Infection Prevention and Control
“IPC is unique in the field of patient safety and quality of care, as it is universally relevant to every health worker and patient, at every healthcare interaction.”
The World Health Organisation (WHO)
The importance of good Infection Prevention and Control (IPC) knowledge and practice for all NHS staff has come to the fore during the COVID-19 pandemic. The UK NHS ambulance sector engaged with their respective Public Health bodies and advisors throughout and continues to do so. AACE has been able to input into the guidance at national level to ensure it fits within the ambulance context, as well as producing our own sector COVID-secure guidance when it was needed.
The AACE Specialist IPC Advisor and all ambulance services IPC Leads have been heavily involved and influential in this engagement, as well as in managing ongoing IPC communication within their organisations.
National survey of the ambulance workforce on IPC practice
It is really important that we learn from all aspects of our experiences during the pandemic; and for IPC it is vital that we hear from all staff in order to do so. AACE therefore commissioned a survey across all ambulance staff, clinical and non-clinical, including volunteers and students who worked with us during the pandemic, to capture their perspectives and levels of awareness and knowledge of IPC practice and COVID response.
We needed to better understand how this has impacted on their behaviour, well-being and attitude to work and engagement with patients.
The aims of conducting the survey were to identify how we can most effectively improve our ongoing response to this, or any other future pandemic, how we can best communicate with staff in relation to IPC/PPE, and to improve training and general IPC knowledge and practice for day-to-day service provision across ambulance services.
The bespoke survey, designed and run by occupational psychologists, Zeal Solutions Ltd, was distributed to the entire ambulance workforce and our volunteers last year.
Their methodology is scientifically robust, and the outputs are three-dimensional, in that as well as establishing what the significant negative or positive factors may be, they correlate these with impact – what difference those factors make on individuals, and on the organisation – how behaviour may have changed as a result, or how health and wellbeing may have been affected and to what extent.
This enables us to identify the factors (positive or negative) that make the biggest difference, and therefore where we can most effectively make changes.
The impact of the behaviour of others on compliance (‘social norms’)
Behaviour of the people around us influences our own behaviour. The behaviour of managers and colleagues/peers is particularly important.
Enhancing feelings of capability and confidence (‘self-efficacy’)
In order for staff to comply with guidance of any kind, they of course must feel capable of doing so, and confident in their own ability to comply.
The importance of cues to action
Reminders and prompts keep the required IPC behaviours at the forefront of staff’s minds.
A psychologically safe work environment boosts compliance
When people feel as though their welfare is considered important and that their well-being is prioritised people will feel psychologically safe and more able to challenge behaviour that is not acceptable.
Remember: Infection Prevention and Control is everyone’s responsibility. It protects not only our people, but also our patients and the wider community.
We have developed a template of identified learning points that need to be taken to improve IPC compliance and safety practice. Responsibility for developing and implementing actions to address these is described at different levels – for national and service leaders, managers within organisations, and individual members of the workforce.
What staff told us in the survey:
“My IPC confidence has massively increased since becoming familiar with IPC and PPE wearing during the pandemic – now it is normal practice done daily.”
“I have good access to our IPC team and managers, so I am confident that if I need information, I will know who to approach.”
“I am now more aware than ever about IPC issues and my responsibilities to others.”
“I believe we have become better at complying with IPC as the pandemic has progressed. Previous to the pandemic the attitude in the control centre was somewhat ‘laissez-faire’ and people did not care much whether the work stations were wiped down between users: now it is expected.”
We would like to thank all the bodies involved in commissioning and funding this piece of work: the Association of Ambulance Chief Executives (AACE) members – all UK NHS ambulance services, as well as the Office for Health Improvement & Disparities (England), Public Health Agency Northern Ireland and Health Protection Scotland. We would also like to thank Zeal Solutions Ltd. and all contributors, including all staff involved in the design and validation focus groups, as well as every member of staff and ambulance volunteers who took the time to complete the survey and share their view.