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As it is currently International Infection Prevention Week (IIPW) I thought I would write a quick post about hand hygiene promotion today – as it ties in with a lot of recent activities I have been involved in alongside tweaking the (almost complete!) PhD dissertation.

In addition to IIPW, earlier this month saw Global Handwashing Day (UK site here) whilst on May the 5th we celebrated SAVE LIVES: Clean Your Hands, the WHO annual Hand Hygiene awareness day.   Each of these carefully planned and well supported events allows the topic of Infection Prevention (and importantly for me, hand hygiene) to be promoted and discussed at perhaps a wider level than during the rest of the year.  One of the activities I have been involved in is writing a separate blog on human behaviour, technology and the WHO 5 Moments, which has been a great source of feedback and discussion.

Anyone visiting their local hospitals or health centres during these periods has probably noticed promotional material regarding hand hygiene, or seen information about the activities of the IPCT at that particular location.  A few photos from Twitter this week allowed a glimpse at the effort the Countess of Chester Hospitals NHS Foundation Trust IPCT have been putting in to promoting their work (captions their own)….

We’re keeping it clean… reducing MRSA and C.Diff #InfectionPreventionWeek

We’re keeping it clean… reducing MRSA and C.Diff #InfectionPreventionWeek

 

It’s Infection Control Week, keep your hands clean #InfectionPreventionWeek

It’s Infection Control Week, keep your hands clean #InfectionPreventionWeek

 

By keeping your hands clean, you are helping your local hospital to stay infection free #InfectionPreventionWeek

By keeping your hands clean, you are helping your local hospital to stay infection free #InfectionPreventionWeek

 

UHCW IPCT also used Twitter to promote their activities during IIPW.  Every Wednesday they #WIPEWednesday – standing for Wash Hands – Isolate promptly – Prudent Antibiotic prescribing – Environmental Cleaning.  This week they launched their new #WIPE stickers, and followed a board-to-ward strategy to ensure everyone got the message.  Here are just a few of their photos (captions their own):

It's #WIPEWednesday for #IIPCW today!

It’s #WIPEWednesday for #IIPCW today!

What does the W in #WIPE stand for? #WIPEWednesday #AskTheTeam

What does the W in #WIPE stand for? #WIPEWednesday #AskTheTeam

Our Chief Operating Officer knows what the I is for in #WIPE - he's got a sticker & a card! #WIPEWednesday #IIPCW

Our Chief Operating Officer knows what the I is for in #WIPE – he’s got a sticker & a card! #WIPEWednesday #IIPCW

Who knows the P of #WIPE ? Our CEO might be the man to ask? His sticker invites you to! #WIPEWednesday #IIPCW

Who knows the P of #WIPE ? Our CEO might be the man to ask? His sticker invites you to! #WIPEWednesday #IIPCW

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

They have also been doing some great work with the Paediatric teams and Patients, using creative play to produce some beautiful hand hygiene promotional work:

They maybe our smallest patients, but they're big on getting involved! #IIPC2013 #ptsafety #handhygiene

They maybe our smallest patients, but they’re big on getting involved! #IIPC2013 #ptsafety #handhygiene

Finally they also launched their much awaited #HygieneHop video last week….a must see and share for all interested in Infection Prevention and Hand Hygiene: http://www.youtube.com/watch?v=eGCPPqGweNQ&sns=tw

Enjoy!!

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ExploringHandHygiene
When I started this blog, and thinking about how to discuss “my” area of research, I wanted to have an image that I could use to symbolise my work – perhaps a form of icon really – so that any related social media/dissemination outlets could follow the same theme.  Therefore both my Twitter feed, and all my presentations/posters have included the image (above), along with the phrase “exploringhandhygiene“.

Because that’s what I have been doing during my PhD really, exploring the concept of hand hygiene.

Whilst, due to the academic nature, I have had to be specific as to which areas I am particularly addressing (i.e. measurement, through researching auditing, technology, human behaviour), I have naturally been open to many other themes within the area during my research.  And that’s the point of today’s post.

One of the key additional themes that has come up time and time again, although not central to my current project, is the role of gloves within hand hygiene.   This was first pointed out to me during the interview phase of my Study 1, when participants were discussing their perceptions of barriers to hand hygiene.  Once it had been explained to me I was much more aware of it during my participatory observation sessions.  Further reading, and some excellent presentations at conferences, has shown me that this is a huge area of concern and research in the field of hand hygiene.  and aside from the clear implications for Patient Safety, it has left me more than a little uncomfortable about my originally chosen logo…..

Look at it again.

Indeed.  Why is the medical professional wearing gloves to touch the baby?  The infant has intact skin.  There appears to be no imminent bodily fluid risk.  It’s not a clinical setting where one would expect PPE to be required due to the infant being identified as being contaminated by some particular pathogen – indeed, the other hand we see holding them is not gloved….   So, barring the scenario that the medical professional is about to whip out a needle (possible) or other such ‘clutching-at-straws’ explanation, I have to say, I think this picture may be one for the archive now.

linkedin

I may keep it until submission day, and launch a new picture for the next phase of my research life though.  That feels appropriate.  It’s been a comforting image through some pretty big events, like my first international conference, and my foray into social media, and so I’m not quite ready to dump it unceremoniously.   And to mark its passing with some style, I’m using it to launch my LinkedIn page.

