StrengtheningIPCStructuresThroughEduationProf. Shaheen Mehtar,StellenboschUniversity,CapeTown,SouthAfrica
AWebberTrainingTeleclass
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StrengtheningIPCStructuresThroughEducationCapacityBuildinginAfrica
ProfShaheenMehtarChairInfectionControlAfricaNetwork(ICAN),
andStellenboschUniversity,CapeTown,[email protected]
www.webbertraining.com October12,2017
Objectives
1. Howtosetupeducationprogrammeswithlowresources2. What,andwhere,tostartsuchprogrammes3. Howdoesonemeasureprogressofsucheducationsystems4. Whyhighincomesystemsdon’talwaysworkinLMICs
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StrengtheningIPCStructuresThroughEduationProf. Shaheen Mehtar,StellenboschUniversity,CapeTown,SouthAfrica
AWebberTrainingTeleclass
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ChallengesinsettingupeducationprogrammesinIPCinAfrica
• Levelofbasiceducation(primaryandhighschool)isvaried• Learningisbyrote;criticalthinkingisnotwelldeveloped• Difficulttounderstandconceptswherethereisalackofinfrastructure
• Irregularaccesstotheinternet;selflearningislimited• Littleornoaccesstocurrentliterature• Adoptingconceptsandguidelinesfromothercountrieswithoutbeingabletoadaptthemlocally
• FewpublicationsfromAfrica(nowimproving)toinformlocalguidelines
• Irregularsupplyofwaterandelectricity(WASHinadequate)
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StrengtheningIPCStructuresThroughEduationProf. Shaheen Mehtar,StellenboschUniversity,CapeTown,SouthAfrica
AWebberTrainingTeleclass
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StrengtheningIPCStructuresThroughEduationProf. Shaheen Mehtar,StellenboschUniversity,CapeTown,SouthAfrica
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StrengtheningIPCStructuresThroughEduationProf. Shaheen Mehtar,StellenboschUniversity,CapeTown,SouthAfrica
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StrengtheningIPCStructuresThroughEduationProf. Shaheen Mehtar,StellenboschUniversity,CapeTown,SouthAfrica
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CurrentIPCtraininginAfrica
• Variedprovisionforhealthcaredeliverybyprovince• IPCisnotrecognisedasaspecialityinitsownright• NoestablishedcareerpathinIPCwhichrequiresspecialisedtraining• Consideredanursingspeciality- doctorsarenotinvolved- thereforetherearenoteams!
• Surveillance:informationgatheringislimited• Guidelinesandpoliciesareneitherwelladvertisednorpromoted• TheWHOCoreComponents(2016)recommendsthe“presenceofafullytrainedIPCpractitionerfor250acutebeds”!
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StrengtheningIPCStructuresThroughEduationProf. Shaheen Mehtar,StellenboschUniversity,CapeTown,SouthAfrica
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Typesoftrainingoffered
• Classroomteaching- facetoface• E- learningplatformacrossAfrica• Skillsdevelopment– practicalclassesforallcadresofhealthstaff• Trainthetrainers(MasterTrainers)• Managerscourses• Capacitybuildingandknowledgetransfertocommunities• DevelopingguidelinesandappsspecificallyforAfrica’sneeds
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StrengtheningIPCStructuresThroughEduationProf. Shaheen Mehtar,StellenboschUniversity,CapeTown,SouthAfrica
AWebberTrainingTeleclass
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FacetoFaceTeaching
Advantagesoffacetoface• Closerelationshipdevelopsbetweentutorsandwithintheclass- networking
• Revisionwhennecessary• Modificationofmethodofteachingifnecessary
• Demonstrationsandvisualteachingisunderstoodbetter
Disadvantagesoffacetoface• Expensiveforbothstudentsandfaculty
• Timeconsuming• Shorttermengagement• Routineandsometimesboring• Tutordependenttransferofknowledge
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StrengtheningIPCStructuresThroughEduationProf. Shaheen Mehtar,StellenboschUniversity,CapeTown,SouthAfrica
AWebberTrainingTeleclass
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Barrierstoteaching
• Cultural– Donotarguewithelders(teachers)– Cannotsayhowmuchyouknow– Cannottellanolderpersonwhattodo.– acceptwhatoneistoldwithoutquestion
• Hierarchical-– “Icannotquestiontheboss”– “IAMTHEBOSS!”
• Language- differentwordsmeandifferentthings!
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StrengtheningIPCStructuresThroughEduationProf. Shaheen Mehtar,StellenboschUniversity,CapeTown,SouthAfrica
AWebberTrainingTeleclass
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Barrierstolearning- cultural
• Hierarchalbarriers– “Whatyoulearntinclassstaysthere!!Hereyoudowhatyouaretold!”
