Preventing healthcare-associated infection through education: Have surgeons been overlooked?

McHugh, Seamus; Hill, Arnold D.; Humphreys, Hilary

doi:10.1016/j.surge.2009.11.009

Cited by 18 publications

(14 citation statements)

References 52 publications

(62 reference statements)

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“…A review of patient programmes and studies amongst healthcare professions has recently indicated the absence of an educational strategy for surgical trainees and this requires attention given the frequency and importance of surgical infections. 21 As patients themselves become more educated about the risks and the consequences of HCAI and the measures that have been shown to be successful in their prevention, this will impact on postgraduate training programmes necessitating greater emphasis on education in this area.…”

Section: Discussionmentioning

confidence: 99%

Undergraduate and postgraduate medical education on the prevention and control of healthcare-associated infection. More progress is needed

Humphreys¹,

Richards²

2011

Int. j. infect. control

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The prevention and control of healthcare-associated infection (HCAI) is a significant patient safety and quality issue that has not been accorded sufficient emphasis in the medical school curriculum. Compliance amongst medical students and graduates with basic measures such as hand hygiene is inferior to that amongst other healthcare groups such as nurses. While there are some studies assessing the knowledge of medical students on HCAI prevention, few have assessed attitudes and practice or behaviour. Although, HCAI is being recognised in the medical curriculum there is scope for greater co-ordination in educational delivery and assessment. At postgraduate level, there has been some success in enhancing the prevention of catheter-associated bloodstream infection through a multi-modal approach that has been shown to be superior to traditional measures. Education programmes need to be developed at the postgraduate level geared to the specialty, but much more work needs to be done to highlight the importance of this area and to ensure better compliance

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Section: Discussionmentioning

confidence: 99%

Undergraduate and postgraduate medical education on the prevention and control of healthcare-associated infection. More progress is needed

Humphreys¹,

Richards²

2011

Int. j. infect. control

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“…595,596,[643][644][645] Although existing studies highlight success in limiting HCAIs 48,181 through hand hygiene 195,639,[646][647][648] and wider reaching educational programmes, [649][650][651][652][653] a high level of non-compliance with basic infection control measures persists among health-care professionals. 654 Indeed, junior medical and nursing staff copy the aberrant behaviour of their superiors, [655][656][657] which results in the entrenchment of non-compliance across successive generations. [655][656][657][658][659][660] IPAC teams, therefore, have a central role to play in active staff engagement, 661 support for peer-to-peer education, 662 and the monitoring of HCAIs to reduce the burden of avoidable harm to patients and its associated untoward costs.…”

Section: Reducing Health-care-associated Infectionmentioning

confidence: 99%

“…654 Indeed, junior medical and nursing staff copy the aberrant behaviour of their superiors, [655][656][657] which results in the entrenchment of non-compliance across successive generations. [655][656][657][658][659][660] IPAC teams, therefore, have a central role to play in active staff engagement, 661 support for peer-to-peer education, 662 and the monitoring of HCAIs to reduce the burden of avoidable harm to patients and its associated untoward costs. 581, The changing epidemiology of HCAIs 607,608,611,612,617, also places demands on medical microbiologists and clinical pharmacists specialising in antibiotic medicines management.…”

Section: Reducing Health-care-associated Infectionmentioning

confidence: 99%

A realist analysis of hospital patient safety in Wales: applied learning for alternative contexts from a multisite case study

Herepath

Kitchener

Waring

2015

Health Serv Deliv Res

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BackgroundHospital patient safety is a major social problem. In the UK, policy responses focus on the introduction of improvement programmes that seek to implement evidence-based clinical practices using the Model for Improvement, Plan-Do-Study-Act cycle. Empirical evidence that the outcomes of such programmes vary across hospitals demonstrates that the context of their implementation matters. However, the relationships between features of context and the implementation of safety programmes are both undertheorised and poorly understood in empirical terms.ObjectivesThis study is designed to address gaps in conceptual, methodological and empirical knowledge about the influence of context on the local implementation of patient safety programmes.DesignWe used concepts from critical realism and institutional analysis to conduct a qualitative comparative-intensive case study involving 21 hospitals across all seven Welsh health boards. We focused on the local implementation of three focal interventions from the 1000 Lives+patient safety programme: Improving Leadership for Quality Improvement, Reducing Surgical Complications and Reducing Health-care Associated Infection. Our main sources of data were 160 semistructured interviews, observation and 1700 health policy and organisational documents. These data were analysed using the realist approaches of abstraction, abduction and retroduction.SettingWelsh Government and NHS Wales.ParticipantsInterviews were conducted with 160 participants including government policy leads, health managers and professionals, partner agencies with strategic oversight of patient safety, advocacy groups and academics with expertise in patient safety.Main outcome measuresIdentification of the contextual factors pertinent to the local implementation of the 1000 Lives+patient safety programme in Welsh NHS hospitals.ResultsAn innovative conceptual framework harnessing realist social theory and institutional theory was produced to address challenges identified within previous applications of realist inquiry in patient safety research. This involved the development and use of an explanatory intervention–context–mechanism–agency–outcome (I-CMAO) configuration to illustrate the processes behind implementation of a change programme. Our findings, illustrated by multiple nested I-CMAO configurations, show how local implementation of patient safety interventions are impacted and modified by particular aspects of context: specifically, isomorphism, by which an intervention becomes adapted to the environment in which it is implemented; institutional logics, the beliefs and values underpinning the intervention and its source, and their perceived legitimacy among different groups of health-care professionals; and the relational structure and power dynamics of the functional group, that is, those tasked with implementing the initiative. This dynamic interplay shapes and guides actions leading to the normalisation or the rejection of the patient safety programme.ConclusionsHeightened awareness of the influence of context on the local implementation of patient safety programmes is required to inform the design of such interventions and to ensure their effective implementation and operationalisation in the day-to-day practice of health-care teams. Future work is required to elaborate our conceptual model and findings in similar settings where different interventions are introduced, and in different settings where similar innovations are implemented.FundingThe National Institute for Health Research Health Services and Delivery Research programme.

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“…10 11 Since it has been shown that hospitals with a higher trainee-to-bed ratio also have an increased SSI incidence 12 , there is a need for dedicated infection prevention and control programmes relating to surgical practice and incorporating the education of surgeons. 13 In this way, surgeons will be better educated and motivated and are expected to take ownership of their own input into minimising HCAI.…”

Section: Introductionmentioning

confidence: 99%

Preventing infection in general surgery: improvements through education of surgeons by surgeons

McHugh

Corrigan

Dimitrov

et al. 2011

Journal of Hospital Infection

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Preventing healthcare-associated infection through education: Have surgeons been overlooked?

Cited by 18 publications

References 52 publications

Undergraduate and postgraduate medical education on the prevention and control of healthcare-associated infection. More progress is needed

Undergraduate and postgraduate medical education on the prevention and control of healthcare-associated infection. More progress is needed

A realist analysis of hospital patient safety in Wales: applied learning for alternative contexts from a multisite case study

Preventing infection in general surgery: improvements through education of surgeons by surgeons

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