Mona Khashoggi

I'm Mona Khashoggi.

I'm a pharmacist by background.

I did most of my work in clinical standards and governance before I moved into academia full time.

So I'm currently a DPhil researcher at Nuffield Department of Primary Care at Oxford University and I'm also a pharmacist teaching fellow at Kingston University London.

One of the things that my colleagues and I, so Lucy, Caitlin and myself have been working on is looking at how pandemic spreads can be contained in care homes and

We've roughly tried to look at that from a human resources angle, the types of nursing activities and medications that this involves, and also the role that external visitors play in pandemics.

So in terms of if we're looking at the effectiveness of infection control measures, it's dependent upon a number of factors and a combination of strategies providing the most useful output.

So the vast majority of the research out there is around hand hygiene, which is proving to be very important.

But more critically than that, it's the availability of sanitizers and hand washing facilities that there is a good evidence base for in terms of cluster randomized control trials for both reducing infection rates and deaths, in addition to using four or more of the World Health Organization's multimodal strategy.

generally tends to be the most effective in improving adherence to hand hygiene measures.

The other things that we found were things around staff movement appears to be a key source of the outbreaks, although this is based on observational evidence and there's no real randomized control evidence in terms of the impact that staff are having.

So this is looking at anybody that is delivering

any type of care to residents and it also includes external visitors so this isn't just the residents or the patients family or carers or members it's actually looking at contractors potentially that are delivering things into and out of so it combines everybody and it also includes our community nursing team so it's anybody that isn't resident

within that environment that is leaving and then re-entering that facility.

When we're looking at this, there's a potential the staff and the movement and entry and re-entry into different facilities actually suggests that from an intuitive point of view in terms of in the context of social distancing, that this is where the primary source of infection is coming from and entering into these care facilities.

So when we're looking at the effectiveness of the infection control measures, it's things like hand hygiene that are important.

It's things like limiting the movement of staff between different facilities and between different patients.

So some studies have found that actually limiting staff movement between the various different facilities or in larger care homes, having staff assigned to certain zones can potentially control that outbreak.

In terms of testing, there's some evidence, primarily from case studies around the SARS outbreak in care homes, that this allows early identification and a rapid response so that additional infection control measures can be put in place in the care home to safeguard and protect the patients and staff.

So in terms of one of our other key findings around well-being, we still don't know how much this affects the resident's quality of life