Best practices for teaching healthcare workers about infection prevention and control : a systematic review

Aucamp, Magdalena C. (2016-03)

Thesis (MPhil)--Stellenbosch University, 2016.

Thesis

ENGLISH ABSTRACT: Background: Education and training of healthcare workers (HCWs) in the theory and practice of infection prevention and control (IPC) is widely regarded as a pivotal measure to reduce the risk of healthcare-associated infection (HAI). Although IPC programmes in healthcare facilities devote much time and effort to teach HCWs about IPC, the education methods may not always be effective to establish immediate and long-term changes in IPC practices. Aim of the study: The aim of the study is to determine which teaching strategies have been used with success to teach HCWs about IPC and to recommend a set of best practices for effective IPC education and training. Method: The researcher conducted a systematic review of primary studies on IPC education interventions published from 1990 to 2013. A total of 76 studies were eventually selected from sources identified by means of an extensive electronic literature search in several databases. Data was extracted and then analysed using a combination of qualitative and quantitative methods. Finally the data was synthesized and the limitations in the methodology acknowledged. Results: The interventions mostly employed a combination of two or more teaching methods and made a conscious attempt to actively engage students in the learning process. There was a strong focus on behaviour change and reinforcement of learning to ensure long-term compliance with IPC standards. Assessment of learning and e-learning was left mostly underutilized and unexplored. No new or useful insights could be obtained from interventions done in resource-poor healthcare facilities. Limitations: Only interventions published in English were reviewed. Most of the interventions were done in resource-rich settings and in urban tertiary education facilities. Conclusion: IPC education strategies require careful consideration, perhaps in equal measure to the subject matter that is being taught, to facilitate effective learning that will result in a change in behaviour and practice in the long term. The systematic review revealed that the approach to IPC education and training needs to be holistic: Apart from the teaching content, consideration must be given to the context within which the teaching will provided, as well as teaching methods that will actively engage HCWs in the learning process and stimulate behaviour change. There should be continuous reinforcement of learning by various means. These considerations and more are included in a set of recommended best practices for in-service education and training in IPC. Recommendations are made for future research projects.

AFRIKAANSE OPSOMMING: Agtergrond: Onderrig en opleiding van gesondheidsorgwerkers in die teorie en praktyk van infeksievoorkoming en -beheer (IVB) word allerweë as 'n deurslaggewende maatstaf beskou om die risko van gesondheidsorgverwante infeksies te verminder. Hoewel infeksiebeheerprogramme in gesondheidsorgfasiliteite baie tyd en moeite bestee om gesondheidsorgwerkers van IVB te leer, is die onderrigmetodes moontlik nie altyd effektief om onmiddellike en langtermynveranderinge in IVB-praktyke te bewerkstellig nie. Doel van die studie: Die doel van die studie is om te bepaal welke onderrigstrategieë met sukses aangewend is om gesondheidsorgwerkers van IVB te leer en om ‘n stel beste praktyke vir doeltreffende IVB-onderwys en -opleiding aan te beveel. Metode: Die navorser het ‘n sistematiese oorsig van primêre studies oor IVB-onderrig- intervensies wat van 1990 tot 2013 gepubliseer is, gedoen. ‘n Totaal van 76 studies is uiteindelik geselekteer uit bronne geïdentifiseer deur middel van ‘n uitgebreide elektroniese soektog in verskeie databasisse. Data is onttrek en daarna geanaliseer deur van ‘n kombinasie van kwalitatiewe en kwantitatiewe metodes gebruik te maak. Laastens is die data gekombineer met ‘n erkenning van die beperkinge in die metodologie. Resultate: Die intervensies het meestal ‘n kombinasie van twee of meer onderrigmetodes gebruik en het ‘n doelbewuste poging aangewend om studente aktief by die leerproses te betrek. Daar was ‘n sterk klem op gedragsverandering en die versterking van leer ten einde volgehoue navolging van IVB-standaarde te verseker. Assessering van leer en e-leer is meestal onderbenut en onverkend gelaat. Geen nuwe of bruikbare insigte kon verkry word van intervensies wat in hulpbron-arm gesondheidsorgfasiliteite gedoen is nie. Beperkings: Slegs intervensies wat in Engels gepubliseer is, is geëvalueer. Die meeste intervensies het in hulpbronryke lande en in stedelike tersiêre onderriginstellings plaasgevind. Gevolgtrekking: IVB-onderrigstrategieë en –opleidingsmetodes moet sorvuldig oorweeg word, moontlik met net soveel aandag as wat aan die onderwerp gegee word, ten einde effektiewe leer te bewerkstellig wat tot ‘n verandering in gedrag en praktyk op die lang termyn sal lei. Die sistematiese oorsig toon dat die benadering tot IVB-onderrig en –opleiding holisties moet wees: Behalwe vir die onderrig-inhoud, moet die konteks waarbinne die onderrig sal plaasvind, ook oorweeg word tesame met onderrigmetodes wat gesondheidsorgwerkers aktief in die leerproses sal betrek en gedragsverandering sal stimuleer. Daar moet voortdurende versterking van leer op verskillende maniere wees. Hierdie oorwegings en ander is in ‘n aanbevole stel beste praktyke vir indiensopleiding in IVB ingesluit. Aanbevelings vir toekomstige navorsing word gemaak.

Please refer to this item in SUNScholar by using the following persistent URL: http://hdl.handle.net/10019.1/98368
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