient safety.  The core aspect of my work is Meaningful Data for Behaviour Change, and this involves psychology, human factors and technology.  As I have a strong belief that research should have a practical application I will be looking to maintain close links with day-to-day infection prevention activity, and increase the level of involvement of front-line healthcare professionals in research: exploring issues that they identify as important for Patient safety.

  • What I’ve been doing outside the hand hygiene bubble

Finally, because it has been an unusual time, I have been offline quite a bit recently – hence the blog/twitter silence.  This is in part due to a technical hitch (I’m awaiting a new shiny machine, as currently my old faithful laptop is on the way out to pasture), but mainly due to taking some time out on holiday, AND training for the walkthewalk.org London Moonwalk 2014.  You can read all my team, and our motivations here – plus see some rather spectacular training photos…!wtw

 

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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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The past few weeks since finishing data collection have been spent going back over my thesis outline, working out what can be “written up without delay”, what “needs more work”, and what I would ideally like to put in a big box called “never look at again”….

Image from dreamstime.com

Safety deposit box for Dissertation Issues….(Image from dreamstime.com)

Naturally it is that third category that contains rather a lot of the “meat” of the dissertation at the moment, and it takes a lot of self-discipline to ensure that each of the “issues” are logged, so that I can plan to tackle them as I write-up, even if it is not something I can do all at once.  Fortunately I have been able to call on some great sources of assistance so far to help me with each “issue” I have plucked from the box, and therefore I am hoping that over the next few months the balance of what can be “written up without delay and what I’d like to “never look at again” will swing…but one thing is for sure, the whole thesis “needs a lot more work”.

What I have found really useful though, is the use of copious “pictures” to help me translate both my ideas and actions into formats that are easier to communicate – I am now forever drawing process flow diagrams of some kind, showing how my thoughts are flowing, what actions I carried out, and why certain processes were carried out in particular orders.  Whilst these started out as being tools to help me avoid “head-pop“, I have now found that they may well be jolly useful to include in the finished written dissertation, to help the examiner avoid the same fate, and to save the legendary 1,000 words

Learning - Risky Times (Image from ninapaley.com)

Learning – Risky Times (Image from ninapaley.com)

The “head-pop” issue has actually been a serious one this past week, as I’ve succumbed to 2 migraines – which as previously noted are not the best news.  Having to cancel hard to arrange meetings is never a good thing, nor is the time lost to feeling like you’ve just run a marathon. And that’s an analogy I can just about work with these days – except with a migraine you miss out on the shiny medal and cake rewards.  Still, fingers crossed it has just been a blip, and happily I managed to proceed with a re-arranged meeting, during which I learnt some fascinating new information which will help underpin a major theme in my discussion section, and plans for future Post-Doc work.  Well worth the snowy walk up to Warwick Medical School!

I also had a fantastic discussion re: my plans for Post-Doc work, which has really helped clarify the direction I want my research to go in, as well as help motivate me to keep up the pressure to get a thesis draft produced sooner rather than later.  More details on this further down the line, suffice to say Hand Hygiene remains close to my heart!

Icing on the Cake - going literal...

Icing on the Cake – going literal…

Outside the thesis write-up the past few weeks have seen me once again having some great help and advice from Claire Kilpatrick who gave some really useful feedback and encouragement on my ICPIC abstract draft.  ICPIC promises to be an amazing event, with some of the leading experts in the Infection Prevention field coming together, and I am keeping everything crossed that I will be able to attend; being able to take contribute my research in some capacity would only be the icing on the cake.

 

 

And finally, exciting times tomorrow on the Hand Hygiene and Technology front….will post soon…..

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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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clockTime has flown by over the past few weeks, so to briefly update you…..

Study 3

I have been spending rather a lot of time loitering on the Ward carrying out my in-situ observations for Study 3, looking at Hand Hygiene and Behaviour. Trying (and failing!) not to get in the way/be mistaken for a Doctor/freak the staff out has been rather entertaining, but mainly I have been collecting some great data for my study, and all being well I should complete this final phase early next week, then move onto the analysis straight away.  Really looking forward to seeing whether the data matches my original hypothesis….will keep you posted on that one!

twitterTwitter

Had a great surprise this week when my IPCT heroes launched their Twitter account, to coincide with a big Valentine’s Day activity they had planned to mark their #GetStoolSmart campaign. So great to be able to keep in touch with the work they are doing, and from the photos they posted during the day it looks like they spread a lot of smiles as well as vital information during their rounds…you can check them out here.

Thesis

Have been filling my non-observation time with writing up my thesis (submission date races ever closer…) and have now officially got 1 Chapter draft reviewed (we’re ok, mainly positive!), and have swapped it for half of another Chapter. I have to try to get the other half-finished by 6th March now, so it’s very much head down and write as much as I can…this week it’s been all about Methods for Measuring Hand Hygiene Compliance.  I jump around a lot (in writing, not physically, that’d be somewhat self-defeating to the deadline target…) though, so it’s hard to try to concentrate on one topic – as concurrently I am reviewing some Hand Hygiene technologies for a later section/paper…however need to just concentrate on getting one thing finished, rather than constantly having too many unfinished bits on the go. So self-discipline is the watchword for next week…

Conferences

Also on the approach for next week is my abstract draft for ICPIC 2013. Really hope to make it to Geneva in June, fingers crossed I can pull it all together – have 2 main topics to decide between, so that’s in the diary for next week. Oh, and then writing the abstract!

Off for more observations this afternoon, then a weekend of (hopefully) sunshine, another short run as I continue my uphill return from injury, and some epic baking. Because there is always a good reason for cake….

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Had a great meeting this morning at my Case Study site (an Acute Trust NHS University Hospital), where I have been finalising  the plans for Study 3 – an observational study investigating the behavioural aspects of Hand Hygiene, to add to the work I have already been doing on Hand Hygiene Auditing and the potential role for technology (for more information, see here).

The written thesis continues to grow. Slowly. Working on a review of  Hand Hygiene Literature at the moment – sample of current headings being:

History of Hand Hygiene

Importance of Hand Hygiene

                Chain of Infection

                Hands as Vectors for Pathogen Transmission

                Environment as Reservoir for Pathogens           

Hand Hygiene Compliance

                Ideal Standards

                Problems with Adherence

                Behavioural Influences on Adherence – Inherent/Elective

Auditing

               Concept and Definition

               Auditing in Healthcare

               Hand Hygiene Auditing

               Problems of Hand Hygiene Auditing

 Hand Hygiene Technologies

               Purpose of existing technologies – Monitoring, Measurement, Feedback (Audit)

                

Fair to say there is a long way to go, but really looking forward to the final stage of ‘active’ reasearch before 5 months of solid writing, reviewing, re-writing and final submission in June 2013.  Really interested in following up the emergent themes from the work, and continuing to work with some of the amazing people who are so motivating in this field.  For now though, it’s back to the 70,000 words….

 

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