COMMENT
880
I
had an unusually attentive audience this week for a session on ‘how to fit test an FFP3 face mask’. In the wake of the Ebola outbreak in West Africa, there has been a parallel outbreak in the need to learn how to find and put on personal protective equipment (PPE). This time, phones and other devices were ignored. I was genuinely concerned that efforts to ensure that masks fitted properly (by obstructing the air flow) were so enthusiastic that they might lead to casualties. A problem encountered by many services and specialties that seek to prevent harm is that the target audience may be reluctant or too busy to prepare and train. However, in my experience, any infectionprevention messages delivered in the context of a real or perceived risk are received with rapt attentiveness. Sometimes, a little fear can be useful in getting people’s attention. The media and internet help to increase the anxiety, but there is usually a requirement for less sensational and more accurate information in health care. In the past, interest in necrotising fasciitis rocketed after headlines about ‘flesh-eating bugs’. The danger of a pre-antibiotic era associated with antibiotic resistance is a more recent example. Infection prevention and control teams have to be alert to current affairs and flexible enough to respond to education opportunities as they arise. Perhaps I notice more because it’s my specialty, but there seems to be a new or potential infectionrelated issue or threat every week. Responding to every report is not advisable, as there is a danger of audience overload. It’s also rarely good news, so unless you plan to provide simultaneous counselling, it is better to concentrate on subjects that can be explained clearly, are useful in practice, and don’t suggest that we are all doomed. The good news is that, as infection prevention and control is based on relatively simple principles, once you know which micro-organism you are dealing with, the rest is simple. The bad news is that it isn’t that simple—and you often don’t know what you are dealing with. The plethora of guidance from various expert groups and interpretations by experts can make it even more complicated. To add to the confusion, every organisation seems to want to write its own version in a local policy. All of this takes a while to assimilate and is usually not to hand when you actually need it. As a clinician remarked to me recently: ‘I haven’t got time to read all that. Just tell me what I need to do!’ This assumes that I actually know what they need to do. Usually I do, but sometimes I also
need to seek advice or clarification as I don’t know everything. We teach new infection-control nurses to be honest and, if they do not know the answer to a query, just to say so. Generally, these queries or uncertainties are brought back to the team, which may hold varying opinions.Visiting animals, relatives bringing in food, and staff in scrubs eating in the cafeteria seem to cause the most debate. Gaining consensus and consistency in the team is important; otherwise, considerable confusion and uncertainty can arise. Often our deliberations lead to consensus, but sometimes we have to compromise or recognise what is actually possible. Although our ultimate aim is effectively to make ourselves redundant—by empowering and enabling others to risk-assess and determine the infection controls required—our contribution is still essential. In my own organisation, the level of awareness of what is required in infection prevention and control is high and is a regular feature in executive board meetings. The considerable resources invested in this specialty are matched only by the expectation of its contribution to the quality and safety agenda. This contribution hasn’t happened overnight and is the culmination of years of opportunities to influence, engage and inform. Sometimes, using learning opportunities when staff are concerned about an issue can be valuable because you can be sure of having their attention. In infection control it’s particularly useful, as you can reiterate the importance of the basic principles of hand hygiene, PPE, isolation, cleaning and waste disposal. Concern can enable staff to use this core knowledge and practise it safely when they need it. Anxiety and fear can be reduced if they are confident that they know what to do. I ended my week by attending a lecture from a doctor who had recently worked in Sierra Leone. The room was full and included experts and specialists. The recognition of the value of simple infection-control practices based on basic principles was clear to everyone. No-one was asking for evidence that they needed to roll up their sleeves or arguing about the value of hand hygiene. In the face of a potential threat to themselves, knowledge and experience in how to get and put on PPE became really important. So who wants some training? Please form an BJN orderly queue. Annette Jeanes Director of Infection Prevention and Control and Consultant Nurse, University College London Hospitals Foundation Trust, London
© 2014 MA Healthcare Ltd
