Journal article
Effectiveness of a structured, framework-based approach to implementation: The Researching Effective Approaches to Cleaning in Hospitals (REACH) Trial
Antimicrobial Resistance & Infection Control, Vol.9(1), Art. 35
2020
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.
Details
- Title
- Effectiveness of a structured, framework-based approach to implementation: The Researching Effective Approaches to Cleaning in Hospitals (REACH) Trial
- Authors/Creators
- L. Hall (Author/Creator) - Queensland University of TechnologyN.M. White (Author/Creator) - Queensland University of TechnologyM. Allen (Author/Creator) - Abt Associates, Brisbane, Queensland, Australia.A. Farrington (Author/Creator) - Queensland University of TechnologyB.G. Mitchell (Author/Creator) - Avondale UniversityK. Page (Author/Creator) - University of Technology SydneyK. Halton (Author/Creator) - Queensland University of TechnologyT.V. Riley (Author/Creator) - The University of Western AustraliaC.A. Gericke (Author/Creator) - The University of QueenslandN. Graves (Author/Creator) - Queensland University of TechnologyA. Gardner (Author/Creator) - Queensland University of Technology
- Publication Details
- Antimicrobial Resistance & Infection Control, Vol.9(1), Art. 35
- Publisher
- BioMed Central Ltd
- Identifiers
- 991005542033307891
- Copyright
- © 2020 Hall et al.
- Murdoch Affiliation
- School of Veterinary and Life Sciences
- Language
- English
- Resource Type
- Journal article
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- Collaboration types
- Industry collaboration
- Domestic collaboration
- Citation topics
- 1 Clinical & Life Sciences
- 1.23 Antibiotics & Antimicrobials
- 1.23.173 MRSA and VRE
- Web Of Science research areas
- Infectious Diseases
- Microbiology
- Pharmacology & Pharmacy
- Public, Environmental & Occupational Health
- ESI research areas
- Pharmacology & Toxicology