1. Decontamination Safety Programme
Education can we make a Difference?
RCN,PgDip IPC,MSc MDD Lead Auditor

2. Irish Tradition

3. Decontamination Safety Programme Aim
Minimise the risk of device related Healthcare Associated Infection in Primary and Acute Care by improving reliability in the management and decontamination of reusable invasive medical devices (RIMD).
Reliability Theories, minimise variation in practice , reduce likelihood of error
safety/Medical Devices/decontamination/

4. Context
51 hospitals – 7 Hospital Groups 300k surgical procedures Elective Procedures ↑ 3.6% (2017) ↑75% from k endoscopy procedures Colonoscopy 2nd most common procedure across Europe – Ireland / UK/ Malta 14/ 1000 Colorectal cancer is 2nd most common cause of cancer death in Ireland.

5. Context 673 public acute hospitals 2.7 million surgical procedures
Elective surgery ↑ 4.4% /year
Most common elective surgery – cataracts and malignant skin disease
Colonoscopies 10/1000
Highest coeliac disease rate in the world
Australian Institute of Health and Welfare
Canberra

6. Key Drivers for Education Development
Pressure on Turnaround Times
Outbreaks relate to equipment, process, practice and device design.
Training- absence of recognised academic training for technicians.
Complex Device Design
More Complex Procedures
Doing more with less
Unique Technical Skills

7. Key Findings and Recommendations HSE Service Review 2015
Over reliance on Manufacturer Training
HSE

8. HIQA-Regulator Report 2016
Key Findings
lack of dedicated endoscopy decontamination technicians .
Recommendations
Trained dedicated staff should be assigned to decontamination duties.
HIQA commence thematic review of Decontamination Services in Acute Hospitals / August 2018
Education and training high on agenda

9. Investing in Education-Our Journey
Curriculum Development
What matters to the patient?
Environment, Personnel, Equipment is safe for re use –
Microbiology Theory and Practice – Module 1
What matters to staff?
How do I reliably and safely reprocess an endoscope from manual clean to storage-
Theory and Frontline Practical Skills – Module 2
What matters to the organisation?
Process reliability, Validation, Water Quality, environmental monitoring , facility design – Module 3

10. Other Factors Considered
Facility – Design – Collaboration
Time constraints – Frontline challenges
Learning Mode
Online with 4 days contact.
Tutors Cost- Funding -Target date
Outcomes
Staff: Academic Recognition ,Progression
Quality Improvement Project in the
Workplace -Conference Presentation
Peer Recognition –
Organisation
Compliance with best practice- consistency
What are the outcomes for

11. Project Examples

12. Decontamination Education Evaluation Methods
Kirkpatrick 5 tier model of education evaluation
Kirkpatrick (2016)

13. Student Evaluation
Kirkpatrick’s Model : Satisfaction, Learning and Impact
on learner
Questionnaire- 16 question using 5 point Likert scale.
Space to include free text comments on the questionnaire- .
Questionnaire completed 2015, 2016, 2017
Response rate 52%
(Sandelowski, 2004)

14. Student Evaluation

15. Are We Making A Difference in Practice or Ticking the Box?
Kirkpatrick's 4th Level of Training Evaluation

16. Evaluation of Managers Perception
Questionnaire- 5 point Likert Scale
Questions n=8.
Space to include free text comments
Qualitative thematic analysis used to explore free text comments.
Questionnaire completed April 2018
Response rate 48%
(Sandelowski, 2004)

17. Evaluation of Managers Perception re Impact on Service

18. Thematic Analysis of Managers Comments
Greater Engagement
Changes in the attitude to work and ability to trouble shoot
Tangible -Taking ownership of new tasks , Environmental Monitoring , Audit etc
More proactive in the implementation of quality initiatives
Improved compliance to standards in the department
Greater awareness of their role in driving patient safety.

19. Thematic Analysis of Managers Comments
Confidence
Great knowledge and pride in work and confidence in decision making
using knowledge to participate in conversations in relation to best practice
Willingness to challenge poor practice
Profile
Willingness to progress to Degree Level/ other PD opportunities
Raised profile and educational needs of department.
Greater financial support from SMT.

20. Summary of Outcomes 220 Decontamination Students- 70% from HSE
30% Private Hospitals and Industry – Accessibility
Standardised Learning
20% Progression to Degree
Endoscopy, RIMD and US Probes
Primary Care
Frontline Engagement
Empowering FLO –

21. Go Raibh Maith Agat !