Training and elearning

Combating infection with online learning

Abstract

This article looks at elearning within the NHS and how it is being used as a key tool in combating healthcare-associated infections (HCAIs) and creating awareness of effective decontamination processes within NHS facilities. The author looks at the uptake of the programme so far and how, in the future, key groups of NHS staff can be targeted with specialised training options in order to broaden the use of best-practice methods across a variety of different areas of the organisation. The article concludes with a brief examination of how integrated learning programmes can be used to extend the uptake and success of infection control initiatives further in the future.

November 2007

Infection prevention and control Is everybody’s business.

That is why the core part of the NHS infection-control elearning programme is aimed at all staff working in the organisation, whatever their role, and is available online to provide maximum flexibility for all users.

The programme provides an overview of the scope and cost of HCAI to both patients and the NHS, and describes how these are spread and the fundamental steps everybody can take to break the chain of infection. The programme is delivered by the NHS Core Learning Unit (NHS CLU) and by the technology-enabled learning expert, Intuition, and has just registered its 10,000th user.

Aims and achievements of the programme to date

The programme aims to support busy hospital staff by providing both elearning material that learners can access independently and face-to-face sessions that can be cascaded throughout the organisation by a broad range of trainers. It was launched in October 2005 by the NHS’s Chief Nursing Officer, Christine Beasley, and since then the NHS CLU and Intuition have promoted the programme, first in a series of ‘roadshows’, and thereafter through direct contact with each of the strategic health authorities (SHAs) and other healthcare providers to encourage uptake.

Two versions of the programme have been created, tailored to suit both clinical and non-clinical staff, and these are available free of charge to all NHS staff. The training materials are also available for classroom use.

The learning resources provide an underpinning knowledge of the principles of infection control and prevention and are designed to be relevant to all levels of staff within the NHS, from cleaners, porters, technicians and receptionists to nurses, doctors, managers and chief executives. It was developed on behalf of the service by an expert reference group from the service, and by education supported by infection-control experts at the Richard Wells Research Centre (at Thames Valley University) in conjunction with Intuition.

Numbers registering on the infection-control programme have far exceeded expectations, says June Lancaster, Head of Learning Programmes at the NHS CLU: Ten thousand users is well ahead of projections, but it is also just the beginning in terms of the potential impact of this programme. We expect that this resource will be applicable widely across the healthcare sector.

So far a high proportion of registered users are from a nursing background that's positive in that it demonstrates their commitment to improving standards, but we are now moving on to target other staff groups taking the clinical version as refresher education. There's also a big push to increase the uptake of the programme for non-clinical staff, initially through engaging with estates and facilities managers.

There is a strong evidence base that staff education in this area can make a real difference, and considering the impact to patients and provision of services in the NHS, there is little reason for healthcare providers not to take up the programme, she added.

Making an impact

According to figures released by the National Audit Office (NAO) for 2004, one in nine patients will acquire an infection during their healthcare treatment, resulting in 5,000 deaths and contributing to a further 15,000.

It is hoped that the use of elearning to combat infections will continue to have a demonstrable effect on the estimated £1bn a year of NHS spending as a result of HCAI. These infections clearly have a major impact on the availability of beds and the length of waiting lists, because infected patients have to spend, on average, an extra 11 days in hospital. Furthermore, infected patients cost around three times more to treat than uninfected patients. With improved hand hygiene and environmental cleanliness, it has been estimated that 1530% of HCAIs could be avoided. This is where educational programmes come in.

Auditable tracking of learners’ progress

Investment in elearning technology to address these issues also results in less downtime while whole sections of staff undertake training to the same timetable. The three-part infection-control programme covers the key aspects of infection prevention, and staff can access individual modules in their own time and track their progress online. Remote access to the programme gives users much greater flexibility to complete the course when compared with classroom-only education.

The programme also meets the recent requirements announced by the Governments Health Act 2006, which includes a code of practice for the prevention and control of HCAI. It requires every NHS body to ensure that mechanisms are in place to provide prevention and control of infection in induction programmes for new staff and ongoing training programmes for existing staff.

