Evidence map›Paper›PMID 37605224›Full record

ArticleBMC nursing2023

The ACCELERATE Plus (assessment and communication excellence for safe patient outcomes) Trial Protocol: a stepped-wedge cluster randomised trial, cost-benefit analysis, and process evaluation.

Mark Liu, Susan Whittam, Anna Thornton, Liza Goncharov, Diana Slade, Benjamin McElduff, Patrick Kelly, Chi Kin Law, Sarah Walsh, Vivien Pollnow and 28 more

Erratum issuedOpen access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC nursing, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.7field-weighted citation impact, top 28% of its field
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

2 citing papers in PubMed, 2 citations in OpenAlex.

  1. Article
  2. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

38 authors at 14 institutions in 1 country.

Mark LiuNursing Research Institute, St Vincent's Health Network Sydney, St Vincent's Hospital Melbourne, Australian Catholic University, De Lacy Building, 390 Victoria Street, Darlinghurst, NSW, 2010, Australia.
Susan WhittamNursing Research Institute, St Vincent's Health Network Sydney, St Vincent's Hospital Melbourne, Australian Catholic University, De Lacy Building, 390 Victoria Street, Darlinghurst, NSW, 2010, Australia.
Anna ThorntonSt Vincent's Health Network Sydney, 390 Victoria Street, Darlinghurst, NSW, 2010, Australia.
Liza GoncharovInstitute for Communication in Healthcare, Australian National University, Baldessin Precinct Building, 110 Ellery Crescent, Acton, ACT, 2601, Australia.
Diana SladeInstitute for Communication in Healthcare, Australian National University, Baldessin Precinct Building, 110 Ellery Crescent, Acton, ACT, 2601, Australia.
Benjamin McElduffNursing Research Institute, St Vincent's Health Network Sydney, St Vincent's Hospital Melbourne, Australian Catholic University, De Lacy Building, 390 Victoria Street, Darlinghurst, NSW, 2010, Australia.
Patrick KellySchool of Public Health, University of Sydney, Edward Ford Building, A27 Fisher Road, Camperdown, NSW, 2006, Australia.
Chi Kin LawNational Health and Medical Research Council Clinical Trials Centre, University of Sydney, Medical Foundation Building, 92-94 Parramatta Road, Camperdown, NSW, 2050, Australia.
Sarah WalshNursing Research Institute, St Vincent's Health Network Sydney, St Vincent's Hospital Melbourne, Australian Catholic University, De Lacy Building, 390 Victoria Street, Darlinghurst, NSW, 2010, Australia.
Vivien PollnowSt Vincent's Health Network Sydney, 390 Victoria Street, Darlinghurst, NSW, 2010, Australia.
Jayde CuffeNursing Research Institute, St Vincent's Health Network Sydney, St Vincent's Hospital Melbourne, Australian Catholic University, De Lacy Building, 390 Victoria Street, Darlinghurst, NSW, 2010, Australia.
Jake McMahonNursing Research Institute, St Vincent's Health Network Sydney, St Vincent's Hospital Melbourne, Australian Catholic University, De Lacy Building, 390 Victoria Street, Darlinghurst, NSW, 2010, Australia.
Christina AggarSouthern Cross University, Military Road, East Lismore, NSW, 2480, Australia.
Jacqueline BiloSt Vincent's Hospital Melbourne, 41 Victoria Parade, Fitzroy, VIC, 3065, Australia.
Karen BowenNorthern NSW Local Health District, Crawford House, Hunter Street, Lismore, NSW, 2480, Australia.
Josephine S F ChowSouth Western Sydney Local Health District, Liverpool Hospital Eastern Campus, Corner of Lachlan and Hart Streets, Liverpool, NSW, 2170, Australia.
Katharine DuffyNorthern NSW Local Health District, Crawford House, Hunter Street, Lismore, NSW, 2480, Australia.
Bronwyn EverettUniversity of Wollongong, Northfields Avenue, Wollongong, NSW, 2522, Australia.
Caleb FergusonUniversity of Wollongong, Northfields Avenue, Wollongong, NSW, 2522, Australia.
Steven A FrostSouth Western Sydney Local Health District, Liverpool Hospital Eastern Campus, Corner of Lachlan and Hart Streets, Liverpool, NSW, 2170, Australia.
Narelle GleesonLismore Base Hospital, 60 Uralba Street, Lismore, NSW, 2480, Australia.
Kate HackettSouth Eastern Sydney Local Health District, The Sutherland Hospital and Community Health Service, Corner The Kingsway and Kareena Road, Caringbah, NSW, 2229, Australia.
Ivanka KomusanacSydney Local Health District, King George V Building, Missenden Road, Camperdown, NSW, 2050, Australia.
Sonia MarshallSouth Western Sydney Local Health District, Liverpool Hospital Eastern Campus, Corner of Lachlan and Hart Streets, Liverpool, NSW, 2170, Australia.
Sharon MayFairfield Hospital, Polding Street and Prairie Vale Road, Prairiewood, NSW, 2176, Australia.
Gemma McErleanUniversity of Wollongong, Northfields Avenue, Wollongong, NSW, 2522, Australia.
Gregory MelbourneSouth Western Sydney Local Health District, Liverpool Hospital Eastern Campus, Corner of Lachlan and Hart Streets, Liverpool, NSW, 2170, Australia.
Jade MurphySt Vincent's Hospital Melbourne, 41 Victoria Parade, Fitzroy, VIC, 3065, Australia.
Joanne NewburyThe Sutherland Hospital, Corner The Kingsway and Kareena Road, Caringbah, NSW, 2229, Australia.
Deb NewmanLismore Base Hospital, 60 Uralba Street, Lismore, NSW, 2480, Australia.
John Rihari-ThomasUniversity of Wollongong, Northfields Avenue, Wollongong, NSW, 2522, Australia.
Hayley SciuriagaRoyal Prince Alfred Hospital, 50 Missenden Road, Camperdown, NSW, 2050, Australia.
Lauren SturgessSt George Hospital, Gray Street, Kogarah, NSW, 2217, Australia.
Joanne TaylorSt Vincent's Health Network Sydney, 390 Victoria Street, Darlinghurst, NSW, 2010, Australia.
Karen TuqiriPrince of Wales Hospital, 320-346 Barker Street, Randwick, NSW, 2031, Australia.
Elizabeth McInnes *Nursing Research Institute, St Vincent's Health Network Sydney, St Vincent's Hospital Melbourne, Australian Catholic University, De Lacy Building, 390 Victoria Street, Darlinghurst, NSW, 2010, Australia.
Sandy Middleton *Nursing Research Institute, St Vincent's Health Network Sydney, St Vincent's Hospital Melbourne, Australian Catholic University, De Lacy Building, 390 Victoria Street, Darlinghurst, NSW, 2010, Australia. sandy.middleton@acu.edu.au.
ACCELERATE Plus Project Team
St Vincent's Hospital Melbourne · AUUniversity of Wollongong · AUSt Vincent's Health · AULismore Base Hospital · AULiverpool Hospital · AUNorthern Sydney Local Health District · AUSutherland Hospital · AUAustralian National University · AUFairfield Hospital · AUThe University of Sydney · AUPrince of Wales Hospital · AURoyal Prince Alfred Hospital · AUSt George Hospital · AUSydney Local Health District · AU