Editorial Board David Aldulaimi, Consultant Physician, Gastroenterologist, Worcestershire Acute Hospitals NHS Trust Palo Almond, Academic and Research Consultant, Anglia Ruskin University Irene Anderson, Prinicipal Lecturer and Reader in Learning and Teaching in Healthcare Practice, University of Hertfordshire Russell Ashmore, Senior Lecturer in Mental Health Nursing, Sheffield Hallam University Steve Ashurst, Critical Care Nurse Lecturer, Maelor Hospital, Wrexham Christopher Barber, Residential Nurse Dimitri Beeckman, Lecturer and Researcher, Florence Nightingale School of Nursing & Midwifery, King’s College London Lizzy Bernthal, Research Fellow and Lead Nursing Lecturer, Medical Directorate, Birmingham Martyn Bradbury, Clinical Skills Network Lead, University of Plymouth Emma Collins, Senior Sister, Practice Development Lead, Brighton and Sussex University Hospitals NHS Trust Alison Coull, Lecturer, Department of Nursing and Midwifery, University of Stirling, Scotland David Delaney, Charge Nurse, Clinical Research, Alder Hey Children’s Hospital Jane Fox, Independent Consultant, Derbyshire Alan Glasper, Professor of Child Health Nursing, University of Southampton Angela Grainger, Assistant Director of Nursing, King’s College Hospital NHS Trust, London Michelle Grainger, Ward Manager, Moseley Hall Hospital, Birmingham Helen Holder, Senior Lecturer, Nursing Studies, Birmingham City University Mina Karamshi, Specialist Sister in Radiology, Royal Free Hospital, Hampstead Joanne McPeake, Acute Specialist Nurse/Senior Staff Nurse in Critical Care; Honourary Lecturer/Practitioner in Critical Care, University of Glasgow Andrew McVicar, Reader, Dept of Mental Health & Learning Disabilities, Anglia Ruskin University Danny Meetoo, Lecturer in Adult Nursing, University of Salford Mervyn Morris, Director, Centre for Mental Health Policy, Birmingham City University Aru Narayanasamy, Associate Professor, University of Nottingham Ann Norman, RCN Criminal Justice Services Nursing Adviser and Learning Disability Nursing Adviser Joy Notter, Professor, Birmingham City University & Saxion University of Applied Science, Netherlands Anne-Maria Olphert, Chief Nurse, Director of Quality, Erewash CCG, Derbyshire Hilary Paniagua, Senior Lecturer, School of Nursing & Midwifery, University of Wolverhampton Ian Peate, Director of Studies, Head of School, Gibraltar Health Authority Bernadette Porter, Nurse Consultant, National Hospital for Neurology and Neurosurgery, UCLH NHS Trust Angela Robinson-Jones, Consultant Nurse, Gynaecology, Liverpool Women’s Hospital John Tingle, HRS Reader in Health Law, Nottingham Law School, Nottingham Trent University Geoffrey Walker, Matron for Medicine, Cardiology and Specialist Nursing Services Poole Hospital NHS Foundation Trust Catherine Whitmore, Research Nurse, Diabetes and Endocrinology, University of Liverpool Jo Wilson, Director, Wilson Healthcare Services, Newcastle Cate Wood, Lecturer, Bournemouth University, PhD student at London School of Hygiene and Tropical Medicine Sue Woodward, Lecturer, Specialist and Palliative Care, Florence Nightingale School of Nursing and Midwifery, King’s College London
Catching the chance to teach infection control
British Journal of Nursing, 2014, Vol 23, No 16
British Journal of Nursing. Downloaded from magonlinelibrary.com by 130.194.020.173 on November 15, 2015. For personal use only. No other uses without permission. . All rights reserved.
880
I
had an unusually attentive audience this week for a session on ‘how to fit test an FFP3 face mask’. In the wake of the Ebola outbreak in West Africa, there has been a parallel outbreak in the need to learn how to find and put on personal protective equipment (PPE). This time, phones and other devices were ignored. I was genuinely concerned that efforts to ensure that masks fitted properly (by obstructing the air flow) were so enthusiastic that they might lead to casualties. A problem encountered by many services and specialties that seek to prevent harm is that the target audience may be reluctant or too busy to prepare and train. However, in my experience, any infectionprevention messages delivered in the context of a real or perceived risk are received with rapt attentiveness. Sometimes, a little fear can be useful in getting people’s attention. The media and internet help to increase the anxiety, but there is usually a requirement for less sensational and more accurate information in health care. In the past, interest in necrotising fasciitis rocketed after headlines about ‘flesh-eating bugs’. The danger of a pre-antibiotic era associated with antibiotic resistance is a more recent example. Infection prevention and control teams have to be alert to current affairs and flexible enough to respond to education opportunities as they arise. Perhaps I notice more because it’s my specialty, but there seems to be a new or potential infectionrelated issue or threat every week. Responding to every report is not advisable, as there is a danger of audience overload. It’s also rarely good news, so unless you plan to provide simultaneous counselling, it is better to concentrate on subjects that can be explained clearly, are useful in practice, and don’t suggest that we are all doomed. The good news is that, as infection prevention and control is based on relatively simple principles, once you know which micro-organism you are dealing with, the rest is simple. The bad news is that it isn’t that simple—and you often don’t know what you are dealing with. The plethora of guidance from various expert groups and interpretations by experts can make it even more complicated. To add to the confusion, every organisation seems to want to write its own version in a local policy. All of this takes a while to assimilate and is usually not to hand when you actually need it. As a clinician remarked to me recently: ‘I haven’t got time to read all that. Just tell me what I need to do!’ This assumes that I actually know what they need to do. Usually I do, but sometimes I also