The online learning programme also helps the NHS meet the codes requirement that there should be a record of training for all staff. This is available through the reporting function of the learning-management system (LMS) (see jargon Buster below), which is available to training administrators of the programme and which provides auditable evidence of uptake for individual trusts. The code of practice, which came into effect on 1 October, further strengthens the legal basis for infection-control practice accountability, which is already a key area for self assessments submitted to the industry regulator, the Healthcare Commission, by all providers of healthcare.


Figure 1. A screenshot from the infection control website.

A single entry point for all

A standards-based log-in offers learners the ability to launch and track their learning either from the national system, or from whichever LMS or virtual-learning environment (VLE) (see jargon Buster below) is in use at their trust, thereby maximising the investment by the organisation in its own delivery platform. Learner progress is tracked concurrently on the national and local systems, thereby meeting the requirements for both local and national uptake data.

An integrated approach

The infection control programme complements the hugely successful NHS National Decontamination Training Programme, launched in 2004 to acute trusts around England and Northern Ireland. This programme, again run by Intuition, is also available in elearning format and has achieved registration levels of almost 50% of its expected user base.

Feedback from trusts with high levels of registration shows staff are given protected time each week to complete the training, using an Internet-enabled PC with full encouragement and support from management. Some trusts are making the training compulsory for new recruits, while others are incorporating the training as part of the personal development planning for staff members in the knowledge skills framework or training programmes within the trust. It is recommended that staff undertaking the decontamination programme also complete the infection-control programme.

We want the infection-control training programme to be equally impactful in the broader NHS as the National Decontamination Training Programme has been to that more targeted sector, said June Lancaster. This not only benefits the staff member but also their department and drives the standards within their hospitals, which ultimately leads to greater patient safety.

Registration for the programme takes just a couple of minutes at www.infectioncontrol.nhs.uk

Lee-Anne Smith, Programme Marketing Manager, Intuition.

Case study: Devon PCT

In September 2006, the NHS Core Learning Unit (NHS CLU) and Intuition piloted a solution with Devon PCT to tackle the problems of accessibility to IT hardware and poor computer literacy by use of tablet PCs.

The programme is available on A4-sized tablet PCs running offline, meaning that it is truly accessible at any place and at any time. Tablet PCs help the programme reach the widest possible audience and offer an e-learning experience of the highest quality — one that is cost effective, easy to use and highly intuitive. The digitised pen removes the need for any pre-existing keyboard skills and offers a fun, user-friendly platform from which to learn.

“The tablet PCs have been received remarkably well by our staff, who find them extremely simple to use”, said Paul Norrish, Service Improvement Manager at the PCT. “The portable nature of the device also means that they have much more flexibility to complete their training — which is a hugely important factor for support staff, who do not necessarily have a permanent day-to-day presence on site.”

Case study: Addenbrooke’s Hospital, Cambridge

Rodney Wood, Head of Sterile Services at Addenbrooke’s Hospital in Cambridge explains how his department is using the infection-control programme: “We have made the programme mandatory within our department — we give each member of staff protected time during their first six months with us during which they have access to an Internet-enabled PC (usually within a designated training facility).
“Currently 78% of the department’s staff have completed the programme. It has certainly broadened their knowledge base and given them much more confidence; many of them are now willing to raise questions about the procedures that are used. In particular washroom practice as a whole has improved and this has raised standards of decontamination.”

Jargon buster

LMS (learning-management system) 

Software that auto­mates the administration of training. The LMS registers users, tracks course usage, records data from learners and provides reports to management.

PDP (personal development planning) 

The creation of an action plan based on a reflection of a staff member’s personal, career and academic objectives.

VLE (virtual-learning environment) 

A software system designed to facilitate teachers in the management of educational courses for their students, especially by helping teachers and learners with course administration. The system can often track the learner’s progress, which can be monitored by both teachers and learners. The term is often used interchangeably with LMS, above.

 		  

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