Evaluating remote facilitation intensity for multi-national translation of nurse-initiated stroke protocols (QASC Australasia): a protocol for a cluster randomised controlled trial
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| Název: | Evaluating remote facilitation intensity for multi-national translation of nurse-initiated stroke protocols (QASC Australasia): a protocol for a cluster randomised controlled trial |
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| Autoři: | O. Fasugba, S. Dale, E. McInnes, D. A. Cadilhac, M. Noetel, K. Coughlan, B. McElduff, J. Kim, T. Langley, N. W. Cheung, K. Hill, V. Pollnow, K. Page, E. Sanjuan Menendez, E. Neal, S. Griffith, L. J. Christie, J. Slark, A. Ranta, C. Levi, J. M. Grimshaw, S. Middleton |
| Přispěvatelé: | Institut Català de la Salut, [Fasugba O, Dale S, McInnes E, Coughlan K] Nursing Research Institute, St Vincent’s Health Network Sydney & St Vincent’s Hospital Melbourne & Australian Catholic University, Darlinghurst, Australia. School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Sydney, Australia. [Cadilhac DA] Stroke and Ageing Research, Department of Medicine, School of Clinical Sciences at Monash Health, Monash University, Melbourne, Victoria, Australia. [Noetel M] School of Psychology, University of Queensland, Brisbane, Australia. [Sanjuan Menendez E] Vall d’Hebron Hospital Universitari, Barcelona, Spain, Vall d'Hebron Barcelona Hospital Campus |
| Zdroj: | Implement Sci Scientia Scientia. Dipòsit d'Informació Digital del Departament de Salut instname Implementation Science, Vol 18, Iss 1, Pp 1-18 (2023) |
| Informace o vydavateli: | Springer Science and Business Media LLC, 2023. |
| Rok vydání: | 2023 |
| Témata: | Medicine (General), economic evaluation, Fever, DENOMINACIONES DE GRUPOS::personas::grupos profesionales::personal sanitario::enfermeros, Process evaluation, facilitation, DENOMINACIONES GEOGRÁFICAS::localizaciones geográficas::Oceanía::Australasia, TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::terapéutica::paquetes de medidas asistenciales, Malalties cerebrovasculars - Tractament - Austràlia, Study Protocol, 03 medical and health sciences, R5-920, ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Therapeutics::Patient Care Bundles, 0302 clinical medicine, ENFERMEDADES::enfermedades cardiovasculares::enfermedades vasculares::trastornos cerebrovasculares::accidente cerebrovascular, DISEASES::Cardiovascular Diseases::Vascular Diseases::Cerebrovascular Disorders::Stroke, Humans, implementation, Randomized Controlled Trials as Topic, Australasia, Australia, Remote, stroke, remote, process evaluation, NAMED GROUPS::Persons::Occupational Groups::Health Personnel::Nurses, 3. Good health, ATENCIÓN DE SALUD::calidad, acceso y evaluación de la atención sanitaria::calidad de la atención sanitaria::mecanismos de evaluación de la atención sanitaria::características de los estudios epidemiológicos::protocolos clínicos, Stroke, GEOGRAPHICALS::Geographic Locations::Oceania::Australasia, Care bundle, Assistència sanitària - Control de qualitat, Implementation, Hyperglycemia, HEALTH CARE::Health Care Quality, Access, and Evaluation::Quality of Health Care::Health Care Evaluation Mechanisms::Epidemiologic Study Characteristics::Clinical Protocols, care bundle, Facilitation, Infermeres, Protocols clínics, Deglutition Disorders |
| Popis: | Background Facilitated implementation of nurse-initiated protocols to manage fever, hyperglycaemia (sugar) and swallowing difficulties (FeSS Protocols) in 19 Australian stroke units resulted in reduced death and dependency for stroke patients. However, a significant gap remains in translating this evidence-based care bundle protocol into standard practice in Australia and New Zealand. Facilitation is a key component for increasing implementation. However, its contribution to evidence translation initiatives requires further investigation. We aim to evaluate two levels of intensity of external remote facilitation as part of a multifaceted intervention to improve FeSS Protocol uptake and quality of care for patients with stroke in Australian and New Zealand acute care hospitals. Methods A three-arm cluster randomised controlled trial with a process evaluation and economic evaluation. Australian and New Zealand hospitals with a stroke unit or service will be recruited and randomised in blocks of five to one of the three study arms—high- or low-intensity external remote facilitation or a no facilitation control group—in a 2:2:1 ratio. The multicomponent implementation strategy will incorporate implementation science frameworks (Theoretical Domains Framework, Capability, Opportunity, Motivation – Behaviour Model and the Consolidated Framework for Implementation Research) and