Methods and processes to develop and deliver a theory-informed education program for sustained behaviour change in...

Area of Science:

• Nursing Education
• Healthcare Quality Improvement
• Behavioral Science in Healthcare

Background:

• HIRAID® (History including Infection risk, Red flags, Assessment, Interventions, Diagnostics, communication and reassessment) is an evidence-based framework designed to enhance safety, quality, and patient experience in emergency care.
• The framework was implemented in a modified stepped-wedge cluster randomized controlled trial across 29 Australian emergency departments.

Purpose of the Study:

• To describe the development and delivery of a theory-informed education program aimed at facilitating behavior change for HIRAID® implementation.
• To outline the methodological and process-related aspects of creating and disseminating the educational intervention.

Main Methods:

• The program's development integrated existing HIRAID® research, the Behaviour Change Wheel, and the Theoretical Domains Framework to identify implementation barriers and enablers.
• Educational theories including constructive alignment, backwards design, scaffolded learning, Bloom's taxonomy, and active/collaborative learning were applied.
• Australian standards for safety, quality, clinical governance, and emergency nursing, alongside behavioral diagnostic data from 670 nurses, informed the program's design.

Main Results:

• The HIRAID® education program comprised Provider and Instructor Courses, delivered via a 'train-the-trainer' model.
• Fifteen Instructor Courses trained 162 participants between February 2021 and March 2023.
• By November 2023, over 1300 emergency nurses had completed the HIRAID® Provider Course.

Conclusions:

• A theory-informed educational strategy enabled the creation of a structured program suitable for the complex emergency department environment.
• This approach offers a replicable blueprint for researchers seeking to drive behavior change in challenging clinical settings.