Determinants of action in the implementation of infection prevention and control: a European in-depth comparative study
| ISRCTN | ISRCTN17561963 |
|---|---|
| DOI | https://doi.org/10.1186/ISRCTN17561963 |
| IRAS number | 290543 |
| Secondary identifying numbers | IRAS 290543, HRA Protocol number 22IC8060 |
- Submission date
- 05/04/2023
- Registration date
- 12/04/2023
- Last edited
- 12/04/2023
- Recruitment status
- No longer recruiting
- Overall study status
- Completed
- Condition category
- Other
Plain English summary of protocol
Background and study aims
Hospital-acquired infections are infections acquired by patients admitted to the hospital for other reasons. These infections can severely complicate the patient journey because they are associated with prolonged hospital stays and increased morbidity and mortality. The emergence of antimicrobial resistance further adds to the problem, because many of these infections are caused by bacteria resistant to most frequently used antibiotics.
Infection prevention and control best practices (hand hygiene, surgical antibiotic prophylaxis, urinary catheter care bundles, etc.) prevent the majority of hospital-acquired infections. There are many evidence-based guidelines on this matter, but their effective implementation is difficult to achieve. This is a problem across all hospitals around the world.
Little is known about the impact of contextual factors (such as social-cultural elements, policies, regulations, etc.) in healthcare organizations and how these influence the uptake of Infection prevention and control practices by healthcare workers.
In this study, we aim to investigate what are the determinants of healthcare workers’ behaviour towards Infection prevention and control implementation, how these relate to the contextual elements and how these differ from hospital to hospital.
Who can participate?
Infection prevention and control practitioners, physicians, nurses, pharmacists and managers involved in the development and implementation of Infection Prevention and Control and Antimicrobial Stewardship directly or indirectly as well as frontline healthcare professionals from different hierarchy levels and key departments in the hospital.
What does the study involve?
We will perform face-to-face interviews, focus groups, questionnaires and co-participatory workshops with healthcare workers. We will also perform direct, non-participatory observations of healthcare workers’ routine clinical practices and infection control rounds. We will conduct this study in five hospitals across four countries in Europe (Norway, Portugal, Switzerland, United Kingdom).
What are the possible benefits and risks of participating?
We believe that the information obtained with this study could ultimately help to inform the future development of implementation strategies in infection prevention and control and thus improve the safety of patients. We do not expect that healthcare workers will face any kind of risk or burden from participating in the research. All information collected will be anonymised or pseudonymised.
Where is the study run from?
Imperial College London (UK)
When is the study starting and how long is it expected to run for?
March 2022 to December 2023
Who is funding the study?
The Swiss National Science Foundation and the National Institute of Health and Care Research, Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Imperial College London (UK).
Who is the main contact?
Daniela Pires (d.pires@imperial.ac.uk)
Contact information
Scientific
The NIHR Health Protection Research Unit
In Healthcare Associated Infections and Antimicrobial Resistance
at Imperial College London
Hammersmith Campus
Commonwealth Building
Du Cane Road
7 floor
London
W12 0NN
United Kingdom
| Phone | +44 78 58 359 724 |
|---|---|
| d.pires@imperial.ac.uk |
Study information
| Study design | One-year in-depth multicentre qualitative study in 5 acute care hospitals in 4 European countries (Portugal, Switzerland, United Kingdom and Norway). |
|---|---|
| Primary study design | Observational |
| Secondary study design | Qualitative study |
| Study setting(s) | Hospital |
| Study type | Other |
| Participant information sheet | Not available in web format, please use contact details to request a participant information sheet. |
| Scientific title | Socio-cultural, “macro” interventions and organisational variables as determinants of action in the implementation of infection prevention and control: a European in-depth comparative study |
| Study objectives | Key health care workers' (HCWs) actions and their capacity to successfully implement infection prevention and control (IPC) practices are shaped by local organizational variables, national/regional “macro” influences (regulative, professional and policy elements) and the wider socio-cultural context. The relative importance of these contextual determinants differs according to country, hospital and HCW category. |
