Implementation Science: How to Jump-Start Infection Prevention

Implementing evidence-based infection prevention practices is challenging. Implementation science, which is the study of methods promoting the uptake of evidence into practice, addresses the gap between theory and practice. Just as healthcare epidemiology has emerged as a paradigm for patient safety, infection prevention may serve as a clinical model for implementation researchers.

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Committing to an Infection Prevention Initiative

Preventing Hospital Infections ◽

10.1093/med/9780197509159.003.0002 ◽

2021 ◽

pp. 10-23

Author(s):

Jennifer Meddings ◽

Vineet Chopra ◽

Sanjay Saint

Keyword(s):

Urinary Tract Infection ◽

Patient Safety ◽

Infection Prevention ◽

Team Building ◽

Evidence Based ◽

Urinary Catheters ◽

Quality Initiatives ◽

Long Run ◽

Building Process ◽

Time And Energy

What motivates a hospital administration to take on an infection prevention initiative? It may simply reflect a hospital’s culture of excellence, a commitment to patient safety, though that may be combined with a determination to keep up with competing institutions or to avoid federal financial penalties. Quality initiatives can drain staff time and energy but save substantial dollars in the long run. Once the decision to proceed with the catheter-associated urinary tract infection initiative is made, hospital leaders start a team-building process, choosing an executive sponsor with experience on the wards, the project’s main venue. The sponsor in turn selects a project manager, who will find physician and nurse champions to carry the goals and content of the initiative to the staff. The initiative calls for the adoption of a bundle of evidence-based behaviors—in this case, to reduce the unnecessary use of indwelling urinary catheters known as Foleys.

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EFFECT OF PERCEPTION, ATTITUDE, PATIENT SAFETY POLICY, STAKEHOLDER SUPPORT, AND HEALTH PROMOTION, ON INFECTION PREVENTION

ACCELERATING THE ACHIEVEMENT OF SUSTAINABLE DEVELOPMENT GOALS FOR THE IMPROVEMENT AND EQUITABLE DISTRIBUTION OF POPULATION HEALTH ◽

10.26911/theicph.2016.034 ◽

2016 ◽

Author(s):

Triani Marwati ◽

◽

AA Subiyanto ◽

Totok Mardikanto ◽

Priyambodo J ◽

...

Keyword(s):

Health Promotion ◽

Patient Safety ◽

Infection Prevention ◽

Safety Policy ◽

Stakeholder Support

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Faculty Opinions recommendation of The influence of organizational context on quality improvement and patient safety efforts in infection prevention: a multi-center qualitative study.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.6253956.6325054 ◽

2010 ◽

Author(s):

Jeffrey Braithwaite ◽

Peter Nugus

Keyword(s):

Patient Safety ◽

Quality Improvement ◽

Qualitative Study ◽

Infection Prevention ◽

Organizational Context

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Best Practices for Data Visualization: Creating and Evaluating a Report for an Evidence-Based Fall Prevention Program (Preprint)

10.2196/preprints.12801 ◽

2018 ◽

Author(s):

Srijesa Khasnabish ◽

Zoe Burns ◽

Madeline Couch ◽

Mary Mullin ◽

Randall Newmark ◽

...

Keyword(s):

