In Issue 1 of Keeping PAACE (Winter 2021), we told you that AACE had commissioned Zeal Solutions Ltd, an independent psychology-based consultancy, to design and issue a survey to all ambulance staff and volunteers to capture experiences of IPC measures during the pandemic.
Almost 4,000 of you responded, and many also participated in a series of ‘sense checking’ focus groups to validate the findings. Your feedback offers the ambulance sector an excellent learning opportunity to shape our preparation and response to future IPC concerns and pandemics, whilst considering how these issues can impact staff wellbeing.
National survey of NHS ambulance staff and volunteers:
Attitudes towards infection, prevention and control before and during the COVID-19 pandemic
What we set out to achieve
Between December 2021 and March 2022, an online survey was distributed to all staff, volunteers, students and bank staff across the ambulance sector. Questions were designed specifically for the ambulance sector with input from staff, volunteers, students and staff side union representatives. The purpose was to explore factors that influence infection prevention and control (IPC) practice across the sector, whilst considering the impact of the global pandemic on compliance with IPC guidance.
Thank you to everyone who shared their experiences and perspectives
Completed surveys from 3,778 individuals were analysed by the team at Zeal Solutions Ltd to help understand the evidence, inform recommendations and decision making to strengthen IPC practice.
Your responses matter – how the feedback has been used
Responses have allowed the identification of many factors that significantly impact on compliance behaviour (both things that encourage compliance and things that prevent it), and we have explored which of these mattered most from ambulance staff’s perspective. A series of focus group discussions have also helped to identify specific actions that staff felt were needed to maximise learning for the ambulance sector nationally, and to help address the key issues.
What were some of the key findings?
When facilitating factors are present (i.e. those that significantly help/encourage compliance), staff report being more likely to comply with IPC guidance now, and report higher intentions to comply in the future. The research also identified certain barriers which serve to hinder (prevent/block/decrease) compliance behaviour and intentions. In summary, compliance with IPC guidance is more likely to occur when there is/are:
- Awareness and knowledge of IPC guidance and requirements
- Staff satisfaction with training around IPC
- Confidence in one’s ability to apply IPC guidance in the work environment
- A realistic perception of threat from infectious diseases
- Good compliance behaviour being demonstrated by others (managers and colleagues)
- Positive prompts and reminders that encourage compliance behaviour
- More positive attitudes towards the benefits of compliance
- Less negative attitudes and fewer perceived barriers towards compliance
- A strong belief that the climate/culture of the organisation is focused on staff safety
- Higher self-efficacy (including confidence in: a) knowledge, b) personal protective equipment (PPE), and c) the logistical reality of applying IPC guidance at work)
Personal experiences during the pandemic (e.g. testing positive for COVID-19, having to isolate from family/friends, etc.) were also considered and shown to impact on compliance behaviour.
What does this mean and what actions are recommended?
Strategies for action have been proposed all of which have been informed by the research and staff who contributed to the feedback focus groups. A report has been produced to illuminate what staff feel can be done to ensure learning is taken forwards across the sector. A ‘blanket approach’ (where the same methods are applied to all individuals, and we expect them to have a similar effect on everybody) is not advisable and Zeal Solutions recommended a more considered and focused look at how to plan and manage the logistics of implementing practicable actions.
Zeal Solutions recommend that an action planning process is undertaken by those responsible for actioning these outcomes, during which proposed actions will be carefully considered, prioritised and implemented as appropriate.
What will happen next?
All ambulance sector workers, both non-patient-facing and patient-facing, continue to work tirelessly to sustain their organisational systems to deliver high quality and lifesaving care. It is important that this level of commitment is now met with open and honest dialogue resulting from this research.
For this reason, we remain committed to valuing all feedback and to sharing themes, actions and timelines created to respond to the lessons learned from this work. To date, key findings have been presented at the Ambulance Leadership Forum conference in September, and a final report is currently being drafted and shared with the project steering group. Members of the national communications group will be involved in ensuring that the findings are shared and communicated transparently with staff moving forwards.
This work was commissioned by the AACE Quality Improvement, Governance and Risk Directors group (QIGARD), who will be taking forward the recommendations in their respective service and can be contacted if you would like to be involved in supporting this work for your organisation.
