Author Faculty (Discipline)

Nursing

Document Type

Article

Publication Date

2-18-2020

JOURNAL

Antimicrobial Resistance and Infection Control

VOLUME NUMBER

9

ISSN

2047-2994

Embargo Period

9-28-2020

ANZSRC / FoR Code

060502 Infectious Agents| 111002 Clinical Nursing: Primary (Preventative)

Avondale Research Centre

Lifestyle and Health Research Centre

Reportable Items (HERDC/ERA)

C1

Abstract

Background

Implementing sustainable practice change in hospital cleaning has proven to be an ongoing challenge in reducing healthcare associated infections. The purpose of this study was to develop a reliable framework-based approach to implement and quantitatively evaluate the implementation of evidence-based practice change in hospital cleaning.

Design/methods

The Researching Effective Approaches to Cleaning in Hospitals (REACH) trial was a pragmatic, stepped-wedge randomised trial of an environmental cleaning bundle implemented in 11 Australian hospitals from 2016 to 2017. Using a structured multi-step approach, we adapted the integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) framework to support rigorous and tailored implementation of the cleaning bundle intervention in eleven diverse and complex settings. To evaluate the effectiveness of this strategy we examined post-intervention cleaning bundle alignment calculated as a score (an implementation measure) and cleaning performance audit data collected using ultraviolet (UV) gel markers (an outcome measure).

Results

We successfully implemented the bundle and observed improvements in cleaning practice and performance, regardless of hospital size, intervention duration and contextual issues such as staff and organisational readiness at baseline. There was a positive association between bundle alignment scores and cleaning performance at baseline. This diminished over the duration of the intervention, as hospitals with lower baseline scores were able to implement practice change successfully.

Conclusion

Using a structured framework-based approach allows for pragmatic and successful implementation of clinical trials across diverse settings, and assists with quantitative evaluation of practice change.

Link to publisher version (DOI)

https://doi.org/10.1186/s13756-020-0694-0

Peer Review

Before publication

Grant Number

1076006

Comments

Used by permission: the author(s).

Creative Commons License

Creative Commons Attribution 4.0 International License
This work is licensed under a Creative Commons Attribution 4.0 International License.

Associated Research Project

https://research.avondale.edu.au/research_documentation/17/

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Nursing Commons

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