Making a difference

Five thousand people a year die from healthcare-related infection, according to figures from the National Audit Office. 

Losing a relative to MRSA (Methicillin Resistant Staphylococcus Aureus) prompted Les Hobbs, director of learning solutions at The Training Foundation, to initiate a programme designed to combat the infection. The result is a one-hour e-learning course, MRSA – you can make a difference, whereby 50 per cent of NHS trusts in England have become licensed users since its launch in July.

The Training Foundation director of corporate development Adrian Snook says: “It doesn’t focus on the ‘how’ of infection control (IC) – it focuses on the ‘why’. It reinforces existing knowledge and complements other IC training that members of the audience may be involved in.”

The course was developed without any backing from the NHS or Department of Health (DoH) and without any advance orders. A series of focus group discussions were held with IC specialists to establish the targets for the course, and it needed to meet the exacting standards of the Infection Control Nurses Association (ICNA). By the end of the course, delegates should be able to:

  • correctly identify all the ways in which the MRSA bacteria is spread
  • identify at least three ways in which they could make a difference in the prevention of MRSA infection in the form of a personal action plan.

The course is aimed at people who come into regular contact with patients and is particularly applicable to clinicians. It is designed as a learning resource for IC nurses (ICNs) and to help drive any behavioural adjustments that might be needed.

The course is intended to complement routine IC training rather than replace it. It can be used as a stand-alone awareness programme, or as part of a wider learning approach, with follow-up discussion or review sessions. Delegates can complete the course on the internet, or via the trust network if they have subscribed to the local installation option. Otherwise, it can be pre-loaded on to a wireless Tablet PC.

It can be undertaken in a self-study mode or as a planned group session. On completion, delegates receive a post-course workbook and can arrange short follow-ups with the IC team to agree and review action plans.

Material was developed and authored by The Training Foundation’s designers in collaboration with IC professionals. Content was evaluated and approved by the ICNA and certified by the Royal Institute for Public Health (RIPH). The course was authored using the Training Foundation’s online tool, Acce-Lerator.

The biggest challenge was developing a course that was relevant to a range of people, from student nurses to senior doctors.

“We overcame these problems by identifying that the key objectives of the course were to focus on attitudes rather than hard skills,” says Hobbs.

“By touching lightly on the detailed medical practices, emphasis could be focused on why they were important, and the difference individuals could make, rather than the mechanics of carrying out procedures. During the course, students are asked to refer to their specific local best practice.”

Cartoons and characterisations are used to illustrate the programme. “We were concerned that some people might find this approach anomalous with the seriousness of the subject,” Snook says. “We believe learning must be enjoyable and we’re pleased that the majority of feedback has been positive.”

The content has been designed to be accessible to as many people as possible. This meant that video streaming, audio and Macromedia Flash content were ruled out at an early stage, as NHS networks and PCs are often not equipped to access such media, or are barred by security settings on firewalls.

Following its launch, 281 organisations are participating in the course, spanning acute, ambulance, care, mental health and primary care trusts. The course has been welcomed by MRSASupport, the support group for sufferers.

Group chairman Tony Field, who has undertaken the course, says: “Attitudes must surely be irrevocably changed by going through this course.”

Health service professionals have been equally welcoming and it complements many of their own initiatives. Margaret Bruce of the North Central London Strategic Health Authority says: “We are keen to get staff engaged ready for the launch of our sector-wide hygiene awareness onslaught this autumn. Now we have the perfect means of doing this, and a key building block for our programme.”

Jacky Hunt, a lead nurse in IC for East and North Hertfordshire Hospitals NHS Trust, says the course integrates well with the trust’s policies and procedures. “The course contains sound infection control information, and I like the way it emphasises that each healthcare worker can really make a difference.”

As with any successful training course, the objective must be to change behaviour, says Hobbs. “This is achieved by using effective adult learning principles: ensuring the course has clearly-defined and achievable objectives; is relevant to the students’ role; actively engages the student (not the transfer of information to passive students), and has measurable outcomes to carry back into the workplace.”

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