Evidence map›Paper›PMID 32070419›Full record

Trial reportAntimicrobial resistance and infection control2020

Effectiveness of a structured, framework-based approach to implementation: the Researching Effective Approaches to Cleaning in Hospitals (REACH) Trial.

Lisa Hall, Nicole M White, Michelle Allen, Alison Farrington, Brett G Mitchell, Katie Page, Kate Halton, Thomas V Riley, Christian A Gericke, Nicholas Graves and 1 more

Abstract readPragmatic Clinical Trial
In one paragraph

Trial report in Antimicrobial resistance and infection control, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Lisa HallSchool of Public Health, University of Queensland, 288 Herston Road, Herston, Queensland, 4006, Australia. l.hall3@uq.edu.au.ORCID 0000-0002-9309-9315
Nicole M WhiteSchool of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia.
Michelle AllenAbt Associates, Brisbane, Queensland, Australia.
Alison FarringtonSchool of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia.
Brett G MitchellDiscipline of Nursing, Avondale College of Higher Education, Cooranbong, New South Wales, Australia.
Katie PageCentre for Health Economics Research and Evaluation, University of Technology Sydney, Ultimo, New South Wales, Australia.
Kate HaltonSchool of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia.
Thomas V RileySchool of Biomedical Sciences, University of Western Australia, Perth, Western Australia, Australia.
Christian A GerickeSchool of Clinical Medicine, University of Queensland, Brisbane, Queensland, Australia.
Nicholas GravesSchool of Public Health and Social Work, Queensland University of Technology, Brisbane, Queensland, Australia.
Anne GardnerSchool of Nursing, Queensland University of Technology, Brisbane, Queensland, Australia.

Funding

National Health and Medical Research Council GNT1076006
6 · The paper itself

Abstract

backgroundImplementing 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/

methodsThe 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).

resultsWe 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.

conclusionUsing 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.

trial registrationAustralia New Zealand Clinical Trial Registry ACTRN12615000325505, registered on 4 September 2015.

Indexed as

AustraliaCross InfectionEvidence-Based PracticeHealth PromotionHealth Services ResearchHospital Bed CapacityHousekeeping, HospitalHumansOutcome Assessment, Health CarePhylogenyEnvironmental cleaningImplementation scienceInfection prevention

Identifiers

PMID32070419
PMCPMC7029491

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.