Funding

Maridulu Budyari Gumal Sydney Partnership for Health, Education, Research and Enterprise (SPHERE) Big Ideas GrantNational Health and Medical Research Council Investigator Leadership Grant 1196352
6 · The paper itself

Abstract

backgroundNurses play an essential role in patient safety. Inadequate nursing physical assessment and communication in handover practices are associated with increased patient deterioration, falls and pressure injuries. Despite internationally implemented rapid response systems, falls and pressure injury reduction strategies, and recommendations to conduct clinical handovers at patients' bedside, adverse events persist. This trial aims to evaluate the effectiveness, implementation, and cost-benefit of an externally facilitated, nurse-led intervention delivered at the ward level for core physical assessment, structured patient-centred bedside handover and improved multidisciplinary communication. We hypothesise the trial will reduce medical emergency team calls, unplanned intensive care unit admissions, falls and pressure injuries.

methodsA stepped-wedge cluster randomised trial will be conducted over 52 weeks. The intervention consists of a nursing core physical assessment, structured patient-centred bedside handover and improved multidisciplinary communication and will be implemented in 24 wards across eight hospitals. The intervention will use theoretically informed implementation strategies for changing clinician behaviour, consisting of: nursing executive site engagement; a train-the-trainer model for cascading facilitation; embedded site leads; nursing unit manager leadership training; nursing and medical ward-level clinical champions; ward nurses' education workshops; intervention tailoring; and reminders. The primary outcome will be a composite measure of medical emergency team calls (rapid response calls and 'Code Blue' calls), unplanned intensive care unit admissions, in-hospital falls and hospital-acquired pressure injuries; these measures individually will also form secondary outcomes. Other secondary outcomes are: i) patient-reported experience measures of receiving safe and patient-centred care, ii) nurses' perceptions of barriers to physical assessment, readiness to change, and staff engagement, and iii) nurses' and medical officers' perceptions of safety culture and interprofessional collaboration. Primary outcome data will be collected for the trial duration, and secondary outcome surveys will be collected prior to each step and at trial conclusion. A cost-benefit analysis and post-trial process evaluation will also be undertaken. DISCUSSION: If effective, this intervention has the potential to improve nursing care, reduce patient harm and improve patient outcomes. The evidence-based implementation strategy has been designed to be embedded within existing hospital workforces; if cost-effective, it will be readily translatable to other hospitals nationally.

trial registrationAustralian New Zealand Clinical Trials Registry ID: ACTRN12622000155796. Date registered: 31/01/2022.

Indexed as

Clinical handoverCost–benefit analysisEvidence-based nursingImplementation scienceLearning health system.Multidisciplinary handover communicationNursing assessmentPatient safetyProcess evaluationRandomised controlled trial

Identifiers

PMID37605224
PMCPMC10440862
OpenAlexW4386028294

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.