Feeds:
Posts
Comments

Posts Tagged ‘WHO 5 Moments’

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

 

Advertisements

Read Full Post »

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!!

Read Full Post »

Ribeiro et al P118

Ribeiro et al P118

   The second theme discussed in ICPIC 2013 posters that I enjoyed pondering was that of Hand Hygiene compliance rates split by each of the WHO 5 Moments

A clear example of this can be seen in the figure from Ribero et al’s poster (P118 – left), where compliance levels in the ICU at each of the moments were measured pre- and post the study intervention.  Compliance After Patient Contact was found to have the highest rate of compliance (both pre and post intervention), followed by Before Patient Contact, then After Body Fluids Exposure Risk.  After Contact with  Patient Surrounding and Before an Aseptic Procedure had the lowest levels of compliance respectively.

These were surprising findings for me, especially the fact that Moment 5 (After Contact with Patient Surroundings) did not show the lowest levels of compliance; as I had found this Moment the one to be perceived most likely to be considered able to be “dropped” if workload/other factors also occurred, and the Moment most Healthcare Professionals in my Study (2) felt likely to be “missed”.  Also, other literature supports Moment 5 as the one with lowest levels of compliance – for example Rossini et al. (2013, in press) found M5 compliance = 22.5% compared with M1 =36.5%, M2 =54.5%, M3 =25.2% and M4 = 25.4%.  

Grayson et al (2011)

Grayson et al (2011)

 

 

Finally the figure (right) provided by Grayson et al (2011) – who also spoke at ICPIC 2013 – from the Australian National Hand Hygiene Initiative  shows Moment 5 having the lowest rate of Hand Hygiene, and a different spread of compliance over the Moments than that presented by Ribeiro et al at ICPIC.  

Ikeda et al P119

Ikeda et al P119

 

A further poster at ICPIC 2013, that of Ikeda et al (P119 left) caused additional confusion, with another variation of spread being seen across the 5 Moments. Here, Moment 3 was found to have the highest level of compliance, followed by Moment 4, Moment 5, Moment 2 and Moment 1.

 

As this is a blog post rather than a paper I’ll leave the discussion brief; but naturally variables such as context, method and sample size need to be considered when comparing findings across studies. However, for me the lack of consistency drives me forward with my next level of research, which hypothesises that there is a difference between the likelihood of Hand Hygiene dependent on the activity being performed (based on Study 3 – see preliminary results here).  My future work aims to investigate whether the 5 Moments can be “split” in a similar way, dependent on the activities each may represent, and therefore could be treated differently in terms of education and measurement opportunities. 

Based on my work to date I would have expected more consistency across emerging results employing the 5 Moments….but it is still early days. I need to wait for papers to develop based on the posters shown at ICPIC 2013, and carefully consider additional contextual factors.  It’s definitely thought provoking…I’ll give it that…

Read Full Post »

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!

Read Full Post »

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!

Read Full Post »

Today was my first day attending sessions at IFIC 2012 – yesterday being spent registering, having a tour of Zagreb, and attending the Opening Ceremony and welcome reception.

There is far too much to cover right now (and my scrawl may take a while to decipher) but it is immediately clear that attending this Conference has been hugely important for my research – both in terms of content, and also in terms of the potential sources of support, inspiration and future direction.  I have written lots of ‘notes for home’, which will help me remember all the thoughts buzzing through my mind, and hopefully help me turn them into actions over the next few months.

Today I concentrated on Hand Hygiene ( surprise!), but through a wider lens than I perhaps would usually focus – thus the sessions covered work on an international scene, in environments outside the acute setting, and often in settings with dramatically fewer resources than I am used to interacting with.  However, a strong theme of the importance of Hand Hygiene was never far from the surface, alongside a continual mention/nod towards the WHO 5 Moments – an ever-increasing integral part of my thesis.