| Ethics approval(s) | Approved 22/03/2022, Health Research Authority and Health and Care Research Wales (Health Research Authority, Skipton House, 80 London Road, London, SE1 6LH, UK; +44 (0)20 7972 2545; approvals@hra.nhs.uk); ref: 23/HRA/0669 |
| Health condition(s) or problem(s) studied | Determinants of healthcare workers' actions in the implementation of Infection prevention in control best practices in acute care hospitals . |
| Intervention | Healthcare workers will be invited to take part in: 1. Interviews or focus groups 2. Ethnographic observations 3. Co-participatory workshops and 4. A short questionnaire. These activities will be conducted on-site in each hospital setting for the duration of the study. |
| Intervention type | Other |
| Primary outcome measure | This is a qualitative study. The expected main outcomes of this study are: 1. To comprehensively describe the health system in each country as well as the infection prevention and control (IPC) and antimicrobial resistance (AMR) national programmes, its implementation status and its main indicators. For this, the study will analyse publicly available documents regarding the state of the healthcare system in each country and of the policies and indicators regarding Infection prevention and control and Antimicrobial resistance. Validated hospital-level surveys will be performed at the participating sites (WHO hospital-level validated tools on the implementation of Infection prevention and control, hand hygiene and 2014 CDC key components of Stewardship). 2. To map health care workers (HCWs) actions towards IPC and AMR and their determinants based on the relevant Consolidated Framework for Advancing Implementation Science (CFIR) dimension, the Systems Engineering Initiative for Patient Safety (SEIPS) model and informed by the New Institutional theory by using qualitative interviews, focus groups and co-participatory workshops. We will also perform individual questionnaires on safety culture. 3. To achieve a consensus on the ranking of determinants of HCWs' actions as well as potential actions to be taken to improve the implementation of IPC practices by means of co-participatory workshops. |
| Secondary outcome measures | Other relevant outcome is to highlight the differences and similarities between organizational life aspects as well as the broader national context amongst the case studies. |
| Overall study start date | 22/03/2022 |
| Completion date | 31/12/2023 |
Eligibility
| Participant type(s) | Health professional |
|---|---|
| Age group | Adult |
| Sex | Both |
| Target number of participants | 75 |
| Key inclusion criteria | Infection prevention and control practitioners, physicians, nurses, pharmacists and managers involved in development and implementation of Infection prevention and Control and Antimicrobial Stewardship directly or indirectly as well as frontline healthcare professionals from different hierarchy levels and key departments in the hospital will be included in this study. |
| Key exclusion criteria | Does not meet inclusion criteria |
| Date of first enrolment | 12/04/2023 |
| Date of final enrolment | 30/09/2023 |
Locations
Countries of recruitment
- England
- Norway
- Portugal
- Switzerland
- United Kingdom
Study participating centres
The Commonwealth Building
Du Cane Road
London
W12 0NN
United Kingdom
Zurich
8091
Switzerland
Medical School Teaching Building
University of Sussex
Brighton
BN1 9PX
United Kingdom
Westminster Bridge Rd
London
SE1 7EH
United Kingdom
Lisbon
1500-650
Portugal
Tromsø
9019
Norway
Sponsor information
University/education
Research Governance and Integrity Team
Academic Health Science Centre
Imperial College London and Imperial College Healthcare NHS Trust
Room 215, Medical School Building
St Mary’s Hospital
Pread Street
London
W2 1NY
England
United Kingdom
| Phone | +44 (0)20 759 49459 |
|---|---|
| Thomas.lewis@imperial.ac.uk | |
| Website | http://www.imperial.ac.uk/ |
"ROR" |
https://ror.org/041kmwe10 |
Funders
Funder type
Government
Private sector organisation / Trusts, charities, foundations (both public and private)
- Alternative name(s)
- Schweizerischer Nationalfonds, Swiss National Science Foundation, Fonds National Suisse de la Recherche Scientifique, Fondo Nazionale Svizzero per la Ricerca Scientifica, Fonds National Suisse, Fondo Nazionale Svizzero, Schweizerische Nationalfonds, SNF, SNSF, FNS
- Location
- Switzerland
No information available
Results and Publications
| Intention to publish date | 01/06/2024 |
|---|---|
| Individual participant data (IPD) Intention to share | No |
| IPD sharing plan summary | Data sharing statement to be made available at a later date |
| Publication and dissemination plan | Planned publication in a high-impact peer-reviewed journal. |
| IPD sharing plan | The data-sharing plans for the current study are unknown and will be made available at a later date. |
Editorial Notes
12/04/2023: Trial's existence confirmed by Health Research Authority and Health and Care Research Wales (UK).
