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'This initial success might kick-start further cross-infection training for staff'

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Nursing Times blogger Becky Cridford on her experiences of leading teaching on global hand-washing day in Sierra Leone.

A few weeks ago, one of the nurses approached me and said that he would like to do some teaching on cross infection. Initially, the idea was to educate the nurses, and time spent in the dressing clinic where children often have injection or cannula-site abcesses dressed, confirms this as a pressing need. But global hand-washing day happened to be coming up and when we spoke to a senior nurse she suggested educating parents, rather than staff.

Initially, I was unsure that this was the right decision, but we went with it, and on Friday 15th October a group of eight nurses moved around the wards, the antenatal clinic and the local primary health unit to deliver an extravaganza of hand-washing education for parents. Three nurses performed a short play demonstrating correct hand-washing practice; then all of the nurses joined in with a song explaining the importance of hand-washing for the health of children. It was great fun, went down well with the mothers, raised a few laughs, and was widely perceived to be a success.

Research suggests that hand-washing with soap is one of the most cost effective interventions to prevent diarrhoeal disease and respiratory infections. However, from my point of view, the importance of the events stretched far beyond any impact the health promotion might have on parents. My role here is to support the nurses rather than communities or patients directly, so while I hope it will have an effect on the latter two, I am more interested in what the experience could do for the nurses themselves.

Since the first nurse was keen to deliver cross-infection training for staff, I am hopeful that this initial success might kick-start further cross-infection training for staff.  I particularly liked the idea of the training being brought to the trainees, rather than the other way round, and I hope we can try out the same model when delivering training to nurses. Currently, most education takes place in a classroom and there is little bedsides teaching or ongoing mentorship for trained nurses or students. Apart from reducing disruption to the already over-stretched staffing, I think that if training can take place in-situ, then it will be easier for nurses to identify barriers and find ways to overcome them.

A welcome outcome was that the hand-washing team thoroughly enjoyed themselves. They felt that the mothers enjoyed and appreciated the event and the team are now looking in to contacting a national television station in order to spread the hand-washing message and demonstrate the good work of the Ola During nurses. I think it is fair to say that nursing morale within the hospital is not as high as it could be and the nurses are often criticised by other hospital staff and patients. Sometimes this is justifiable, but not always, and it is certainly far removed from the ‘no-blame’ culture and multi-disciplinary team work that we aspire to in the NHS.

I have said it before, but I continue to be impressed by the resilience that many nurses show despite the often difficult circumstances of their work. Certainly there are problems and it is true that Sierra Leone’s express their displeasure much more openly than I would. But I still wonder how staff feel - and what impact it may have on their work - when they are the subject of criticism. Is the culture here different enough to allow this to motivate rather than demoralise? For the time being I think anything that increases the nurses’ pride in the hospital, the profession and themselves is definitely worth pursuing.

About the author

Becky Cridford is a nurse who is spending the next year working with The Welbodi Partnership in Sierra Leone, a charity that supports the delivery of vital paediatric care.

The 2010 Vodafone World of Difference UK programme, delivered by the Vodafone Foundation, offers 500 winners the chance to work with their chosen charities for two months and get paid for their time.

The Vodafone Foundation World of Difference UK programme is now open for applications, to find out more and apply please visit before 23rd November 2010.

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