The development of a link practitioner framework and competences for Infection prevention Rose Gallagher Nurse Adviser Infection Prevention and Control
My presentation Introduction to the RCN and my role Developing the framework and competences European experience Evaluation methodology 2
3 Council Recommendation 2009
Challenges for UK Link practitioners are widely used Variation in what they are called, how they are used and the support they receive Expectations of the role and purpose vary Programmes are rarely evaluated Need to avoid improvement evaporation Creating a post that is desirable rather than onerous Professional and personal development on the job
Looking deeper at some of the challenges Culture is everything Significant negative perception of NHS linked to safety and dignity Change in focus to outcomes which bring with it an emphasis on measurement (includes assurance audit and surveillance) Need to bring successful incentive and performance partnership to the clinical level
Putting evidence into practice Easy to say, hard to do not straightforward Tension between policy imperatives and the ability to successfully support and enable change locally Spread of evidence or change in practice is not a linear process Whole system change is needed - includes both individuals and organisation A successful link worker programme can be invaluable with this 6
What did we want to achieve? To develop a generic role framework for a link practitioner that could be used in any area of practice To apply the role profile to infection prevention and publish as a resource To develop simple competences to support those in that role To work with stakeholders to evaluate the work 7
8 October 2012
Key themes from the analysis Enabling factors Attributes Outcomes or consequences 9
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Attributes How would you recognise a link practitioner role? What would the link role do? Acting as a role model and visible advocate Enabling individuals and teams to learn and develop their infection prevention practice Communicating and networking around infection prevention practice Supporting individuals and teams in local audit/surveillance (optional) 11
Part 3 - Thinking about competences Need to match levels of skills to need Need to create simple, usable competences that support professional development and the link practitioner role Only identify what is needed beyond the core competence and career framework (for nurses) Match to the UK KSF Promote importance of attitudes and behaviours its not all about tasks
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Core behaviours Person-centred Inclusive Reflective Passionate about infection control Visible in practice area Welcomes feedback Good communicator Proactive 14
European experience EUNETIPS informal survey of member countries Aims: 1 - To gain an oversight of awareness and use of link professionals with a focus on IC/HH 2. To determine interest among EUNETIPS members to undertake further work in this area
Summary of survey EUNETIPS members Short survey (17 questions) exploring experiences and knowledge of LP systems Distributed electronically in June 2012 Response rate 16 out of 20 member countries
The LP role Are LP s used for other areas of practice? 12/16 yes Which professional group do you most associate with LP s in IC/HH? Nurses: 12/16, Doctors: 8/16, Others:4/16 Are they primarily Nurses: 8/16, Nurses and Doctors: 4/16 Doctors:2/16
Formality of the role Nationally agreed role profile/job description 4/16 yes, 9/16 no, If yes when was this introduced? Total 6 responses Range 1995-2012 Do LP receive payment for the role? 11/16 no, 2/16 D/K, 1/16 local incentives Do competencies exists for LP s? 2/16 - yes
Impact of using LP s Has the LP role ever been evaluated? no 11/16, D/K 1, yes 1 How beneficial do you think the LP role is? Likert scale 1-5 Score Nurse Doctor 1 9 6 3 3 2 4-5 3 3
What next? Validation and evaluation of the framework and competences working with practitioners and organisations To identify strategies for others to do the same Identify further indicators to evaluate what we set out to change 20
How will we do this? Warning!!!!!! 21
Methodology principles Using CIP principles, collaboration, inclusion and participation Enable development of participants through participation Using the workplace as the main resource for learning Focus is all on Person centred care 22
2 key elements of methodology Practice development approach Action learning 23
Practice development A complex, specific intervention Not the same as professional development or ad hoc projects Uses CIP principles collaborative, inclusive and participative (bottom up!) Everyone s voice in important Person centred care (not patient centred care) Essential for changing workplace cultures and getting evidence into practice 24
Action learning Focus is on individual learning/practice Learning occurs in the workplace Participants bring experience and share strategies to group sessions to find solutions links to peer support 25
Our first meeting Capturing themes Hopes, fears and expectations Claims concerns and issues Values clarifications exercise Theming Action plan 26
Claims Positive statements Favourable Concerns Something unfavourable A barrier actual or perceived Issues Questions Drawn from concerns and claims e.g. what, how questions
Evaluating the project Using claims concerns and issues tool throughout the project at monthly active learning days to monitor themes. 360 degree feedback around the competences Monitoring local key performance indicators (audits, infection rates etc). Needs to be area specific 28
Some feedback Claims Use of action learning in the workplace Opportunity to motivate Link nurses Being able to demonstrate the value of LN s Reassuring that the project group has a shared vision for achievement Value of RCN support 29
Some feedback Concerns Project may not show the benefits of LN s Release of staff for the project Low morale in the workplace LN is not a volunteer Language of project is nurse centric Competing priorities in organisations (e.g. Beds etc) 30
In summary It is a start, not the solution We have started to explore some of the complexities of the link nurse role We are working on the pilot evaluation We welcome your feedback and contribution
In summary Issues Who will support the LN in the workplace day to day? What is the true time commitment for project participants? Is it ok to have non nurse Link practitioners? How do you measure the Practice development approach? What resources will i need? 32
33 Thank you for listening