Train-the-trainers in hand hygiene : a standardized approach to guide education in infection prevention and control

Background Harmonization in hand hygiene training for infection prevention and control (IPC) professionals is lacking. We describe a standardized approach to training, using a “Train-the-Trainers” (TTT) concept for IPC professionals and assess its impact on hand hygiene knowledge in six countries.Methods We developed a three-day simulation-based TTT course based on the World Health Organization (WHO) Multimodal Hand Hygiene Improvement Strategy. To evaluate its impact, we have performed a pre-and post-course knowledge questionnaire. The Wilcoxon signed-rank test was used to compare the results before and after training.Results Between June 2016 and January 2018 we conducted seven TTT courses in six countries: Iran, Malaysia, Mexico, South Africa, Spain and Thailand. A total of 305 IPC professionals completed the programme. Participants included nurses (n = 196; 64.2%), physicians (n = 53; 17.3%) and other health professionals (n = 56; 18.3%). In total, participants from more than 20 countries were trained. A significant (p < 0.05) improvement in knowledge between the pre- and post-TTT training phases was observed in all countries. Puebla (Mexico) had the highest improvement (22.3%; p < 0.001), followed by Malaysia (21.2%; p < 0.001), Jalisco (Mexico; 20.2%; p < 0.001), Thailand (18.8%; p < 0.001), South Africa (18.3%; p < 0.001), Iran (17.5%; p < 0.001) and Spain (9.7%; p = 0.047). Spain had the highest overall test scores, while Thailand had the lowest pre- and post-scores. Positive aspects reported included: unique learning environment, sharing experiences, hands-on practices on a secure environment and networking among IPC professionals. Sustainability was assessed through follow-up evaluations conducted in three original TTT course sites in Mexico (Jalisco and Puebla) and in Spain: improvement was sustained in the last follow-up phase when assessed 5 months, 1 year and 2 years after the first TTT course, respectively.Conclusions The TTT in hand hygiene model proved to be effective in enhancing participant’s knowledge, sharing experiences and networking. IPC professionals can use this reference training method worldwide to further disseminate knowledge to other health care workers.peer-reviewe

Implementation research for the prevention of antimicrobial resistance and healthcare-associated infections; 2017 Geneva infection prevention and control (IPC)-think tank (part 1)

Background Around 5–15% of all hospital patients worldwide suffer from healthcare-associated infections (HAIs), and years of excessive antimicrobial use in human and animal medicine have created emerging antimicrobial resistance (AMR). A considerable amount of evidence-based measures have been published to address these challenges, but the largest challenge seems to be their implementation. Methods In June 2017, a total of 42 experts convened at the Geneva IPC-Think Tank to discuss four domains in implementation science: 1) teaching implementation skills; 2) fostering implementation of IPC and antimicrobial stewardship (AMS) by policy making; 3) national/international actions to foster implementation skills; and 4) translational research bridging social sciences and clinical research in infection prevention and control (IPC) and AMR. Results Although neglected in the past, implementation skills have become a priority in IPC and AMS. They should now be part of any curriculum in health care, and IPC career paths should be created. Guidelines and policies should be aligned with each other and evidence-based, each document providing a section on implementing elements of IPC and AMS in patient care. International organisations should be advocates for IPC and AMS, framing them as patient safety issues and emphasizing the importance of implementation skills. Healthcare authorities at the national level should adopt a similar approach and provide legal frameworks, guidelines, and resources to allow better implementation of patient safety measures in IPC and AMS. Rather than repeating effectiveness studies in every setting, we should invest in methods to improve the implementation of evidence-based measures in different healthcare contexts. For this, we need to encourage and financially support collaborations between social sciences and clinical IPC research. Conclusions Experts of the 2017 Geneva Think Tank on IPC and AMS, CDC, and WHO agreed that sustained efforts on implementation of IPC and AMS strategies are required at international, country, and hospital management levels, to provide an adequate multimodal framework that addresses (not exclusively) leadership, resources, education and training for implementing IPC and AMS. Future strategies can build on this agreement to make strategies on IPC and AMS more effective

Research: a personal approach

Fundamental Psychology •Individual Cognition, Motivation and Emotion •Cognitive bio-social approaches to human and animal life Applied Psychology •Health Psychology; Psychology in physical medicine •Customer Psychology; Psychology of product developmen

The many faces of diabetes: a critical multimodal analysis of diabetes pages on Facebook

Health communication published on Facebook has become a popular source of medical information and large organisations now utilise Facebook to disseminate multimodal representations of health and illness. Drawing on a sample of posts to two popular diabetes-related Facebook pages, this paper aims to examine the multimodal representation of people with diabetes and consider the implications of this emergent context of health communication. These posts draw upon visual and linguistic features of social intimacy to synthesise personal relationships with their audiences and to foster user involvement with their authoring organisations. The promissory vision of living well with diabetes that predominates on these pages is thus also designed to serve the agendas of organisations who are dependent on user participation to generate revenue. Keyword

#any use? What do we know about how teachers and doctors learn through social media use?

