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ID: 4506
Application of novel outcome evaluation criteria to UK social
marketing campaigns focused on infections
Enrique Castro-Sanchez
1
, Michiyo Iwami
2
, Raheelah Ahmad
2
,
Alison Holmes
2
.
1
National Centre for Infection Prevention and
Management, Imperial College London,
2
Imperial College London
Background:
Social marketing interventions have been valuable in
addressing communicable diseases. Outcome evaluation is a critical
yet often excluded component of any intervention.
Aim(s)/Objective(s):
We applied a novel set of evaluation criteria to UK
social marketing campaigns focused on infections.
Method(s):
Campaigns active between 2001 and 2013 were identified
from literature and internet searches. Two researchers scored each
campaign on 13 areas including (1) Understanding of problem and
stakeholders; (2) Clear definition of outcome; (3)
‘
A priori
’
indication
of required change for long-term effect; (4) Clear theory/plausibility
of intervention mode of action; (5) Outcome measures that meet
stakeholder needs; (6) Impact measurement; (7) Acceptability and
sustainability; (8) Link between intervention and outcome; (9)
Competing factors; (10) Unpredicted effects from intervention; (11)
Evaluation strategy; (12) Economic analysis, and (13) Peer-reviewed
publication. Campaigns received 0, 1 or 2 points depending on how
well they conducted or reported on the indicators presented.
Results:
17 campaigns focusing on vaccination, sexual health, hand
hygiene and others were identified. Median score for all campaigns
was 14.2+/
−
2 (26 points maximum possible). Indicators 1 and 5 were
best described (score 26; 34 points maximum possible). The lowest
score (11) was achieved for indicator
‘
Link between intervention and
outcome
’
. Indicators 3, 7, 10 and 12 were insufficiently or inadequately
reported in 88% of campaigns.
Discussion and/or Conclusion(s):
UK social marketing campaigns
could improve their reporting of key outcome evaluation aspects.
Sustainability, economic evaluation and unintended effects of cam-
paigns require increased attention.
ID: 4517
Basal skull osteomyelitis: experience with OPAT and conservative
management
Brama Hanumunthadu, Aodhan Breathnach.
St. George
’
s University
Hospital NHS Foundation Trust
Background:
Basal skull osteomyelitis is a challenging condition:
surgery risks serious morbidity and mortality; the optimum duration
of antibiotics is unknown. We have seen cases referred to the out-
patient parenteral antimicrobial therapy (OPAT) service for conserva-
tive treatment.
Aim(s)/Objective(s):
We wished to determine complications on OPAT,
the duration of intravenous antibiotics, and overall treatment success.
Method(s):
Retrospective analysis of a clinical OPAT database from
2009 to 2016, with individual review of case notes.
Results:
We found six cases of basal skull osteomyelitis treated on the
OPAT service. Of these, 4/6 had a complication requiring admission:
1/4 antibiotic side effect; 1/4 line thrombosis; and 2/4 related to
worsening condition. Subsequently 3/4 were discharged back to
OPAT. The mean duration of antibiotics on OPAT was 44 days, mean
total IV antibiotic duration was 66 days and mean overall treatment
duration including oral antibiotics was 94 days. OPAT treatment
success, defined as completion of intended intravenous antibiotics
whilst on OPAT was 5/6. Overall treatment success, defined as
completion of intended intravenous (on OPAT and inpatient) and
subsequent oral antibiotics was 6/6. Of note, one case failed a twelve
week course of antibiotics but achieved success following a repeat
twelve week course of IV followed by twelve weeks of oral antibiotics.
Although all patients finished their intended course of antibiotics, 3/6
had ongoing morbidity including: hearing loss 2/3; and ear discharge
needing surgery 1/3.
Discussion and/or Conclusion(s):
OPAT services can effectively
support the conservative management of basal skull osteomyelitis,
despite a high complication and re-admission rate.
ID: 4625
“
The devil is in the (clinical) details
”
Michael Addidle, Vani Sathyendran, Tim Taylor, Yvonne Peckover.
Pathlab, New Zealand
Background:
Baseline auditing demonstrated that the provision of
clinical details to the microbiology laboratory was very poor, despite
various educational efforts.
It was decided to trial a mandatory clinical details policy, starting with
infectious serology, and then extending into other areas of clinical
microbiology.
If the sample arrives at the laboratory without clinical details then it is
stored for a certain time period depending on type of sample, a
message is sent back to the requestor, and processing does not proceed
until clinical details are received.
Aim(s)/Objective(s):
The aimwas to have clinical details present on all
sampes coming into the microbiology laboratory for the following
reasons:
•
To ensure that the correct tests are being performed.
•
To facilitate interpretation of of borderline results or results of
uncertain significance.
•
To allow further tests to be performed by the laboratory or be
recommended to the requestor for further consideration.
•
To ensure the test is performed for diagnostic reasons.
Method(s):
A thorough consultation process was carried out with all
laboratory stakeholders. This was followed by a lead-in period before
going live with the policy.
The details, exceptions and pitfalls of the policy will be described.
Results:
So far, negative feedback has been limited. Clinical details
are now received on the vast majority of requests, and unnecessary
testing has been reduced. Post implementation audits are being
performed.
Discussion and/or Conclusion(s):
This is an important quality
initiative. The initial implementation was difficult, but the long term
quality benefits are very significant.
ID: 4692
Safe surgical hands in the operating theatre
–
sustained
improvement following a multi modal hand hygiene campaign
2009
–
2016
Fiona Smith, Karen Wares, Eleanor McLeod, Mark Higgins,
Elizabeth Irvine, Janet Mitchell, Angela Henderson.
NHS Grampian
Background:
Bacterial transmission in an operating room frompatient
to equipment and healthcare provider
’
s hands and even to the next
patient in the operating room has been associated with Healthcare
Associated Infection. Hand hygiene will interrupt transmission of
microbes between patients, healthcare workers and the inanimate
environment. In 2009 the Operating Theatre team asked the Infection
Prevention and Control Team for help implementing the World Health
Organisation
’
s concept of
‘
My five moments of hand hygiene
’
.
Aim(s)/Objective(s):
To embed the concept of
‘
My five moments of
hand hygiene
’
in the Operating Department.
Method(s):
Direct observation was utilised by Infection Prevention
and Control Nurses in the operating room in 2009. This established
work flow of operating room staff to guide additional alcohol based
hand rub placement, and measure baseline hand hygiene compliance
rates using the World Health Organisation
’
s observation method.
Multidisciplinary operative staff interviews were undertaken in 2009
to establish training needs and understanding of
‘
My 5 moments
for hand hygiene
’
. Infection Prevention and Control Nurses trained
Operating Theatre staff to hand hygiene audit within their own
department.
Results:
A timeline will show a summary of the milestones demon-
strating the ongoing collaborative improvement work since 2009.
Abstracts of FIS/HIS 2016
–
Poster Presentations / Journal of Hospital Infection 94S1 (2016) S24
–
S134
S95