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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
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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 • 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