Phase IV: Actual implementation of Infection Control Standards

The team decided on starting with “Infection-free Injections” as a first goal.  Accordingly, a series of activities were performed as described below:

a.     Holding an Infection Control training course for 200 volunteers (mainly medical students, in addition to some house officers) on the theoretical aspects of IV sampling and cannulation, given by Dr. Mervat Gaber on Oct 30, 2007. 

b.     Holding a Practical Workshop for training on IV sampling and cannulation for the 200 volunteers in Mubarak-Kohl centre from Oct 31 to Nov 10. The workshops involved hands-on training on dummies (mannequin/mock-up) that was useful and appealing to the volunteers.

c.     Holding a Practical Workshop for training on IV sampling and cannulation for 8 nurses in Mubarak-Kohl centre from Oct 31 to Nov 10. The workshops involved hands-on training on manikins that was very attractive to the volunteers.

d.     Holding an Infection Control Course involving training of 32 nurses on the theoretical aspects of IV sampling and cannulation.

e.     Holding a series of 2 lectures and 3 Workshops about Behavioral Changes, given by Dr. Ahmad Zaafan to 70 volunteers, in the period from Nov 11 to Nov 29. The aim was to teach them how to convey information to hospital staff in a friendly and influential way so as to change their attitudes and behavior. The workshops involved interactive scenarios for the volunteers to practice before facing the real life situations.

f.      Holding a Planning workshop to 28 volunteers, where the volunteers were allowed to share their ideas as to how to implement the infection control behavior in the hospital, and identify what their prospective means, goals and action plans would be, after sharing in a SWOT analysis of the current situation.  Evaluation report of the workshop is attached later in the file

g.     Currently, the Infection Control Training Program with a similar framework as the course described above is being given to 70 new House-officers (2008-2009) including an Orientation Session, Planning workshop, Infection Control Workshop (held on March 17, 2008), Data Collection Workshop (held on April 1, 2008), Behavioral Changes session by Dr Ahmed Zaafan (held on April 10, 2008), Behavioral Changes workshop by Dr Ahmed Zaafan (held on April 14, 2008) and Real-Life Training sessions (yet to be held)

 h.     Supervision started on 16^th of March 2008 and has continued up to the writing of this report, the 15^th of April 2008. Volunteers supervise the nurses while doing venous blood sampling procedures and intra-venous cannula insertion procedures in the following manner:

• Our current supervision strategy depends on continuous daily presence of volunteers during all working days (Sat-Thurs), in the period from 8.30 am to 10.00 am (which according to our surveys is the maximum risk period – about 70% of injections are done during this period) in the areas we cover.
• The aim is to make the volunteers directly witness almost all of the injection procedures done in all of the floors which are supervised during the high risk period described above.
• Geographically, the team started in the 2^nd and 4^th floors of the Internal Medicine Hospital as a first step. Later the team managed to include the 6^th floor.
• More than 30 volunteers have participated in Supervision campaign until now, with 3 to 12 volunteers available each day.
• 230 procedures have been observed until the preparation of this report.

The improvement in the behavior of nurses after less than one month of supervision and without the implementation of our reward and punishment systems was much better than expected. (See Annex I)