Effective communication network structures for hospital infection prevention: a study protocol

Area of Science:

• Healthcare Management
• Organizational Behavior
• Infection Prevention

Background:

• Hospitals struggle to implement evidence-based practices (EBPs) at the unit level, leading to
• change implementation failure.
• Consistent adoption of the central line bundle (CLB) to prevent catheter-related bloodstream infections (CRBSIs) is a common challenge.

Purpose of the Study:

• To prospectively examine the associations between quality improvement (QI) interventions and communication dynamics.
• To investigate the relationship between unit-level communication structure/content and CLB adherence/CRBSI rates.

Main Methods:

• A 52-week prospective study in two intensive care units with low CLB compliance and high CRBSIs.
• Weekly "communication logs" from nurses, physicians, and managers to assess communication structure and content.
• Weekly chart reviews for CLB adherence, catheter utilization, and CRBSI rates.

Main Results:

• QI interventions are expected to positively influence communication patterns.
• Improved communication is anticipated to correlate with increased CLB adherence and reduced CRBSIs.
• The study aims to provide insights into communication's role in collective learning and culture change.

Conclusions:

• Successful EBP implementation hinges on understanding and optimizing unit-level communication.
• Findings may inform context-sensitive "evidence-based management" strategies.
• An "action-learning framework" for healthcare practice change is a potential deliverable.