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 Adult Learning 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 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