Transcript National Resource for Infection Control (NRIC)

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
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National Resource for Infection Control
(NRIC): www.nric.org.uk
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Bugs and Drugs on the Web
(www.antimicrobialresistance.org)
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Professionals
Public
Edugames4all (edugames4all.org)
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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
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Evaluating users needs
Clinical practice 48%
 Diseases 17%
 Policy 16%
 Settings 14%
 Transmission 5%
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Measuring Impact – recent research
(NRIC)
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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/
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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
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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
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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
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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
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Evidence of Improvement
2012 - DH funding for NRIC ceased to exist
 NRIC was successfully transferred to the
Department of Computer Science,
University College London (UCL) in June
2013
 Search for funding continues!
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Updating
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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 future
 Facebook and Twitter
Future Steps
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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
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European Antibiotic Awareness Day
2013 @ UCL
“A response to the Department of Health Antibiotic
Resistance Strategy (20 November 2013)”
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Promoting NRIC at international level
IPS EXCEL 2013
 APIC IIPW 2013
 Presentation at ICAN 2013
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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
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Patient safety/Sharing best practice
on IP&C and AMR
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NRIC - Keeping patients safe through
sharing evidence & best practice and
evaluating need through an ever
increasing user base : Locally, Nationally and Globally
Global Reach – geographical
distribution of top 20 searches
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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Summary of results - Science Museum
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Google, msn searches that led to the AR site between 1 Sep & 31st Jan
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38883 searches
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7161 included the word alcohol
12949 antibiotic
6515 chest
3467 bacteria
2085 virus
1852 acne
1149 flu
…. And 250 included "cat"
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Some users have an addiction problem:
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Quit antibiotics
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Quit working
Many users are concerned about animal
welfare:
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Antibiotics in disadvantaged animals
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information on cat colds
Others have an international approach:
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swedish acne remedy
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mrsa chinese formula
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edugames4all - Games of the
moment!
GHD Game
Bad Bacteria at BBQ
Training
Bugs Kingdom
Detective Game
Bugs Chefs
http://www.edugames4all.org/
Learning Objectives…
 Microbes
are all shapes
and sizes:
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Microbes exist in various locations:
(in the kitchen)
(inside the body)
(on the skin’s surface)
Teaching by playing:
Good and Bad Microbes
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Player transports lactobacillus to make
yogurt
Antibiotics and Vaccine Use
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Player throws white blood cells
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Player delivers full course of antibiotics to
infection
Game Evaluation:
Statistically significant knowledge gain
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)
 Level
Senior Detective Game
 The
player explores a crime scene
narrative, interviewing characters and
finding evidence that illuminates their
understanding of microbes, hygiene
and antibiotics.
Microvision…
Seamless Evaluation
Evaluation integrated in the game flow
Pre-test questions are asked at
different stages of the game
Number of games users per country:
Junior Games
Senior Game
DH AMR Strategy
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Aim 1: To improve knowledge and
understanding of AMR
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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
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