need to seek advice or clarification as I don’t know everything. We teach new infection-control nurses to be honest and, if they do not know the answer to a query, just to say so. Generally, these queries or uncertainties are brought back to the team, which may hold varying opinions.Visiting animals, relatives bringing in food, and staff in scrubs eating in the cafeteria seem to cause the most debate. Gaining consensus and consistency in the team is important; otherwise, considerable confusion and uncertainty can arise. Often our deliberations lead to consensus, but sometimes we have to compromise or recognise what is actually possible. Although our ultimate aim is effectively to make ourselves redundant—by empowering and enabling others to risk-assess and determine the infection controls required—our contribution is still essential. In my own organisation, the level of awareness of what is required in infection prevention and control is high and is a regular feature in executive board meetings. The considerable resources invested in this specialty are matched only by the expectation of its contribution to the quality and safety agenda. This contribution hasn’t happened overnight and is the culmination of years of opportunities to influence, engage and inform. Sometimes, using learning opportunities when staff are concerned about an issue can be valuable because you can be sure of having their attention. In infection control it’s particularly useful, as you can reiterate the importance of the basic principles of hand hygiene, PPE, isolation, cleaning and waste disposal. Concern can enable staff to use this core knowledge and practise it safely when they need it. Anxiety and fear can be reduced if they are confident that they know what to do. I ended my week by attending a lecture from a doctor who had recently worked in Sierra Leone. The room was full and included experts and specialists. The recognition of the value of simple infection-control practices based on basic principles was clear to everyone. No-one was asking for evidence that they needed to roll up their sleeves or arguing about the value of hand hygiene. In the face of a potential threat to themselves, knowledge and experience in how to get and put on PPE became really important. So who wants some training? Please form an BJN orderly queue. Annette Jeanes Director of Infection Prevention and Control and Consultant Nurse, University College London Hospitals Foundation Trust, London
© 2014 MA Healthcare Ltd
Editorial Board David Aldulaimi, Consultant Physician, Gastroenterologist, Worcestershire Acute Hospitals NHS Trust Palo Almond, Academic and Research Consultant, Anglia Ruskin University Irene Anderson, Prinicipal Lecturer and Reader in Learning and Teaching in Healthcare Practice, University of Hertfordshire Russell Ashmore, Senior Lecturer in Mental Health Nursing, Sheffield Hallam University Steve Ashurst, Critical Care Nurse Lecturer, Maelor Hospital, Wrexham Christopher Barber, Residential Nurse Dimitri Beeckman, Lecturer and Researcher, Florence Nightingale School of Nursing & Midwifery, King’s College London Lizzy Bernthal, Research Fellow and Lead Nursing Lecturer, Medical Directorate, Birmingham Martyn Bradbury, Clinical Skills Network Lead, University of Plymouth Emma Collins, Senior Sister, Practice Development Lead, Brighton and Sussex University Hospitals NHS Trust Alison Coull, Lecturer, Department of Nursing and Midwifery, University of Stirling, Scotland David Delaney, Charge Nurse, Clinical Research, Alder Hey Children’s Hospital Jane Fox, Independent Consultant, Derbyshire Alan Glasper, Professor of Child Health Nursing, University of Southampton Angela Grainger, Assistant Director of Nursing, King’s College Hospital NHS Trust, London Michelle Grainger, Ward Manager, Moseley Hall Hospital, Birmingham Helen Holder, Senior Lecturer, Nursing Studies, Birmingham City University Mina Karamshi, Specialist Sister in Radiology, Royal Free Hospital, Hampstead Joanne McPeake, Acute Specialist Nurse/Senior Staff Nurse in Critical Care; Honourary Lecturer/Practitioner in Critical Care, University of Glasgow Andrew McVicar, Reader, Dept of Mental Health & Learning Disabilities, Anglia Ruskin University Danny Meetoo, Lecturer in Adult Nursing, University of Salford Mervyn Morris, Director, Centre for Mental Health Policy, Birmingham City University Aru Narayanasamy, Associate Professor, University of Nottingham Ann Norman, RCN Criminal Justice Services Nursing Adviser and Learning Disability Nursing Adviser Joy Notter, Professor, Birmingham City University & Saxion University of Applied Science, Netherlands Anne-Maria Olphert, Chief Nurse, Director of Quality, Erewash CCG, Derbyshire Hilary Paniagua, Senior Lecturer, School of Nursing & Midwifery, University of Wolverhampton Ian Peate, Director of Studies, Head of School, Gibraltar Health Authority Bernadette Porter, Nurse Consultant, National Hospital for Neurology and Neurosurgery, UCLH NHS Trust Angela Robinson-Jones, Consultant Nurse, Gynaecology, Liverpool Women’s Hospital John Tingle, HRS Reader in Health Law, Nottingham Law School, Nottingham Trent University Geoffrey Walker, Matron for Medicine, Cardiology and Specialist Nursing Services Poole Hospital NHS Foundation Trust Catherine Whitmore, Research Nurse, Diabetes and Endocrinology, University of Liverpool Jo Wilson, Director, Wilson Healthcare Services, Newcastle Cate Wood, Lecturer, Bournemouth University, PhD student at London School of Hygiene and Tropical Medicine Sue Woodward, Lecturer, Specialist and Palliative Care, Florence Nightingale School of Nursing and Midwifery, King’s College London
Catching the chance to teach infection control
British Journal of Nursing, 2014, Vol 23, No 16
British Journal of Nursing. Downloaded from magonlinelibrary.com by 130.194.020.173 on November 15, 2015. For personal use only. No other uses without permission. . All rights reserved.
