Jump the evaluation hurdle in IC education
Incorporate elements from other programs
Developing an infection control education program can be a challenging endeavor for employee health professionals, but determining if the program is successful doesn't have to be, say EHPs who've recently designed or revamped their programs.
Effective and successful infection control education programs are an essential component in an employee health program. In fact, annual education is required for existing employees on infection control by the Oakbrook Terrace, IL-based Joint Commission on Accreditation of Healthcare Organizations and the Occupational Safety and Health Administration (OSHA) in Washington, DC. The Centers for Disease Control and Prevention in Atlanta also recommends annual education for tuberculosis for health care employees.
Relying on human resources for support is how the Medical College of Georgia (MCG) in Augusta is educating its staff about infection control and TB in an effort to meet educational guidelines. Providing meaningful education to large numbers of employees is accomplished through cluster days for licensed and non-licensed staff. Human resources provides staff with rosters of employees who need an annual review, says Margaret Johnson, MSN, RN, adult nurse educator for more than 3,000 HCWs at the university's hospital.
EHPs can evaluate infection control programs for effectiveness by incorporating the following six strategies into educational efforts:
1. Identify problems currently hampering education efforts.
Brainstorming with infection control staff to identify problems within the department and beyond helped to pinpoint specific problems, says Gina Oda, MS, CIC, an infection control practitioner at Veterans Affairs Palo Alto (CA) Health Care System. The Palo Alto system's hospitals involve more than 5,000 HCWs in infection control education, adds Oda.
Oda's department, which consists of one half-time and three full-time HCWs, first identified existing problems not necessarily limited to the department through a staff brainstorming session. Next, a staff member met with each department to find out what problems staff identified. "Our TB program, for example, started last year, and we evaluated it to see what infection control practices staff were retaining and what items they weren't. We reaffirmed our initial guess that the problems were in early identification and isolation of TB patients," notes Oda.
Palo Alto's identification process led to a list of four main problems affecting the infection control education program:
* Education policy was not mandated at the administrative level.
* Support from human resources for new employees was minimal.
* Education policy enforcement by each department was inconsistent.
* Outcome measurement for effectiveness was not available.
For MCG, the problem was providing meaningful education to a large number of employees, says Johnson. To remedy the problem, the department of patient care services began sponsoring cluster days in 1994 for licensed employees. The program was expanded this year to include non-licensed employees.
Cluster days involve an eight-hour class, which includes presentations on radiology safety, fire safety, and a group participation game. Licensed employees play "jeopardy" while non-licensed employees play "feud," notes Johnson.
2. Gain administrative support in stressing the importance of education.
Administrative support is essential in gaining support from other departments for a successful educational program, says Oda. Solving the administrative support problem is an ongoing process and requires consistent reinforcement, she says, but the initial efforts paid off by increasing Palo Alto's educational compliance rates. "We're not at 100%, but it's better than before we looked at evaluating our program, which had about a 50% compliance rate at best," adds Oda.
Policies were rewritten at Palo Alto to reflect administrative support for all employees to receive adequate infection control education. "The policy stated that employees should receive education on infection control, but now the policy states that employees must receive education," explains Oda.
3. Teach human resources staff about the importance of infection control education.
Infection control staff at Palo Alto gained support from the human resources department by explaining the importance of education. "We explained that both the Joint Commission and OSHA require education for employees. The education policy was changed to require department heads to attend classes to help instruct their staff," says Oda.
The human resources department at Palo Alto now assists in educating employees by helping obtain equipment and a conference room for education classes. The human resources department also is helpful for educating new employees at MCG, adds Johnson.
Human resources notifies patient care services of newly hired employees who are reporting for pre-employment physicals. New employees are informed about hepatitis B immunizations and are encouraged to receive a vaccination. "We've seen a rise in hepatitis B immunization, but no data are available," says Johnson.
4. Evaluate employee knowledge through assessment tools.
One of the best ways to evaluate your program is through individual assessments. MCG, for example, began offering a monthly class followed by a quiz earlier this year.
Palo Alto also uses the "jeopardy" game for its licensed employees, but staff also have the opportunity to participate in an e-mail quiz. "We developed an e-mail quiz for the nursing department when we introduced our new isolation policy for TB patients. We included a contest where the winner got cookies or snacks, and the response is a little better than if we had presented this in a lecture format," says Oda.
Observation is another method of evaluating an employee's level of knowledge. "We really haven't found the best evaluation tool yet, but for our TB policy, we incorporate a question with an environmental round," explains Oda. Staff from the safety, quality assurance, nursing, and infection control departments look at the environment for violations. Staff are then asked to pick a question to answer to determine if knowledge from class was retained, she explains.
5. Incorporate a train-the-trainer program.
Palo Alto offers a train-the-trainer program for department staff who express interest in teaching peers. The educational class is offered to employees who require an annual update on infection control. The next step for the infection control staff is to evaluate the quality of education the trainers are providing, says Oda. "They learn teaching principles and new information about infection control, and now we need to go out and see how they're doing."
6. Involve experts in the education process.
Both Oda and Johnson recommend seeking help from experts in other departments. Not only do the experts know which topics to emphasize, but hearing information from other staff stresses the importance of the education.
MCG's classes, for example, include presentations on fire safety and radiology safety from other departments. Involving other staff eliminates the possibility of forgetting important points, says Johnson. "It's my responsibility to present information accurately, but I depend on that department to provide me with the right information, so we just give them the option of presenting it themselves." *
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