I will cover more on the sessions when I get back to the UK; just to note that I had a great moment of excitement this afternoon when I got to attend a session featuring two highly prominent figures in the field – Benedetta Allegranzi and Sally Bloomfield.  There is a moment when you (I….?!) have to fight hard not to revert to an awe-struck teenager….  Tomorrow I’m going to have to do the same; as it’s the turn of the UK IPS representatives to present, and as their work is about Audit and Surveillance, they are something of a big deal for me…!

Today was also the day of attending my Poster; a great opportunity to speak with people interested/intrigued by the Poster presented, a chance to elaborate, debate and defend the ideas I’m working on.  I thoroughly enjoyed it, there was much more discussion than I expected, and I was overwhelmed by the amount of positive and interested comments I received, and it was especially interesting to hear stories and experiences from all around the World; some very familiar, and some so very different. Lovely to see that the WHO 5 Moments were recognised by everyone though, regardless of background.

Now I need to continue to look towards the future though; this experience is definitely helping me formulate further the research I want to carry out, but I still need the guidance and support of those in the field to clarify, mould, direct and confirm that the plans are in the right vein; it is essential that we build upon the foundation already established, thus I want to make sure that any research I go on to do in a Post-Doc capacity is what is needed, wanted and welcomed…..

Read Full Post »

  So, now I have had time to let my thoughts settle/ferment since I returned from IPS 2012 I can write a little update about how I got on, and try and give a flavour of just how inspiring the whole event was. 

Yes, inspiring. Having thought long and hard, I think that is the best word to use as an overall theme.  Having been through a difficult few months with the PhD with various set-backs, not to mention the episode of quarantine immediately prior to the conference, it is fair to say I was a somewhat jaded character on the train north to Liverpool. Not so on the train home! I was brimming with new ideas, running thoughts over in my head, and with a bag full of notebooks, hand-outs and, naturally, hand-gel samples….

So what inspired me?  The answer is probably best split into 2 categories – my fellow delegates and the information presented.  

Fellow Delegates

The former was a great comfort, and a timely reminder that Infection Control is an area where people are hugely motivated towards moving forwards, and that to do so they understand that team work, multi-disciplinary collaboration and mutual support are crucial elements for success.  Having travelled to the conference alone it was a joy to meet with new people, to share stories, receive feedback on my work, and generally feel welcome in a room full of strangers. I was particularly made to feel welcome by some wonderful ladies from Bournemouth NHS Trust, Plymouth NHS Trust, St John’s Ambulance Head Office, and a Private healthcare provider in Sussex. It was also a perfect co-incidence to bump into one of my host ICT attending a fellow delegate – I was proud to see them there, knowing how hard they work helped me really relate the formal presentations to real-life, and it was great to debrief after a few of these sessions; relating them directly to ‘our’ NHS Acute trust.  A perfect balance of theory, experience and practice.

Information Presented

The formal presentations then, to sum up, were varied yet all thought-provoking.  Because of my focus on Hand Hygiene and Research I tended to attend sessions focused around these – although the session aimed at those new to Infection Control was a lovely way to start the Conference experience, really helped me feel less alienated as a ‘solo’ attendee.  It felt like there was a great emphasis in all of the sessions (I attended) to encourage empowerment in the delegates, to encourage the belief that change was possible, and that it could come from anyone, regardless of position, background or experience. I found that inspiring, as often it can feel like only ‘top’ people can make a difference – both in the academic and medical sectors; I’ve heard this a lot from those I’ve met during my studies, as well as from within my academic circle.  Great examples from Professor Judith Tanner helped illustrate how crucial research has often been born from the ideas of those on the ‘front-line’, continually perplexed or frustrated by a problem, and who took the step beyond fire-fighting to look for a more long-term solution.

Fire-fighting vs. long-term solutions

This was such a key theme in my decision to undertake a PhD; I felt it deserved a quick mention. Having worked in the private sector for 6 years, I had a great team there which was focused on this very topic, looking for, and implementing, long-term solutions rather than continually reverting to emergency work-arounds to get through a deadline; and repeating this again and again.  Doing a PhD allows an in-depth review of a particular issue or problem (for me, Hand Hygiene Auditing), using rigorous methodology, to produce a ‘unique contribution to knowledge’.  In this way it is hoped that the field moves forwards, and that others can benefit from another building block; rather than continually being stuck in a loop of emergency ‘make-do’s’.  

