Hello, my name is Molly Nancy, and I'm an infectious disease epidemiologist, at the Pennsylvania Department of Health. Today I am going to be talking to you, about infection prevention and control, as it applies to the COVID-19 pandemic. Before we get started, I would like to note, that any opinions and content presented in this course, represent the views of the presenters, who are responsible for its content. Do not necessarily represent the views or official position of the Pennsylvania Department of Health or the Commonwealth of Pennsylvania. Let's get started by reviewing the three P's of infection prevention and control, that is, policies, procedures, and practice. The private section, there are a number of things that we want you to learn. We want you to review the differences, between policy and procedures. To be able to discuss some of the strategies for educating staff, on infection prevention and control practices. We would like you to walk away, with an understanding of how policies and procedures can be translated into practice. First, I would like to define each of the three P's. Policies set a general framework to guide an organization decisions and actions. An example of this, might be when a community requires a universal masking for all residents, visitors, vendors, and staff. Procedure describe step-by-step action, that should be taken to complete a task. For example, a community may have a written procedure, outlining the process for screening visitors, vendors, and staff, upon entry for any signs or symptoms of poor exposure to Corona Virus Disease 2019. Finally, practice refers to the actual implementation of a set procedure. In other words, this is how residents, visitors, vendors, and staff members, actually carry out procedure defined by the community. Further explore the differences between policies and procedures. Policies are often broad statement, that set expectations for community, and describes the who, the what, the when, and most importantly, the why. In contrast, procedures have a more narrow focus by nature. They define a process for meeting expectations set in policies, like policies, they describe the who, what, and when, but most importantly, and unlike policies, they describe the how. It is important to note, that clearly defined infection prevention and control policies and procedures, play an essential role in preventing and responding to COVID-19. Now, that we have reviewed the differences between policies and procedure, let's walk through some things to consider when educating staff on these expectation. Education is key, because it is the first step in translating policies and procedures into practice. That should be familiar with relevant infection prevention and control policies, and procedures to foster correct practice. The following is a list of important consideration, when looking to provide staff education. First, educator should consider the age of their audience. Young adult learners, may need to receive education in a different format or style, than more mature learners. Another thing to consider, is the ethnic or cultural background, and preferred language of audience members. Educational material, may need to be available in a variety of languages, especially if the content uses complex jargon or specific details. Additionally, each learner will have their own individualized preference on how they like to learn. While education on COVID-19, in communities will oftentimes, need to be provided to group. It is helpful to have a sense of group preferences. Certainly, the format for which education is provided, will depend on the resources that are available to the community. Is there an established e-learning network? Is there a large enough classroom? Or meeting space to provide group lectures? Or in-person learning section to allow for social distancing? These are the few examples of resources available. Finally, educators will need to consider, what the best setting for providing education. Some procedures or practices, can be discussed or demonstrated in a classroom or meeting room, or even online. Other education may need to occur at the point of care. There are many factors to consider when providing that education. But the take home message here is that the style or format in which it is provided should really be tailored to each of the communities needs and resources. The graphic displayed here is a very helpful tool in planning for staff education. The National Training Laboratories Institute for Applied Behavioral Science, research the retention rate for each of the following most common teaching methods. As you can see, and perhaps some surprisingly, the retention rate increases when more participatory methods are used. For example, lectures, reading, audio visual presentation, and demonstration tend to have lower retention rates whereas group discussions, practice by doing and teaching others lead to longer retention rate. It's important to note that some educational sessions may deploy multiple of these strategies at once, combining methods will increase retention rates. Let's look at some examples of teaching methods specific to infection prevention and control education for COVID-19. One example of reading as an educational tool might be having staff read and sign off on new infection prevention and control policies and procedures. For audio visual methods, staff may have an opportunity to watch a video on proper hand washing techniques. For demonstration, an educator may choose to demonstrate how to don and doff PPE appropriately. In terms of group discussion, maybe your community chooses to engage in a group discussion surrounding this Coursera course and COVID-19 preparedness and response in general. For practice by doing, after the completion of this Coursera course, we hope that your community will ask staff to co-develop and take new infection prevention and control procedures that are not yet in place, but maybe helpful to prevent or respond to COVID-19. Finally, an example of teaching others maybe when, supervisors receive training on proper hand hygiene procedures and then teach staff in their respective departments to follow those same procedures. So far in this section, we have discussed the differences between policies and procedures and educating staff to implement them as routine practice. Now let's discuss some additional strategies for moving from policies and procedures to practice. Two ways to do this are through designating champions and through audit and feedback. We will start with designating champions. Designating champions is an evidence-based approach that identifies leaders to implement, demonstrate, and foster correct practice among their peers. There are many important characteristics to consider when identifying a champion. Communities should consider individuals who're respected by their peers, persuasive, early adopters of new information, effective communicators, and many other considerations. Once champions are identified, communities should train these individuals on correct practice based on established policies and procedures. Education should be provided using the consideration already discussed in this section. Once efficient education has been provided, empower your champion to demonstrate and foster correct practice among their peers each and every day. Communicating with champions to identify successes and challenges for improvement is helpful in sustaining correct practice. Communication must flow both to and from champions, a back and forth dialogue so that all levels of leadership and staff understand how correct practice is achieved. I also mentioned audit and feedback as a tool from moving from policies and procedures to practice. Auditing practices refers to frequent observation and documentation of adherence to policies and procedures. Auditing helps to identify gaps in practice for follow-up education. Some common examples of auditing are to observe and record instances of hand hygiene and or PPE use among staff members when indicated. When an observed practice diverges with policies and procedures, provides staff with constructive feedback for improvement to foster sustained practice. Let's continue with the example of hand hygiene. Let's say a dietary staff member posses from their work to blow their nose and does not wash their hands after doing so, an individual observing that practice may constructively remind the person to wash their hands after coughing, sneezing, or blowing their nose in order to prevent any surface contamination from their respiratory secretion. Those providing feedback should avoid judgment or overly critical language so as not to discourage the person or make them feel uncomfortable. Overall, staff play a key role in preventing and responding to COVID-19 in communities. Ensuring understanding of what is expected and measures to ensure correct practice should be made a priority.