Dr Lesley Price on behalf of: Applied infection prevention & control interventions programme

1. Dr Lesley Price on behalf of: Applied infection prevention & control interventions programme The ‘SHIP’ Research Group (Safeguarding Health through Infection Prevention) Scottish HAI Prevention Institute (SHAIPI) Consortium Infection prevention and control: developing the evidence, challenging the interventions and moving towards implementation science

2. Overview of presentation: The Problem Our contributions

3. Evidence for the effectiveness of the WHO 6 step hand hygiene technique

4. Follow up studies from the 3v6 RCT – could it be how we teach it? 1 year follow up no significant difference in recall of the 6 steps between participants and non-participants. Inconclusive re multimodal or single intervention more effective. Lack of robust design & theoretical underpinning.

5. Need to think beyond the practitioner what can healthcare facilities and countries do? • Interventions were categorised according to type: multimodal, education, care bundles, policy, surveillance and monitoring and feedback. • Evidence of effectives in all categories but best evidence for multimodal interventions and monitoring and feedback. • Impact • Provided evidence for the WHO Core Components for National IPC guidance.

6. Next steps: continuing to develop the evidence base for the most effective hand hygiene technique Currently PhD project exploring the contribution of each of the 6 steps in reducing the bacterial load. Currently conducting a systematic review on hand hygiene with regard to volume of product, time and hand size. Developing a CRT comparing normal practice against 3 different adapted 6 step techniques.

7. Next steps: challenging hand hygiene interventions Currently undertaking study looking at how many days deliberate practice is required before proficiency is developed. • Developing a CRT to test the contribution of each of the 5 components of the WHO multimodal hand hygiene strategy.

8. Next steps: developing the evidence base for implementation of IPC guidelines • 2 PhD projects evaluating the process of implementing the WHO’s Core Component for IPC Guidelines: • National level in Brazil & Scotland • Hospital level in Uganda

9. Summary & conclusion: SHAIPI’s predecessor (SIRN) funded a study that initiated this programme of work (3v6 RCT). SHAIPI has facilitated a programme of work bulding on this study by: • Funding a systematic review on hand hygiene techniques • Funding an overview of systematic reviews on hand hygiene interventions • Funding an evaluation of a Guinness World Record • Funding a PhD studentship • Pump priming the Systematic Review on National IPC intervention • Currently funding the Deliberate Practice Study & the development of 2 CRTs.

10. In addition in recognition of this programme of work GCU has matched funded two other PhD studentships. The work within this programme has been acknowledged by the CDC, WHO & SHEA and changed the WHO’s IPC guidelines. This programme of work is contributing to the evidence base for hand hygiene and other IPC interventions, has had international impact & has and is contributing to IPC research capacity building.

11. Thank you. Any questions? l.price@gcu.ac.uk