SQT Blog

- You go to the Doctor with an outbreak of a bad face rash. You look like a spotty teenager and have the energy of a dead duck. The Doctor pockets your €60, examines you and prescribes an antibiotic and some face cream to use (this is treating the symptom) and in a Root Cause Analysis Approach, this is termed Containment Action. The objective is to contain the issue in the short-term until he establishes the underlying reason for the rash.

– The next step in the RCA (Root Cause Analysis) involves the Doctor probing to establish what caused the rash in the first place – was it a bug picked up on a foreign trip? Was it contact with a plant or shrub? Is it an allergic reaction to a type of food or drink? You scratch your head and think. Slowly it dawns on you that it might be an allergic reaction to beer and nuts of all things as the World Cup Soccer has just finished and the high stool in your local has formed a profile of your posterior and has been retired and dedicated in your honour!

– Your heart sinks as a subsequent Allergy test verifies the terrible news.

– However, the antibiotic and face cream or Containment Action has kicked in and you are feeling much better. Your thoughts drift to a vision of an ice cool beer and KP’s best. You jolt back to reality and realise, no pain no gain and the Corrective Action and Preventative Action is to keep strictly away from your favourite combo. This is going to be tough but will Prevent Recurrence of the rash from hell.

– However, being the kind compassionate individual that you are, you think of your identical twin, Hughie. God forbid that he gets a dose of what you got. So you ring him up and tell him the scéal! Hughie is in love with himself and baulks when you mention that it might be in his interest to avoid beer and peanuts. He states indignantly that he hasn’t touched such plebish food in years and lists his favourite white wine and caviar as being his pleasures in life. How do says you!! as you replace the phone handset. All I was trying to do was to spare you a nightmare (Prevent Occurrence). So much for my Good Samaritan act!

So in summary a Root Cause Analysis Approach involves

1. Implementing Containment Action (this is treating the symptom)

2. Establishing the Root Cause

3. Implementing Corrective Action to deal with the immediate issue

4. Implementing Preventative Action to Prevent Recurrence (avoiding a repetition)

5. Implementing Preventative Action to Prevent Occurrence (applying lessons learnt)

Our Healthcare tutor Dr Kevina O’Donoghue tells us about her recent training experience in Libya…

When I was asked by a colleague to go to Libya to work with theatre nurses on sterilisation processes and parameters, my adventurous side came out and I jumped at the opportunity. Packing the suitcase was the hardest job, trying to get clothes that were light due to the heat yet covered the arms and the bum. On arriving into Tripoli airport the burnt out planes and bullet holes through the glass, were the first signs of the war that had ended not so long ago. On entering the airport building we had to get our passports stamped. This process took 3 hours and could have taken longer only for a libyian stranger happened to cross our paths. He greeted us with ‘conas ata tu’ followed by ‘well ye are brave women coming to libya’ – just what you need to hear at the start of your trip. This guy stayed with us ensuring that 3 hours later, after a lot of shouting through a small window, we got our stamped passports back and insisted on paying our fee to get into the country in return for a prayer – do you know of anybody in Ireland that would do that? This however was the first insight to the lack of systems and processes in Libya. We nearly had an IT system developed for them while we were waiting. It was clear that they work at a very different pace to what we are used to.

Our first day meeting with the nurses was exciting but again the lack of teamwork and communication skills was apparent. The concept of working in teams or groups was incomprehensible on the first day and they kept placing the chairs back to straight lines. By day two we finally had the concept of group work and were beginning to work together. Within the hospital structure, departments are very disjointed from each other and do not rely on other departments for theatres or sterilisation services. There is no link or need for communication between them. Listening to each other is not a skill that is used much. Everybody talks at the same time getting continuously louder so that they can be heard. This at times could get frustrating as tutors, considering the language barrier. We had the most fantastic translator and she could really connect with us. She had fantastic English both written and oral and helped us greatly in getting our message across however we did have to practice our acting skills now and again to deliver key messages and ensure they were embedded.

On visiting the theatres and sterilisation areas it was clear on one hand that the sterilisation process for reusable instruments needed to be improved greatly, however on the other hand I did wonder how there wasn’t more fatalities due to the current process. It became clear that their immune system was far greater than ours, even though there is no tracking or trending of infection control so it’s difficult to know exactly. Again the lack of a system and consistent process was apparent.

Our few days working with the nurses brought a new light to the potential future of the sterilisation service in the hospital for them. The people became excited with the new knowledge they gained into improving their everyday work life and service to patients. By the end of the week, a potential new CSSD dept to cater for all departments within the hospital was looking more positive. A new piece of equipment to aid in their service was approved along with supplies to ensure a more consistent process and sterility of instruments.

To be part of such a small piece of a much larger picture was very fulfilling and I know we made a difference to their lives and their work in such a short space of time. As quoted during our time with them ‘knowledge is power’ and for these people they received the power to now go and make a difference within their own departments. Getting to know the people and understanding their culture over the few days was a very rewarding experience and post revolution, there is an overwhelming good feel factor filled with enthusiasm and hope which made me feel I was part of the history books with them. They were the most fantastic people to work with, I thank them and my colleague for a lifetime experience that I hope would be repeated in the future.

Over the years, on request, SQT have delivered training courses overseas. Over the years people have travelled from abroad to attend our public courses – indeed one person has just relocated to Ireland for nine months to attend our NEBOSH Diploma course. To date this overseas training has largely come from people finding our website or multinationals based in Ireland who ask us to deliver training at their sites abroad.

Delivery abroad accounts for roughly 5% of our business. Delivering abroad poses few problems. Tutors are willing to travel. English can travel. Our courses can travel.

We have now re-engineered our website such that our portfolio of courses available overseas is more organised and visible.

As always we will be available for all our Irish clients but being able to deliver abroad will add a further string to our bow. Enterprise Ireland have been encouraging and supporting us in this direction.

Exciting times indeed.

The Qualifications and Quality Assurance (Education and Training) Act 2012 was signed by the president on 22nd July. The commencement date is scheduled for a date this month. On that date Quality and Qualifications Ireland (QQI) will be formally brought into being and FETAC, HETAC and NQAI will cease to exist. The new body QQI will also be responsible for quality assurance of the Irish Universities, a function previously performed by Irish Universities Quality Board (IUQB).

The legislation has in effect put in place QQI with a provider base across all areas of post-secondary education and training which will also be the custodian for the National Framework of Qualifications (NFQ).

Other changes are happening in education and training.
– The existing 33 Vocational Education Committees (VECs) are being restructured into 16 local Education and Training Boards.
– SOLAS (Seirbhísí Oideachais Leanunaigh agus Scileanna) is being established as the new Further Education and Training (FET) authority. It will be a body under the Department of Education and Skills (DES) and will be responsible for both the coordination and funding of FET. Under its mandate, SOLAS will ensure that the unemployed in particular are offered the upskilling opportunities necessary to get back into employment.
– The potential emergence of technological universities from amalgamated Institutes of Technology.

It is surely a time of change in Irish Education and Training.

The next ISO 13485:2003 & The Medical Devices Directives course will be held on 9th – 10th October in Dublin.

This course will include the latest proposals for future regulation of medical devices published by the commission on 26 September. While these changes were initiated in 2008, the need for revision has been gaining momentum following the PIP* scandal & metal on metal problems associated with hip replacements.

Please contact Jean on 061 339040 or email jfeehan@sqt.ie to book a place on this course.

* Poly Implant Prothèse (PIP) was the French company that produced breast implants.