My Role as a Cleanliness Champion. Thank you for inviting me to speak today. It’s terrifying to be here!! :D. Lesley Brady Community Podiatrist.

Podiatry. High Risk foot care. Wound management Acute and Chronic. Nail Surgery. Patients with Chronic foot pathologies. Foot Ulceration Treatment and Prevention Musculoskeletal (MSK) conditions. We are part of the multi-disciplinary team. Good infection prevention and control standards are an essential part of our practice. Click! And here is why! These are examples of the types of patients we see as a department on a daily basis in Community, Acute, Nursing homes and Domiciliary environments. In NHS Lothian there are 89 of us, over 45 sites covering some 700 Sq miles. most of which are part time clinics, some of which, Myself included. are part time staff. What follows is what we have been able to apply in our dept since I completed the Cleanliness Champions Programme in 2009.

Presentations Hand Hygiene update. The Podiatry Cleaning Matrix Reinforce Mandatory Training. Raise awareness of the monthly requirement for hand hygiene audits. The Podiatry Cleaning Matrix Prevent HAI’s by closing knowledge gaps. Make staff aware of where their cleaning responsibilities lie. Limit the risk of failure on HEI inspection. Daily documented evidence of cleaning tasks. The first thing the programme did for me, and you may be the same? Was make me more observant on all aspects relating to infection control in my own practice and environment. I have shared Audit results and Updates with my colleagues through a presentations via PowerPoint at our team meetings. I had never in my life attempted a PowerPoint presentation before that day… or any kind of public speaking to be quite frank. Click. I decided to start with the most important factor, and immediately after I completed the course, I delivered a hand hygiene update. The aim being two fold…. to reinforce my colleagues knowledge of the subject as it is covered in mandatory training. But also to raise awareness that hand hygiene audits from every dept have been a requirement since 2006. And I’ll be auditing from now on. For several years I audited Hand Hygiene, Clinical waste, Sharps disposal, PPE, and environment. The last of which Environmental, and a request to perform peer reviews with our domestics services team led me to NHS Lothians Cleaning Matrix in 2011. The cleaning Matrix for NHS Lothian was developed to ensure standards of cleaning were the same across NHS Lothian. It also separated which cleaning tasks should be undertaken by Domestic services and which were the clinicians responsibility. When I asked Podiatry staff what was their responsibility to clean? It threw up quite a varied list and some areas were open to being missed and therefore increased risk of HAI’s. Click Using code G of the cleaning matrix which applies to Health centres and GP surgeries. I spent the best part of a year developing and piloting a “check list” for Podiatrists to follow we refer to as “the Podiatry cleaning matrix” It was introduced to staff via PowerPoint presentation in January 2012 Its use was implemented within our dept in Edinburgh, East and Mid-lothian in April 2012. Its aims were: Reduce the risk of HAI’s by closing the knowledge gap clear guidelines for clinical staff re which cleaning tasks were ours. Limit the risk of failure over things we can control if HEI called. Provide documented evidence of cleaning tasks completed.

Audit Results Pie Chart 1: Responses by staff via voting buttons. Question asked of staff via e-mail, 60 staff were emailed 48 responded using voting buttons. “In your opinion, since starting the cleaning matrix, have cleanliness standards within the department improved?” Click We have audited it since. Before we audited In November 2012. We asked staff via email to use voting buttons and answer the question “In your opinion, since starting the cleaning matrix, have cleanliness standards within the dept improved?” staff answered Yes, no ,or maybe. And you can see the results. Our matrix is due to be audited again in November.

Training Self directed learning. Group work. Ensure Learn Pro mandatory modules for HAI prevention are current Complete the Stand alone Hand Hygiene Learn Pro module. Group work. • Step One: PowerPoint presentation and use of the Glow Germ Light box. • Step Two: DVD and Challenging behaviour session. • Step Three: Introduction to the IT aspects of the audit process (QiDS). • Step Four: Team discussion on implementation, and feedback. Approximately 2 hours to complete the group work. In order to reach more of our staff and increase their awareness of the importance of compliance with Hand Hygiene, I was given the go ahead by my Manager earlier this year to train up other staff members to become part of a hand hygiene audit team in Podiatry. All clinical staff were emailed and asked to respond to me if they wanted to be a part of the team. I believed then and still do now that “motivation” combined with knowledge are key in getting the hand hygiene message over. So it was important for me that staff on the team Wanted to be there. Click I developed a training programme which was split into two sections. The first part was self directed learning and was completed prior to group work This was made up of the HAI prevention, and Promoting hand hygiene modules via Learn pro. Group work This aspect is very heavily weighted on practical and observation. We got the 5 volunteers together for the group work I delivered a PowerPoint presentation and then we checked our own hand hygiene technique using the “Glow Germ” light box. I developed a DVD of 3 short films of me failing to comply with the hand hygiene. False nails, rings with stones, bracelets, nail polish…. You get the picture. Everyone sat in a group and had to spot as many “non-compliant” events as possible. We also discussed some of the reasons people offer up as reasons for non-compliance i.e. “My nails are not too long”, “ I got these nail extensions put on for my cousins wedding” (3 wks ago). Double Click I then ran though how to input audit info onto QiDS which is the data entry system in use in NHS Lothian. It took 2hrs to complete the session and feedback was all very positive. Five members of staff have completed training and are actively auditing within Podiatry throughout NHS Lothian. Another 4 are being trained at the end of next month.

Conclusion I have found the Cleanliness Champions programme to be very rewarding. It has allowed me to develop my career in ways I never thought possible (e.g. RIGHT NOW!). I would recommend the programme to any AHP Community or Acute. In Conclusion Click Read Read.

Thank You. Thank you for your attention. Click Are there any questions?

Acknowledgements. Pat Donald. (Podiatry Manager and Acting AHP Manager NHS Lothian). William McMurrich. (Principal Podiatrist and Acting Podiatry Manager NHS Lothian). Gillian Hawthorne. (Podiatry Team Lead NHS Lothian). Carol Horsburgh (Senior I.C. nurse NHS Lothian). Ann McQueen. (Hand Hygiene co-ordinator NHS Lothian). Caroline Bowman. (Cleanliness Champions co-ordinator NHS Lothian).