Evidence-based training helps meet IPC targets

Within the healthcare sector there is growing pressure to reduce the rates of Health Care Associated Infections (HCAI). Infection Prevention and Control (IPC) teams have increasingly stringent targets to aim for with tighter budgets and larger penalties in place if they fail.

Public scrutiny and media coverage on hospital cleanliness is consistently growing, placing additional pressure on IPC teams. What can an IPC team do in 2017 to address these concerns and hit their targets?

It is accepted practice that improved infection control practices, such as good hand hygiene, routine cleaning and disinfection of surfaces, can help break the chain of transmission and therefore reduce HCAI rates.

There have been many initiatives from both the Government and individual Trusts that target hand hygiene, however compliance and product effectiveness can vary. Environmental surfaces can serve as a reservoir for microorganisms, which can be transferred to the hands of healthcare workers, visitors and patients. Good environmental cleaning practices help to reduce bacterial load, preventing the cross transmission of potentially harmful microorganisms. Studies have shown the positive impact of effective environmental cleaning on reducing the bioburden of MRSA, C. difficile and norovirus.

In many Health Services there is a confusing division of labour and responsibility between nursing and cleaning staff regarding environmental cleaning, with some equipment being missed altogether from the cleaning schedule and some items, such as beds having a shared responsibility. Over 70% of the most common patient touch points are not effectively cleaned.

Clinical equipment should be cleaned after each use, placing the responsibility of cleanliness on medical staff. However, according to a Nursing Times, 75% of nurses had not received adequate training in environmental cleaning and only 16% of senior doctors received any training at all. A recent internet-based survey of 98 nurses confirmed that nurses were regularly expected to clean, yet two-thirds of respondents had no formal training in cleaning a commode, mattress or the general hospital environment.

Reducing HCAIs

Education and training are proven to reduce HCAIs. It doesn’t matter how powerful the disinfectant or how effective the delivery mechanism is, it will never achieve its stated claims if it is not used correctly due to insufficient understanding and training. An accessible, comprehensive and universal training scheme should be available to all staff. This should cover the basic tenets of infection control, such as why cleaning is important; how to clean in the most efficient manner; transference and high touch points. Easy-to-understand videos and step-by-step diagrams on the most effective way to clean surfaces and equipment within the healthcare environment would be an invaluable tool for all staff.

Infection Control teams are required to create reports on training interventions and results, these can be time consuming and complicated. The ability to monitor and measure results and then generate comprehensive reports should be intrinsic within a new media based delivery system simplifying the whole process.

Studies have shown that monitoring cleaning efficacy has a positive impact on the thoroughness and level of cleaning that is attained. Ultra Violet marking is a common and cost-efficient solution to assist with monitoring and training good environmental cleaning practices.

GAMA Healthcare, the manufacturer of Clinell (the leading supplier of infection control products to the NHS), invited over 20 senior Infection Prevention and Control professionals, including several past and present members of the IPS board, to join an advisory board. The board was tasked with creating the most flexible and accessible training package for the UK. Their advice, experience and research undertaken on over 130 of the most up-to-date and relevant journals and studies have enabled GAMA to create a package outlining a practical and scientific approach to effective cleaning practices within a healthcare setting. The resulting training package cost over £350,000 to develop, took nearly two years to produce, and is widely considered the most comprehensive educational guide to environmental cleaning available to healthcare professionals.

Training Application

Delivered primarily on a 10in Android powered tablet, the Clinell Training Application is both accessible and enjoyable. Featuring fun and engaging games which help to emphasise key learning points and measure understanding. The application is designed to be used individually, in a small or large group and to assist staff in performing bespoke ward-based training. The videos and instructional diagram sheets explain simply and clearly the most effective way to reduce microorganisms on the most common items found within a hospital.

Included within the Clinell Training Package is the UV Torch Kit: One UV torch, water-soluble UV pens, UV powder and evidence based guidance booklet on where best to mark ward rooms and bathrooms, making monitoring simple and effective.

Resources

1. Otter et al. Am J Infect Control. 2013 May;41(5 Suppl):S6-11. doi: 10.1016/j.ajic.2012.12.004.
2. Weber et al. Curr Opin Infect Dis. 2013 Aug;26(4):338-44. doi: 10.1097/QCO.0b013e3283630f04.
3. Rutala et al. Am J Infect Control. 2013 May;41(5 Suppl):S36-41. doi: 10.1016/j.ajic.2012.11.006.
4. Messina et al. Eur J Public Health (2013) 23 (suppl 1): doi: 10.1093/eurpub/ckt126.342
5. Kundrapu et al. Infect Control Hosp Epidemiol. 2014 Feb;35(2)
6. Plipat et al. BMC Infect Dis. 2013 Dec 17;13:595. doi: 10.1186/1471-2334-13-595.
7. Sitzlar et al. Infect Control Hosp Epidemiol. 2013 May;34(5):459-65. doi: 10.1086/670217.
8. Guerrero et al. Am J Infect Control. 2012 Aug;40(6):556-8. doi: 10.1016/j.ajic.2011.08.002. Epub 2011 Oct 7.
9. Dancer, S. 2011. European journal of clinical microbiology & infectious diseases, 30, 1473-1481.
10. National Patient Safety Agency 2007. In: NPSA (ed.). London.

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