SLIDE 1
Factors influencing infection control in the operating theatre
Dr Jayne Cutter Lecturer, Infection Prevention and Control, College of Human and Health Sciences, Swansea University
SLIDE 2 A cross sectional survey of all surgeons and scrub nurses in 6 acute trusts in Wales was undertaken, response rate 51.47% (n=315). A purposive sample of 16 respondents participated in a series of semi- structured interviews. The senior Infection Prevention and Control Nurse of each trust was interviewed by telephone (n=6). Statistical analysis (inferential statistics) was employed to explore the relationships between key variables. Logistic regression modelling was used to predict the likelihood of sharps injuries. Content analysis was employed to analyse interview data
- Factors influencing sustaining inoculation injuries by
healthcare professionals undertaking exposure prone procedures in the operating theatre
SLIDE 3 Sharps injuries within the last 5 years by profession
Sharps injury within 5 years Total None 1 or more Surgeons Count (% within profession) 61 (33.9%) 119 (66.1%) 180 (100%) Scrub nurses Count (% within profession) 71 (52.6%) 64 (47.4%) 135 (100%) Total Count (%) 132 (41.9%) 183 (58.1%) 315 (100%)
SLIDE 4 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% Safety device Avoid passing sharps Eye protection Double glove Percentage Precaution
Other Never Known or suspected infection All patients
Use of precautions
SLIDE 5
Education, education, education...
A beneficial effect of under-graduate education is suggested by the fact that nursing and medical students, junior doctors and nurses are more likely to comply with precautions than those who are older and have been in practice longer Students are a captive audience resulting in high attendance Securing attendance at mandatory infection prevention and control training may be more problematic
SLIDE 6
The perceived value of mandatory education
Well I know that pointed things are sharp and they hurt and they shouldnt stick into me but I dont know .... unless they are going to teach me different ways of practicing in which case they should come into the theatre and tell me that anyway without me having to go off on a separate half day bonding session (Surgeon) And it will be of no use (Surgeon)
SLIDE 7 Education
- All successful models for altering behaviour
rely on the subject believing change is necessary
- The carrot approach relies on adapting
education to the needs of the audience and requires recognition of what influences practice
SLIDE 8
Profession Interference with working practices Availability of resources Time pressures Expectations Perceptions of teamwork Hierarchy Risk perception and risk taking behaviour Occupational hazard Peer pressure
What influences practice?
SLIDE 9
- Flexibility incorporate adult learning
theories
- Know your audience
- Personal sessions for each profession
- Utilize opinion leaders
- Consider the use of various behaviour change
theories that have been successful in modifying health behaviour e.g. the transtheoretical model (Prochaska and DiClemente (1979)
Improving compliance through education
SLIDE 10
In summary:
Behaviour change represents a reciprocal web of biological, socio-cultural, and psychological factors People change over time and they can learn and grow from unsuccessful attempts at change People modify behaviour most effectively when they see change in the context of factors that matter the most to them