– “WhydoIneedtoknowthis?Itisnotmyjob”• DespiteknowledgeinIPCdifficultyinmaintainingstandardsduetolackofresources
• Willnotadvisesuperiors- donotwanttoappearaggressiveorashowoff
• So,
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StrengtheningIPCStructuresThroughEduationProf. Shaheen Mehtar,StellenboschUniversity,CapeTown,SouthAfrica
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CostofanIPCprogramme• IntheUSA,areductionofonly6%wouldoffsetthecostIPCbysavingonreducedhospitalisation.
• BSIarethehighestcostingHCAI ofallthetypesofinfection• CostinIndiaofBSIinfectioninacardiachospitalcost$15000moreperpatientcomparedwiththosethatdidnotdevelopinfection.
• ABHR introductionatpointofuseandothercosts=$23.7savedforevery$1spent.(ChenY,ShengW,WangJ,etal.PLoS One2011;6:e27163)
• ABHR islesscostlyandgreatercompliance.
• Communicating(feedback)relatingtoHH activitiesandencouragingeachotherincreasedcompliance(p<0.01)
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StrengtheningIPCStructuresThroughEduationProf. Shaheen Mehtar,StellenboschUniversity,CapeTown,SouthAfrica
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StrengtheningIPCStructuresThroughEduationProf. Shaheen Mehtar,StellenboschUniversity,CapeTown,SouthAfrica
AWebberTrainingTeleclass
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TraintheTrainercourse
• Selection- wantstoteachandhaspassedthebasicIPCcoursewithgoodmarks
• Coursestructure– Taughthowtoteachadults(applyingprinciples)– Willreturntoplaceofworkandtrainaminimumof5students
• Examinerswillvisitworkplaceand– examinethe5studentstaught(50%transferofknowledgerequired)– Evaluatetrainingmaterialusedtoteachstudents– Hoursoftraining– Preandpostassessmentofstudentknowledge
• Ifthestudentsget50%ormore,theTutorwillgetacertificateofcompetence(TTT)
• Ifnot,thentheTutorwillonlygetaBasicIPCcoursecertification.• Thestudentswillbecertifiedbytheirlocalinstitutions
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StrengtheningIPCStructuresThroughEduationProf. Shaheen Mehtar,StellenboschUniversity,CapeTown,SouthAfrica
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TraininginEbola• 263healthcareworkerstrainedinIPCbyICAN• Backtobasics!• SoundknowledgeaboutthemodeoftransmissionwillgiveconfidencetotreatEVDcasesastheydeservetobetreated
• Contactprecautions– Singleorisolation– Lookafteryourhands- handhygiene&gloves– Protectionfromsplashes- gowns&faceshield
• Noneedtospraywithchlorine!Wipeonly- ifneeded• Managelinenwithheatdisinfection• Managewastewithheatand/orincineration
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StrengtheningIPCStructuresThroughEduationProf. Shaheen Mehtar,StellenboschUniversity,CapeTown,SouthAfrica
AWebberTrainingTeleclass
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StrengtheningIPCStructuresThroughEduationProf. Shaheen Mehtar,StellenboschUniversity,CapeTown,SouthAfrica
AWebberTrainingTeleclass
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StrengtheningIPCStructuresThroughEduationProf. Shaheen Mehtar,StellenboschUniversity,CapeTown,SouthAfrica
AWebberTrainingTeleclass
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StrengtheningIPCStructuresThroughEduationProf. Shaheen Mehtar,StellenboschUniversity,CapeTown,SouthAfrica
AWebberTrainingTeleclass
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StrengtheningIPCStructuresThroughEduationProf. Shaheen Mehtar,StellenboschUniversity,CapeTown,SouthAfrica
AWebberTrainingTeleclass
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StrengtheningIPCStructuresThroughEduationProf. Shaheen Mehtar,StellenboschUniversity,CapeTown,SouthAfrica
AWebberTrainingTeleclass
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StrengtheningIPCStructuresThroughEduationProf. Shaheen Mehtar,StellenboschUniversity,CapeTown,SouthAfrica
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e- IPCeducationforAfrica
Advantages• Interactivelectures- exciting• Quizzesinterspersedinthelectures– testofknowledge
• Movementwithinthetalks• Canlearninone’sowntimeandrepeatifnecessary
• Muchmoreuserfriendlyonceyougetusedtoit.
• CanbelinkedtoanSMSprogramme
• Standardisedmeasureofoutcome
Disadvantages• NewconceptforIPC• Accesstotheinternetrestricted
• Theprogrammesmightbetoobigforthebandwidth
• Unfamiliarterritory• Mayberesistancefromlearners
• Resistancefromtutors
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StrengtheningIPCStructuresThroughEduationProf. Shaheen Mehtar,StellenboschUniversity,CapeTown,SouthAfrica
AWebberTrainingTeleclass
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StrengtheningIPCStructuresThroughEduationProf. Shaheen Mehtar,StellenboschUniversity,CapeTown,SouthAfrica
AWebberTrainingTeleclass
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DesigningdistancelearningIPCcourses- forAfricanuniversities
• Usesmoodlewhichisnotonlyeducational,butalsohasstrategiesforteaching–learningandforassessingprogressandperformance.
