Infection Control Link Nurses A different educational approach

Infection Control Link Nurses A different educational approach to a familiar concept. Tracey Cooper Consultant Nurse Infection Control Southampton University Hospitals NHS Trust

Background • • • ‘Inherited’ link nurse group Some staff ‘told’ to be ICLN Short meetings monthly Role not defined Objectives not defined Difficult to identify positive impact of role Tracey Cooper

Current Evidence? • Little published objective evidence • Subjective benefits identified – Improved awareness – Higher profile for infection control • Measurable objectives described by 1 study • (Ching & Seto 1990) Tracey Cooper

Traditional ICLN Model • No input to programme by ICLN’s • ICN sets content • Little networking • Follows traditional educational model • . . a bit of a dinosaur! Tracey Cooper

Educational Theory……. • Traditional model – Students passive recipients of information – No control over content, method – Based upon knowledge of how children learn • Adult Learning – Adults learn differently – Need control over content, methods – Must be relevant Tracey Cooper

…. . Into Practice • • • Role description, application process Quarterly, half-day meetings Facilitation of change-management skills Group selection of primary topic for action Agreement on plan for the year Tracey Cooper

The Plan • • • Baseline audit Analysis & feedback Practice interventions Re-audit Analysis & feedback • Supported by ICNS Tracey Cooper

Research Studies • 3 inter-related studies – Link Nurses knowledge and attitudes – Measurable practice improvement – Link nurses experience Tracey Cooper

Study 1: Knowledge & Attitudes • Pre & post questionnaires administered • Attitudes: very positive throughout • Knowledge – Significantly improved at end of study – Lowest scores at start improved the most BUT: Small sample size (n=10) Tracey Cooper

Study 2: Practice Improvement • • • Handwashing facilities chosen Audit tool developed using Delphi method Self-administered Analysis by ICT & feedback to ICLN Practice interventions by ICLN Audit intervention re-audit Tracey Cooper

Study 2: Measurable Outcomes • Comparative data: 222 sinks in 14 areas • 10 of the 11 standards showed: – Significant improvement – Improvements were associated with the study period (p 0. 05) Tracey Cooper

Study 3: Experiences • ICLN need to challenge poor practice – Confidence – Skills – Empowerment – Traditional model did not facilitate this Focus group used to gather data Phenomenology: The Lived Experience Tracey Cooper

Study 3: Themes 1. 2. 3. 4. 5. 6. Experience of application process Effect of the educational programme Authority, influence & empowerment Support & facilitation of the role Barriers to effectiveness Quality & practice improvement Tracey Cooper

Empowered Practice? • ‘I always looked around to see what was going on but I wouldn’t have challenged them quite the same. Now you say – this is my role, this is what I’m trying to do. ’ Tracey Cooper

Conclusions • There appears to have been knowledge improvement • Practice improvement has been demonstrated • This approach has had a positive impact on the ability of ICLN’s to deliver practice improvement • Further studies are required, building upon this Tracey Cooper

Can This Be Used Elsewhere? • Repeat in other organisations? • ‘Pick n Mix’ • Utilise structure for practice improvement • Involve ICLN’s in planning programme Tracey Cooper

And Finally……………. • Link Nurses can make a difference to practice • It is possible to demonstrate this objectively AND • A link nurse programme can make a positive difference to the Link Nurses Tracey Cooper

Work Supported By: Isle of Wight Healthcare NHS Trust Tracey Cooper