What the IPS Conference did was remind me of this initial excitement, the fact that so many people are stuck doing ‘work arounds’, and yet through rigorous research there is the potential to improve the situation in Infection Control; and for me, Hand Hygiene Auditing.

 Ending on a high

This idea, of being able to make a long-term difference, was firmly cemented during my final session at IPS – “Set me free – letting go of hand hygiene” presented by Julie Storr, (the new IPS President, WHO Consultant, Imperial College London) and Claire Kilpatrick (Consultant, World Health Oganisation Patient Safety).

An amazing presentation (you always know it’s going to a bit different, when the lights go down and Coldplay fills the speakers….), featuring an interview style debate on the future of Hand Hygiene.  Too much to jot down here (and I’m sure there would be some rules about plagiarism….), but the 5 ‘things to take away’, as outlined by Claire, were summarised a bit like this:

 Key points:

  1. Hand Hygiene should be part of the natural workflow, embedded in daily tasks
  2. Hand Hygiene interventions should be multipronged
  3. We should all look for ‘one key step for tomorrow’ to improve Hand Hygiene where we are
  4. Hand Hygiene is not that simple (but is should be….?)
  5. We need to understand the complexities (to get back to the simple side….)

An interesting point mentioned was that we may be living under an illusion of a ‘Perception of Success’; infection rates have gone down, we have been used to hearing about Hand Hygiene campaigns, we have seen an increase in AHR use, and AHR dispensers seem abundant – but have we really moved forwards in helping people understand why Hand Hygiene is important? Do we believe it is too simple?  Jules had a great slide, demonstrating the journey from simple, through complex, back to simple – using a myriad of disciplines to navigate the complex stage; including psychology, neuroscience and ergonomics.  Thus, we need to move away from the belief that “It’s easy, everyone can wash their hands’, through to understanding why and how we can enable Hand Hygiene at the right moments, to a point where it really is easy for people to act appropriately and perform Hand Hygiene correctly.  Seriously, the slide explains this so much better….!

Finally, and of real interest to me, someone asked a question about the relevance of ‘Electronic Monitoring’ – a key theme of my research.  A stand in the exhibition (see image, right) was causing great interest; having a badge system that had the ability to track (some) Healthcare worker Hand Hygiene compliance within a set zone – still in a prototype stage, but worthy of investigation.  Issues such as price were definitely high on the agenda for delegates, and for me, issue relating to accuracy of data and, critically the relevance to the 5 Moments….  I was delighted to hear this was something that WHO was already taking active steps towards ensuring.

What I’ve taken away, and what next….

 Now my thoughts have settled, and I have almost finished deciphering my handwritten scrawl, I think my main output from the Conference is twofold.

Firstly, I am confident that the work I have been doing is worthwhile, that Hand Hygiene is still a crucial nut yet to be ‘cracked’ fully, and that the methods to complete this process is still hotly debated.

Secondly, though, I am confused, verging on worried. Where do I go from here?  I was really intrigued by the presentation by Julie and Claire, the concept of Simple/Complex/Simple, the involvement of Neuroscience, Psychology and Ergonomics (to name but a few elements), and the emerging field of electronic monitoring – but I feel I need further guidance as to where to apply my energies next.  My PhD is very ‘open’ at the moment, I feel it could still go in a number of directions, which is exciting, yet I need to start pulling it down, ready to write up into one cohesive ‘story’.  But I do not want it to be the only story. It doesn’t end at submission…!  So, I am now off to IFIC 2012 (Twelfth Congress of the International Federation of Infection Control) and what I’d really like to come away with is a clearer idea of how I could plan my Post-Doc future…..  Time will tell…..

Read Full Post »

Older Posts »

%d bloggers like this: