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National Resource for Infection Control (NRIC) and edugames4all
Evidence dissemination and engagement for professionals and public – a key area in tackling AMR
Sue Wiseman and Patty Kostkova
AMR Projects
National Resource for Infection Control (NRIC): www.nric.org.ukProfessionals
Bugs and Drugs on the Web (www.antimicrobialresistance.org)Public
Edugames4all (edugames4all.org)Children
Methods and measurements of NRIC’s success
Since its launch in May 2005, the ‘National Resource for Infection Control’ (www.nric.org.uk) has provided a freely available website for quick and easy access to IP&C evidence-based guidelines, policy and research in the UK
It has during that time also become an internationally recognised online resource
It’s impact has been measured through research1 using web analysis of traffic and impact evaluation2
Measuring Impact – recent research (NRIC)
1. Kostkova P, Fowler D, Wiseman S, Weinberg JR. Major Infection Events Over 5 Years: How Is Media Coverage Influencing Online Information Needs Of Health Care professionals and the Public? J Med Internet Res 2013; 15(7):e107/
2. P Kostkova, G Madle. “What Impact Do healthcare Digital Libraries Have? An Evaluation of National Resource of Infection Control at the Point of Care Using Impact-ED Framework” International Journal on digital Libraries, December 2012, DOI:10.1007/s00799-012-0101-4
Public and professional interest, and media coverage1
A comparison of Google searches for the terms "clostridium difficile", "MRSA", and "superbug“
The public and professional interest, and media coverage for: -
Clostridium difficile and MRSA Tuberculosis. Meningitis Norovirus. Influenza
Some of the results
Public needs in infection are much more static and do not relate to disease occurrence and media coverage as much as professionals whose needs inevitably increase with a public health event or a key policy change
However, for events of major media interest, such as MRSA/C difficile, media coverage resulted in major public interest
Triangulated qualitative and quantitative data about the resource use and intended purpose of the information sought and its expected impact on target users’ work and clinical practice2
Improvement issues and context
2012 – re-organisation of many of the key government, non governmental organisations, professional bodies and agencies websites in the UK
Publications, guidance, policy and research in IP&C and AMR has become increasingly difficult to source (Archived)
Many URL’s to knowledge that drives and informs IP&C no longer link to the evidence required at the point of care
Evidence of Improvement
2012 - DH funding for NRIC ceased to existNRIC was successfully transferred to the
Department of Computer Science, University College London (UCL) in June 2013
Search for funding continues!
Updating
2013 - NRIC continues to provide open access to knowledge and understanding of AMR and updated IP&C evidence base through re-development, keeping the best of NRIC’s well proven past but moving with the challenges of the present and futureFacebook and Twitter
Future Steps
Face to face interaction in information sharing is now rare; working together over wide geographical areas and in ‘real time’ by use of the internet is the ‘norm’
NRIC provides an internet digital library to keep pace with these changes plus real time data for research and analysis of information needs, a possible future platform for use of social computing and collaborative WIKI type policy and evidence development
Future influencing
European Antibiotic Awareness Day 2013 @ UCL
“A response to the Department of Health Antibiotic Resistance Strategy (20 November 2013)”
Promoting NRIC at international level IPS EXCEL 2013APIC IIPW 2013Presentation at ICAN 2013
Future Research/Future Funding
NRIC meets ICAN: Infection Control in Africa – enabling knowledge transfer of our research into models for Digital Library dissemination of IP&C evidence and user profiling/impact evaluation, piloted at NRIC to global users in low and middle income settings
Working with Industry to secure NRIC’s future while maintaining independence
Patient safety/Sharing best practice on IP&C and AMR
NRIC - Keeping patients safe through sharing evidence & best practice and evaluating need through an ever increasing user base : -
Locally, Nationally and Globally
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2. Bugs and Drugs Site for Public
Evaluation of patient knowledge and attitudes before and after using the site
– Users were free to browse the site between questionnaires
– First study took place in the Science Museum London as part of ‘live science’
– 227 visitors took part of which 177 completed both questionnaires
– Study repeated at Nottingham City Hospital Open Day and also Oxford University Medical School
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Google, msn searches that led to the AR site between 1 Sep & 31st Jan
38883 searches 7161 included the word alcohol 12949 antibiotic 6515 chest 3467 bacteria 2085 virus 1852 acne 1149 flu …. And 250 included "cat"
• Some users have an addiction problem:
• Quit antibiotics
• Quit working
• Many users are concerned about animal
welfare:
• Antibiotics in disadvantaged animals
• information on cat colds
• Others have an international approach:
• swedish acne remedy
• mrsa chinese formula
edugames4all - Games of the moment!
Bad Bacteria at BBQ
Bugs Chefs
Bugs Kingdom
Detective Game
Training GHD Game
http://www.edugames4all.org/
Learning Objectives…
Microbes are all shapes
and sizes:
(inside the body)
(in the kitchen)
(on the skin’s surface)
Microbes exist in various locations:
Teaching by playing: Teaching by playing: Good and Bad MicrobesGood and Bad Microbes
• Player transports lactobacillus to make yogurt
Antibiotics and Vaccine Antibiotics and Vaccine UseUse
• Player throws white blood cells
• Player delivers full course of antibiotics to infection
Game Evaluation:Game Evaluation:Statistically significant knowledge gainStatistically significant knowledge gain
Level 3, Q1: “We use good microbes to make things like bread and yogurt” (p < 0.001, chi = 14.46)
Level 1, Q1: “If you cannot see a microbe it is not there” (p = 0.02, chi =5.60)
Level 2, Q2: “Soap can be used to wash away bad bugs” (p =0.02, chi=5.28)
Senior Detective Game
The player explores a crime scene narrative, interviewing characters and finding evidence that illuminates their understanding of microbes, hygiene and antibiotics.
Evaluation integrated in the game flowPre-test questions are asked at different stages of the game
Seamless Evaluation
DH AMR Strategy
Aim 1: To improve knowledge and understanding of AMR
1. Improving infection prevention and control practices in human and animal health, both through enhanced dissemination and implementation of best practice and better use of surveillance data and diagnostics
3. Improving professional education, training and public engagement to improve clinical practice and promote wider understanding of the need for more sustainable use of antibiotics