Let it have one last hurrah out there in cyberspace!  And if it causes discussion about glove use, then perhaps that is a good thing.  We really should be thinking about the appropriateness of their use more…

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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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ReturnedSo it’s been almost 2 months since my last blog post….

I seem to start a lot of my posts with a comment on how long it has been since I last wrote, but apparently, when you’re writing up a thesis (or doing any kind of intensive project) it is expected that the odd MIA will occur, and I have been reassured that apologies are not necessary….  Still, I have to admit that I have felt rather frustrated at myself for lack of blogging – having had rather a lot to blog about!

That’s where Twitter is such a great tool, those 140 characters have helped me feel in sight of the loop, if not entirely in it over the course of the summer.

Well, what have I been up to?

The Summer List

Resorting to a list seems to be the only sensible course of action here, for everyone:Thesis

  • Working on the thesis – a given, but happily progress has been rapid (give or take a few moments of horror) and I am well on course to submit by Christmas.

 

  • I’ve been accepted to present my work on Study 3 at IPS 2013, the annual conference of the Infection Prevention Society.  I’m really excited about this, as the work on Inherent and Elective hand hygiene has proven really interesting to discuss with those from the field of infection prevention. The study represents the first (as I am aware) work of its kind within the NHS, so will be great to get some feedback now that the results are in. Just waiting on funding news before I can make final plans…

 

  • WHO 5 Moments Spent a great day with the wonderfully bubbly team over at UHCW who hosted hand hygiene heroes Julie Storr and Claire Kilpatrick for a day focussing on the WHO 5 Moments, looking at system and behavioural change.  Absolutely fascinating topics covered, and great to see the involvement of lots of healthcare professionals from a range of clinical settings, engaging in discussions and scenarios designed to help translate the 5 Moments into real-life Patient care. I certainly left the day with a greater level of clarity regarding the concept, and I am sure I wasn’t the only one.

 

  • Outside hand hygiene I’ve also been spending time with the lovely Women in Science committee as we prepare for our symposium on the 26th September.  The event is entitled “WIS A Day With” and follows on from the successful event earlier this year, “WIS An Evening With”, which saw two highly regarded speakers share their experiences of a career in the field of science.  WIS A Day With features 4 speakers who will also share their career stories, along with sessions run by complimentary organisations looking to support career development. And, of course, there will be the popular wine and cheese event to finish.

Migraine

  • And as it’s Migraine Awareness Week it’s fair to say I’ve been doing a bit of that (right) too. I’ve posted about this once before, but I thought I’d mention it again briefly in this post after reading and discussing the condition a lot this week. Key words I noticed featuring heavily in discussions were ‘debilitating’, ‘underestimated’, ‘impact’ and, naturally, ‘pain’.  I’d also throw ‘unpredicatable’ and ‘exhausting’ into the mix, not to mention the effect on those around you.

 

  • But on a brighter note, and what could be better – the Bake Off is back…!  That should take me nicely through until submission. Great timing from The Berry.

 

To celebrate the work with Women In Science, and just because it is rather special in itself, I shall finish this update with this rather glorious picture from Lego:

First female scientist figure by Lego

First female scientist figure by Lego

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Short list-orientated blog today, the week has been a bit of a mixed bag, and I don’t want to dwell on the ups and downs too much. 

This type of mixed bag I can handle...!

This type of mixed bag I can handle…!

    

Instead, here are the things that have made my highlights list in the last fortnight….

 1. Huge excitement over 1st publication appearing in print by fellow University of Warwick researcher, and recent PhD graduate Dr Jamie Mackrill – “Sound source information to improve cardiothoracic patients’ comfort“.  Another paper in the pipeline, great encouragement to see someone go from PhD student to Research Fellow and published author in the same time frame as you, gives me inspiration that it must really be possible….

2. Women In Science 2013 #WISAnEveningWith – had a very interesting evening on the 27th March, our guest speakers Dr Vita Majce and Professor Frances Ashcroft (see here for brief biographies) gave informative, entertaining and inspiring talks to a very varied audience,  followed by a lively discussion and networking session over cheese and wine. Planning for September’s WIS 2013 symposium is already underway and should build upon this very positive foundation…

3. Very happy to have been invited back by UHCW Infection Prevention and Control to judge another phase of their #GetStoolSmart campaign – a wonderful initiative to get ward staff involved and aware of guidelines surrounding CDiff screening and protocols. A lovely treat to be able to be involved in handing out “Smarties for Smarties”, generating a buzz amongst hard working staff – and great for IPCT to be able to be spreading good news and smiles, as I’m sure often they can feel a bit like harbingers of doom…!*

4. Twitter continues to provide many jolts of encouragement as I plough through the Thesis write-up, not least being mentioned in the same sentence as the legendary Professor Didier Pittet….unbelievable. Thank you Claire! Had to have a strong cup of tea after that! 

5. Having a Hollywood victory.  Lashings of butter. Enough said. (photo to come!)

Next week I will be working on two presentations, one for the WMG Doctoral Conference (29th April) and the other for the IPS Ambulance Forum in conjunction with Audit and Surveillance Forum (9th May) – a more detailed blog should appear during that time…

*Which they're not - as established on Twitter over Easter, I've decided my IPCT are rather like bunnies - hence this picture is dedicated to them!

*Which they’re not – as established on Twitter over Easter, I’ve decided my IPCT are rather like bunnies – hence this picture is dedicated to them!

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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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page

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!

IFIC

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