Patient Safety Spotlight interview with Dr Kevin Hambridge, Lecturer in Adult Nursing at the University of Plymouth

Summary

This is part of our series of Patient Safety Spotlight interviews, where we talk to people working for patient safety about their role and what motivates them. Kevin talks to us about the role research plays in improving staff and patient safety. He explains how his own research has uncovered the extent of violence experienced by student nurses and the underreporting of sharps injuries among healthcare students. He also highlights how research can help universities improve awareness of issues facing students across all healthcare courses and provide more effective support.

About the Author

Kevin Hambridge is a lecturer in Adult Nursing at the University of Plymouth. This involves teaching pre-registration and post-graduate nursing students in a range of subjects including the nursing process, Type 2 diabetes, research methodologies and methods, as well as conducting research, literature reviews and systematic reviews. Kevin completed a PhD investigating sharps injuries within nursing students in 2019 and his current areas of research interest are violence sustained by nurses and other healthcare professionals, and the career choices of nursing and midwifery students.

Questions & Answers

Hi Kevin! Please can you tell us who you are and what you do?

My name is Kevin Hambridge and I’m a lecturer at Plymouth University, where I’ve worked for about 20 years. I’m also the course employability lead, which involves helping students find jobs at the end of their training. I also spend one day a week on research. Prior to working at the university, I worked as a nurse for 14 years, mainly in surgical settings.

How did you first become interested in patient safety?

When I worked as a nurse, I became a practice development nurse for my organisation. This involved trying to improve patient care as well as working out how we could reduce risks for patients in hospital. That’s when I really got focused on setting up new systems to try and improve patient safety. We went through all the different areas where patients could come to harm and introduced risk assessments to reduce the likelihood of incidents such as falls, medication errors and pressure ulcers.

Since joining the university, my focus has moved towards safety for student nurses. I run simulations in the skills laboratory to help our students work out ways to reduce risks and improve their safety. For the past ten years, I’ve had a particular interest in preventing sharps injuries in healthcare. I was in the simulation ward one day teaching injection technique and suddenly noticed a student at the sink with blood everywhere—they had put a needle right through their finger and into the next one! I asked myself, if students can injure themselves with sharps in this very safe, controlled environment, what might happen to them when they are out in practice? 

I realised the area hadn’t been explored much in the UK and so made it my goal to find out as much as I could about it. My research showed that about 14% of student nurses in the UK have a sharps injury annually, commonly involving a used sharp. I also found that these incidents are rarely reported and that students are often not using safer sharps devices. We did another study last year looking at other healthcare students, and found that the issues are similar amongst physiotherapy, radiotherapy, occupational therapy, paramedicine and podiatry students. I believe it’s the first study in the world looking at sharps injuries amongst allied health professional students. When it is published in the next few months, it will hopefully demonstrate the need to better educate students in these professions about reducing their risk of sharps injury.

Which part of your role do you find the most fulfilling?

During Covid we had to teach online for a year and a half. I really missed the students, so getting back to seeing them face to face has been great. It gives me a greater understanding of their experiences in practice. Every year, graduation is a real highlight for me—having seen the students from the very beginning of the course, I watch them go past and reflect on how much hard work each of them has had to put in to graduate. Nursing is a very difficult degree and it’s wonderful to see them go off into the big wide world as qualified nurses!

I also find it fulfilling when I get to the end stage of a research project. Once it’s published in a journal, I like the thought that it might help someone out there think about their practice, take a different approach or even do some further research on the subject.

What patient safety challenges do you see at the moment?

The biggest challenge I see is around staffing. I was an admissions tutor for a few years and we saw a reduction in people applying for nursing, largely due to changes to the financial support available. That has led to a reduction in the workforce, making it harder for existing nurses to do their job safely. 

As universities, we have a role to play in ensuring student nurses make it into the workforce by reducing dropout. We need to select applicants carefully, making sure that students understand the sacrifices they will need to make to pursue a nursing degree. The dropout rate varies widely across the country, and in the South West we work quite hard to make sure the right candidates end up on the course. We’re also proud of the fact that we prioritise supporting our students’ wellbeing while they are training.

Another issue the health service faces is the increasing complexity of patients. Since I was in practice, nurses' workload in hospitals has increased because more patients now have complex medical needs.

What role can research play in improving patient safety?

There are so many different types of research that can improve patient safety. When researchers around the world conduct and publish systematic reviews, it helps others see where they should be focusing attention in terms of changing practice or doing further research. We often see research having an impact on patient safety policy, guidelines and practice across health services. 

Investing in research also improves the education we are giving our future workforce of healthcare professionals. Finding an area you are passionate about is a real joy. It was great to be able to commit six years of my life to researching sharps injuries in student nurses for my PhD, and I hope it has added to the knowledge we have on the subject.

I’ve recently been involved in a research project about violence sustained by student nurses. We already know that violence is a risk for healthcare staff, but before this study, we didn’t know how much of an issue it is for healthcare students. If nothing else, it has put the issue on the agenda for other people to start considering. Although the study isn’t yet published, we have had some positive responses to our research already. In my department, we’re going to be looking at the findings and how we can use the learning to better prepare students for the issues they might face when they go out into practice. We’re also looking at the support mechanisms we have in place—it’s so important that people get effective support when they have suffered physical or psychological harm at work. 

I hope that the survey also gave the students who took part a platform to think and talk about their experiences. Some of our students are as young as 18 years old and have just three months preparation at university before they are out in practice for the first time. Even verbal violence can be devastating to students, so these incidents can have a big impact on an individual’s training and career. The results tell us that most students who sustain violence on placements are not reporting it, and some are even being encouraged not to report incidents, which is worrying. We also found that only 10% of students who had sustained violence while working had reported it to their personal tutor at the university—my hope is that the survey has shown them that support from their tutor is a resource available to them. We don’t want students to feel bad or embarrassed about reporting incidents because there is a whole range of support we can offer if we know what the problem is.  

If you could change one thing in the healthcare system right now to improve patient safety, what would it be?

I would make financial changes to boost the number of nurses. Without being too political, I would tackle the issue of tuition fees as we know from UCAS that the number of applicants is decreasing. It would boost nurse numbers significantly if people didn’t have the concern of the financial burden of training. In the same vein, I would also increase nurses' pay, as I don’t believe current salaries correspond to the amount of training nurses have to do. The knock on effect would be an increase in the number of nurses we have available, which would mean safer working practices.

Tell us one thing about yourself that might surprise us!

One of my achievements in life is teaching myself the ukulele! I love music and it’s the one instrument I have found that I can get a tune out of. I set up a club in Plymouth for others who might want to learn to play and within about six months there were 200 of us. Two years after that, we found ourselves supporting the Fisherman's Friends in concert!

Further reading

Read some of Kevin's research studies on the hub:

• Sharps injuries within the healthcare student population: a narrative review (7 December 2023)
• An audit of sharps injuries in clinical skills simulation wards at a UK university (15 September 2022)
• The experience and psychological impact of a sharps injury on a nursing student population in the UK (11 August 2021)