Successful and sustained implementation of a behaviour-change informed strategy for emergency nurses: a multicentre implementation evaluation
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View abstract on PubMed
Summary
This summary is machine-generated.A behavior-change strategy successfully implemented the HIRAID® nursing framework across Australian emergency departments. This approach improved care quality and safety, demonstrating high adoption and sustainability.
Area Of Science
- Nursing Practice
- Healthcare Implementation Science
- Quality Improvement
Background
- Implementing evidence-based practice in emergency departments (EDs) faces significant barriers like uncertainty, resource shortages, and high staff turnover.
- A behavior-change informed strategy was developed to overcome these challenges for implementing the HIRAID® (History, Infection risk, Red flags, Assessment, Interventions, Diagnostics, communication, reassessment) nursing framework.
Purpose Of The Study
- To evaluate the effectiveness of a behavior-change strategy in implementing the HIRAID® framework.
- Assess the strategy's impact on reach, effectiveness, adoption, quality (dose, fidelity), and maintenance (sustainability) in Australian EDs.
Main Methods
- An effectiveness-implementation hybrid design utilizing a step-wedge cluster randomized control trial (SW-cRCT).
- Implementation involved over 1300 emergency nurses across 29 Australian EDs.
- Evaluation used the RE-AIM framework, incorporating surveys, audits, and qualitative analysis.
Main Results
- HIRAID® was implemented in all 29 EDs, with 1123 nurses (82%) completing training.
- The strategy showed high fidelity (100% dose, very high fidelity) and minimal modifications.
- Sustainment was high, with 95% individual and 100% setting sustainability at 6 months and 3 years, respectively.
Conclusions
- The behavior-change informed strategy for HIRAID® implementation was highly successful across diverse Australian ED settings.
- Achieved excellent reach, adoption, quality, and sustainability, demonstrating its effectiveness in reducing clinical variation and enhancing nursing care.
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