This scoping literature review describes the landscape of recent publications (2007-2016) about how teachers and doctors learn through social media to identify whether learning was being considered and, if so, how evidence was collected (N=162). Sixty-seven percent (N=108) were teacher-related and thirty-three percent (N=54) doctor-related, covering empirical studies, literature reviews, position articles and letters to academic journals. Empirical studies were dominant – ninety-one percent (N=98) of teacher-related and sixty-one percent (N=33) of doctor-related – with both fields dominated by in-course evaluations and use/attitude studies. Although doctor-related articles focused on professional online behaviour, rather than professional learning, conference communication and information evaluation were interesting areas of enquiry. Despite professional interest in social media in these professions, there is a dearth of academic studies about their benefits for teacher and doctor learning

Affective Medicine: a review of Affective Computing efforts in Medical Informatics

Background: Affective computing (AC) is concerned with emotional interactions performed with and through computers. It is defined as “computing that relates to, arises from, or deliberately influences emotions”. AC enables investigation and understanding of the relation between human emotions and health as well as application of assistive and useful technologies in the medical domain. Objectives: 1) To review the general state of the art in AC and its applications in medicine, and 2) to establish synergies between the research communities of AC and medical informatics. Methods: Aspects related to the human affective state as a determinant of the human health are discussed, coupled with an illustration of significant AC research and related literature output. Moreover, affective communication channels are described and their range of application fields is explored through illustrative examples. Results: The presented conferences, European research projects and research publications illustrate the recent increase of interest in the AC area by the medical community. Tele-home healthcare, AmI, ubiquitous monitoring, e-learning and virtual communities with emotionally expressive characters for elderly or impaired people are few areas where the potential of AC has been realized and applications have emerged. Conclusions: A number of gaps can potentially be overcome through the synergy of AC and medical informatics. The application of AC technologies parallels the advancement of the existing state of the art and the introduction of new methods. The amount of work and projects reviewed in this paper witness an ambitious and optimistic synergetic future of the affective medicine field

'What was your blood sugar reading this morning?': representing diabetes self-management on Facebook

Social networking sites have swiftly become a salient venue for the production and consumption of neoliberal health discourse by individuals and organisations. These platforms offer both opportunities for individuals to accrue coping resources and a means for organisations to promote their agendas to an online audience. Focusing specifically on diabetes, this article examines the representation of social actors and interactional styles on three organisational Pages on Facebook. Drawing on media and communication theories, we situate this linguistic analysis in relation to the communicative affordances employed by these organisations as they publish content online. Diabetes sufferers are represented as an at-risk group whose vulnerabilities can be managed through forms of participation specific to the respective organisation. More popular diabetes Pages draw on the opportunities for social interaction afforded by Facebook and combine informational and promotional content to foster communication between the organisation and its audience. By encouraging reflexive management of diabetes risks, these Pages contribute to the construction of ‘biological citizens’ who interweave habitual interactions on social networking sites with responsible self-care, consumption of health information and health activism

Multidimensional collaboration; reflections on action research in a clinical context

This paper reflects on the challenges and benefits of multidimensional collaboration in an action research study to evaluate and improve preoperative education for patients awaiting colorectal surgery. Three cycles of planning, acting,observing and reflecting were designed to evaluate practice and implement change in this interactive setting, calling for specific and distinct collaborations. Data collection includes: observing educational interactions; administering patient evaluation questionnaires; interviewing healthcare staff, patients and carers; patient and carer focus groups; and examining written and audiovisual educational materials. The study revolves around and depends on multi-dimensional collaborations. Reflecting on these collaborations highlights the diversity of perspectives held by all those engaged in the study and enhances the action research lessons. Successfully maintaining the collaborations recognises the need for negotiation, inclusivity, comprehension, brokerage,and problem-solving. Managing the potential tensions is crucial to the successful implementation of changes introduced to practice and thus has important implications for patients’ well-being. This paper describes the experiences from an action research project involving new and specific collaborations, focusing on a particular healthcare setting. It exemplifies the challenges of the collaborative action research process and examines how both researchers and practitioners might reflect on the translation of theory into educational practices within a hospital colorectal department. Despite its context-specific features, the reflections on the types of challenges faced and lessons learned provide implications for action researchers in diverse healthcare settings across the world

Digital Illness Narratives: A New Form of Health Communication

Social media has dramatically affected the way information is accessed and circulated. Social networking sites continue to create on-line communities where every participant plays an active role in seeking and sharing information. While social networks have profoundly impacted different industries in terms of communication between business-to-business and business-to-consumer interaction, they also have had significant impact on many stakeholders in the healthcare communication system. This report describes how a non-profit social networking site called CaringBridge can help patients communicate about their health challenges and gain support though their writings. When traditional “Illness Narratives” (a patient’s reflective writing about his/her illness) become interactive and conversational in a digital platform, the selfexpression and connectivity taking place in an on-line social community contribute immensely to the patient’s health journey

Expectations in the field of the Internet and health: an analysis of claims about social networking sites in clinical literature

This article adopts a critical sociological perspective to examine the expectations surrounding the uses of social networking sites (SNSs) articulated in the domain of clinical literature. This emerging body of articles and commentaries responds to the recent significant growth in SNS use, and constitutes a venue in which the meanings of SNSs and their relation to health are negotiated. Our analysis indicates how clinical writing configures the role of SNSs in health care through a range of metaphorical constructions that frame SNSs as a tool, a conduit for information and a traversable space. The use of such metaphors serves not only to describe the new affordances offered by SNSs but also posits distinct lay and professional practices, while reviving a range of celebratory claims about the Internet and health critiqued in sociological literature. These metaphorical descriptions characterise SNS content as essentially controllable by autonomous users while reiterating existing arguments that e-health is both inherently empowering and risky. Our analysis calls for a close attention to these understandings of SNSs as they have the potential to shape future online initiatives, most notably by anticipating successful professional interventions while marginalising the factors that influence users’ online and offline practices and contexts