- Title
- Effectiveness of a structured, framework-based approach to implementation: the Researching Effective Approaches to Cleaning in Hospitals (REACH) Trial
- Creator
- Hall, Lisa; White, Nicole M.; Gardner, Anne; Allen, Michelle; Farrington, Alison; Mitchell, Brett G.; Page, Katie; Halton, Kate; Riley, Thomas V.; Gericke, Christian A.; Graves, Nicholas
- Relation
- NHMRC.GNT1076006 http://purl.org/au-research/grants/nhmrc/GNT1076006
- Relation
- Antimicrobial Resistance and Infection Control Vol. 9, no. 35
- Publisher Link
- http://dx.doi.org/10.1186/s13756-020-0694-0
- Publisher
- BioMed Central
- Resource Type
- journal article
- Date
- 2020
- Description
- 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.
- Subject
- environmental cleaning; implementation science; infection prevention
- Identifier
- http://hdl.handle.net/1959.13/1421212
- Identifier
- uon:37699
- Identifier
- ISSN:2047-2994
- Rights
- This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
- Language
- eng
- Full Text
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