Literature Review ◽

Best Practices ◽

Implementation Science ◽

Data Visualization ◽

Systematic Literature Review ◽

Fall Prevention ◽

Prevention Program ◽

Evidence Based ◽

Data Display ◽

Fall Prevention Program

BACKGROUND Data visualization experts have identified core principles to follow when creating visual displays of data that facilitate comprehension. Such principles can be applied to creating effective reports for clinicians that display compliance with quality improvement protocols. A basic tenet of implementation science is continuous monitoring and feedback. Applying best practices for data visualization to reports for clinicians can catalyze implementation and sustainment of new protocols. OBJECTIVE To apply best practices for data visualization to create reports that clinicians find clear and useful. METHODS First, we conducted a systematic literature review to identify best practices for data visualization. We applied these findings and feedback collected via a questionnaire to improve the Fall TIPS Monthly Report (FTMR), which shows compliance with an evidence-based fall prevention program, Fall TIPS (Tailoring Interventions for Patient Safety). This questionnaire was based on the requirements for effective data display suggested by expert Stephen Few. We then evaluated usability of the FTMR using a 15-item Health Information Technology Usability Evaluation Scale (Health-ITUES). Items were rated on a 5-point Likert scale from strongly disagree (1) to strongly agree (5). RESULTS The results of the systematic literature review emphasized that the ideal data display maximizes the information communicated while minimizing the cognitive efforts involved with data interpretation. Factors to consider include selecting the correct type of display (e.g. line vs bar graph) and creating simplistic reports. The qualitative and quantitative evaluations of the original and final FTMR revealed improved perceptions of the visual display of the reports and their usability. Themes that emerged from the staff interviews emphasized the value of simplified reports, meaningful data, and usefulness to clinicians. The mean (SD) rating on the Health-ITUES scale when evaluating the original FTMR was 3.86 (0.19) and increased to 4.29 (0.11) when evaluating the revised FTMR (Mann Whitney U Test, z=-12.25, P<0.001). CONCLUSIONS Best practices identified through a systematic review can be applied to create effective reports for clinician use. The lessons learned from evaluating FTMR perceptions and measuring usability can be applied to creating effective reports for clinician use in the context of other implementation science projects.

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Implementation Strategies

10.1093/oso/9780190683214.003.0015 ◽

2017 ◽

Cited By ~ 5

Author(s):

JoAnn E. Kirchner ◽

Thomas J. Waltz ◽

Byron J. Powell ◽

Jeffrey L. Smith ◽

Enola K. Proctor

Keyword(s):

Implementation Science ◽

Comparative Effectiveness ◽

Implementation Strategies ◽

Evidence Based ◽

Efficient Manner

As the field of implementation science moves beyond studying barriers to and facilitators of implementation to the comparative effectiveness of different strategies, it is essential that we create a common taxonomy to define the strategies that we study. Similarly, we must clearly document the implementation strategies that are applied, the factors that influence their selection, and any adaptation of the strategy during the course of implementation and sustainment of the innovation being implemented. By incorporating this type of rigor into our work we will be able to not only advance the science of implementation but also our ability to place evidence-based innovations into the hands of practitioners in a timely and efficient manner.

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Interfacility transfer communication of multidrug-resistant organism colonization or infection status: Practices and barriers in the acute-care setting

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2021.131 ◽

2021 ◽

pp. 1-6

Author(s):

Katherine D. Ellingson ◽

Brie N. Noble ◽

Genevieve L. Buser ◽

Graham M. Snyder ◽

Jessina C. McGregor ◽

...

Keyword(s):

Acute Care ◽

Infection Prevention ◽

Multidrug Resistant ◽

Research Network ◽

Resistant Organism ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Hospital Size ◽

Academic Affiliation ◽

Healthcare Epidemiology

Abstract Objective: To describe interfacility transfer communication (IFTC) methods for notification of multidrug-resistant organism (MDRO) status in a diverse sample of acute-care hospitals. Design: Cross-sectional survey. Participants: Hospitals within the Society for Healthcare Epidemiology of America (SHEA) Research Network (SRN). Methods: SRN members completed an electronic survey on protocols and methods for IFTC. We assessed differences in IFTC frequency, barriers, and perceived benefit by presence of an IFTC protocol. Results: Among 136 hospital representatives who were sent the survey, 54 (40%) responded, of whom 72% reported having an IFTC protocol in place. The presence of a protocol did not differ significantly by hospital size, academic affiliation, or international status. Of those with IFTC protocols, 44% reported consistent notification of MDRO status (>75% of the time) to receiving facilities, as opposed to 13% from those with no IFTC protocol (P = .04). Respondents from hospitals with IFTC protocols reported significantly fewer barriers to communication compared to those without (2.8 vs 4.3; P = .03). Overall, however, most respondents (56%) reported a lack of standardization in communication. Presence of an IFTC protocol did not affect whether respondents perceived IFTC protocols as having a significant impact on infection prevention or antimicrobial stewardship. Conclusions: Most respondents reported having an IFTC protocol, which was associated with reduced communication barriers at transfer. Standardization of protocols and clarity about expectations for sending and receipt of information related to MDRO status may facilitate IFTC and promote appropriate and timely infection prevention practices.

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