Infection Control Link Nurses A different educational approach to a familiar concept.

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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

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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

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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)

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Traditional ICLN Model

• No input to programme by ICLNs
• ICN sets content
• Little networking
• Follows traditional educational model
• ..a bit of a dinosaur!

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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

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....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

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The Plan

• Baseline audit
• Analysis feedback
• Practice interventions
• Re-audit
• Analysis feedback
• Supported by ICNS

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Research Studies

• 3 inter-related studies
• Link Nurses knowledge and attitudes
• Measurable practice improvement
• Link nurses experience

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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 (n10)

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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

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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)

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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

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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

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Empowered Practice?

• I always looked around to see what was going on
  but I wouldnt have challenged them quite the
  same. Now you say this is my role, this is what
  Im trying to do.

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Conclusions

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

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Can This Be Used Elsewhere?

• Repeat in other organisations?
• Pick n Mix
• Utilise structure for practice improvement
• Involve ICLNs in planning programme

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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

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Work Supported By

• Isle of Wight
• Healthcare NHS Trust