• DistanceLearningAMScourse–ISC&ICAN
• Alsolookingforprivatepublicpartnership
IPC course
SUN Moodle home page
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StrengtheningIPCStructuresThroughEduationProf. Shaheen Mehtar,StellenboschUniversity,CapeTown,SouthAfrica
AWebberTrainingTeleclass
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StrengtheningIPCStructuresThroughEduationProf. Shaheen Mehtar,StellenboschUniversity,CapeTown,SouthAfrica
AWebberTrainingTeleclass
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StrengtheningIPCStructuresThroughEduationProf. Shaheen Mehtar,StellenboschUniversity,CapeTown,SouthAfrica
AWebberTrainingTeleclass
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Finally.......
• “Thecurrentapproachtoeducatingandtrainingourhealthcareprovidershasoutliveditseffectivenessandutility.
• Withthegrowingcomplexityofhealthcareandtheacceleratedpaceofaccumulationofknowledge,significantreformofhealthprofessionseducationisrequired”.
• “ForLMIcountriesweshouldencourageMultimodalapproaches(whichareculturallysensitivetosustaineffect)Educationalinterventioncouldbeextremelycosteffective-Educatinghealthcareworkerstooptimal(handhygiene)practicesiseffective.”
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StrengtheningIPCStructuresThroughEduationProf. Shaheen Mehtar,StellenboschUniversity,CapeTown,SouthAfrica
AWebberTrainingTeleclass
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Whatactionscanbetaken
• Applyactivitieswhichtakelessfunding• Betterandcosteffectiveoutcomes• Puteffectivestructuresintoplace.• Mostimportant
– Knowledge– ReducewastebyreducingcostofHAI,environmentalcleaning,purchasingpoorqualityitems
– Donations- becarefulwhatyouwishfor?– ReinvestwhathasbeensavedbyreducingHAI
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Thinkoutsidethebox……
• Whiletherewillbeshortages,welltrainedIPCpractitionersandHCWcanthink“outside-the-box”anddeliverhealthcarereasonablysafelyforpatientsandthemselves
• Understandthecommunityandworkcloselywiththem• NeedtoreassessteachingmethodsinLMICusingmoreinnovativewaysofgettingthemessageacross- AWhatsAppIPCgroupinSL!
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StrengtheningIPCStructuresThroughEduationProf. Shaheen Mehtar,StellenboschUniversity,CapeTown,SouthAfrica
AWebberTrainingTeleclass
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StrengtheningIPCStructuresThroughEduationProf. Shaheen Mehtar,StellenboschUniversity,CapeTown,SouthAfrica
AWebberTrainingTeleclass
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MBChBgraduatesurvey:IPCcurriculumIIQuestionn=181
Agreetotally/strongly
Agree Disagree/quitestrongly
IPCisimportant 82.9% 17.1% 0%Adequatelycoveredincurriculum?
notatall/inadequate%
basic%
adequate/comprehensive
%Sharpsdisposal 4.5 7.9 87.7Handhygiene 5 12.7 82.3Asepticprocedures 7.9 15.3 76.8UseofPPE 7.9 17.9 74.3Transmission-prec. 10.8 22.6 66.6Decontamination 11.1 22.9 66Wastemanagement 19.4 28.9 51.8
IPCpolicies 28.5 39.7 31.8HCWbehav.change 28.2 37.9 33.9Occup.health 34.4 39.4 26.2
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MedicaleducationinIPC:proposedSUmodel
MB1 MB2 MB3 MB4 MB5 MB6
Foundationphase Earlyclinical
Middleclinical
LateClinical
IPCteachingintheorymodules
IPC teachinginskillslaboratory
IntegratedIPCteachinginclinicaldisciplines
OUTCOME:
understandsIPCprinciples &terminology
OUTCOME:
appliesIPCprinciplestoclinical
scenarios&attainsIPCclinicalskills
OUTCOME:
evaluateshealthcareservices&reducesclinicalriskby
applicationofIPCprinciples
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StrengtheningIPCStructuresThroughEduationProf. Shaheen Mehtar,StellenboschUniversity,CapeTown,SouthAfrica
AWebberTrainingTeleclass
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Conclusion
• Weneedtousealltheavailablefacilitiestoteachandimproveknowledge– Verbalcommunication(facetofacelearning)– Electronicplatforms– MobilePhonesandtelecommunication– Socialmedia
• Thinkofinnovativewaysoftransferringknowledge!• Thinkofwaysofsustainingknowledge!
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StrengtheningIPCStructuresThroughEduationProf. Shaheen Mehtar,StellenboschUniversity,CapeTown,SouthAfrica
AWebberTrainingTeleclass
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StrengtheningIPCStructuresThroughEduationProf. Shaheen Mehtar,StellenboschUniversity,CapeTown,SouthAfrica
AWebberTrainingTeleclass
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