include an online education package, audit and feedback reports, local clinical champions, barrier and enabler assessments, action plans, reminders and external remote facilitation. The primary outcome is implementation effectiveness using a composite measure comprising six monitoring and treatment elements of the FeSS Protocols. Secondary outcome measures are as follows: composite outcome of adherence to each of the combined monitoring and treatment elements for (i) fever (n=5); (ii) hyperglycaemia (n=6); and (iii) swallowing protocols (n=7); adherence to the individual elements that make up each of these protocols; comparison for composite outcomes between (i) metropolitan and rural/remote hospitals; and (ii) stroke units and stroke services. A process evaluation will examine contextual factors influencing intervention uptake. An economic evaluation will describe cost differences relative to each intervention and study outcomes. Discussion We will generate new evidence on the most effective facilitation intensity to support implementation of nurse-initiated stroke protocols nationwide, reducing geographical barriers for those in rural and remote areas. Trial registration ACTRN12622000028707. Registered 14 January, 2022. |
| Druh dokumentu: | Article Other literature type |
| Popis souboru: | application/pdf |
| Jazyk: | English |
| ISSN: | 1748-5908 |
| DOI: | 10.1186/s13012-023-01260-9 |
| Přístupová URL adresa: | https://pubmed.ncbi.nlm.nih.gov/36703172 https://hdl.handle.net/11351/9090 https://doaj.org/article/4c622c9f6ce44b6ab1e89c90de39cd62 https://acuresearchbank.acu.edu.au/item/8zq78/evaluating-remote-facilitation-intensity-for-multi-national-translation-of-nurse-initiated-stroke-protocols-qasc-australasia-a-protocol-for-a-cluster-randomised-controlled-trial |
| Rights: | CC BY |
| Přístupové číslo: | edsair.doi.dedup.....074fbdf8084943971dbd77e1cb0f46b7 |
| Databáze: | OpenAIRE |
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Nájsť tento článok vo Web of Science | Abstrakt: | Background Facilitated implementation of nurse-initiated protocols to manage fever, hyperglycaemia (sugar) and swallowing difficulties (FeSS Protocols) in 19 Australian stroke units resulted in reduced death and dependency for stroke patients. However, a significant gap remains in translating this evidence-based care bundle protocol into standard practice in Australia and New Zealand. Facilitation is a key component for increasing implementation. However, its contribution to evidence translation initiatives requires further investigation. We aim to evaluate two levels of intensity of external remote facilitation as part of a multifaceted intervention to improve FeSS Protocol uptake and quality of care for patients with stroke in Australian and New Zealand acute care hospitals. Methods A three-arm cluster randomised controlled trial with a process evaluation and economic evaluation. Australian and New Zealand hospitals with a stroke unit or service will be recruited and randomised in blocks of five to one of the three study arms—high- or low-intensity external remote facilitation or a no facilitation control group—in a 2:2:1 ratio. The multicomponent implementation strategy will incorporate implementation science frameworks (Theoretical Domains Framework, Capability, Opportunity, Motivation – Behaviour Model and the Consolidated Framework for Implementation Research) and include an online education package, audit and feedback reports, local clinical champions, barrier and enabler assessments, action plans, reminders and external remote facilitation. The primary outcome is implementation effectiveness using a composite measure comprising six monitoring and treatment elements of the FeSS Protocols. Secondary outcome measures are as follows: composite outcome of adherence to each of the combined monitoring and treatment elements for (i) fever (n=5); (ii) hyperglycaemia (n=6); and (iii) swallowing protocols (n=7); adherence to the individual elements that make up each of these protocols; comparison for composite outcomes between (i) metropolitan and rural/remote hospitals; and (ii) stroke units and stroke services. A process evaluation will examine contextual factors influencing intervention uptake. An economic evaluation will describe cost differences relative to each intervention and study outcomes. Discussion We will generate new evidence on the most effective facilitation intensity to support implementation of nurse-initiated stroke protocols nationwide, reducing geographical barriers for those in rural and remote areas. Trial registration ACTRN12622000028707. Registered 14 January, 2022. |
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| ISSN: | 17485908 |
| DOI: | 10.1186/s13012-023-01260-9 |