About: Implementation and evaluation of a care bundle for prevention of non-ventilator-associated hospital-acquired pneumonia (nvHAP) – a mixed-methods study protocol for a hybrid type 2 effectiveness-implementation trial

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About: Implementation and evaluation of a care bundle for prevention of non-ventilator-associated hospital-acquired pneumonia (nvHAP) – a mixed-methods study protocol for a hybrid type 2 effectiveness-implementation trial Goto Sponge NotDistinct Permalink

An Entity of Type : schema:ScholarlyArticle, within Data Space : wasabi.inria.fr associated with source document(s)

Attributes	Values
type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
title	Implementation and evaluation of a care bundle for prevention of non-ventilator-associated hospital-acquired pneumonia (nvHAP) – a mixed-methods study protocol for a hybrid type 2 effectiveness-implementation trial
Creator	Sax, Hugo Kouyos, Roger Clack, Lauren Held, Leonhard Jakob, Werner Kusejko, Katharina Meier, Marie-Theres Saleschus, Dirk Wolfensberger, Aline Faes Hesse, Mirjam Stefanie, Felten
source	Medline; PMC
abstract	BACKGROUND: Hospital acquired pneumonia (HAP) is divided in two distinct groups, ventilator-associated pneumonia (VAP) and non-ventilator-associated HAP (nvHAP). Although nvHAP occurs more frequently than VAP and results in similar mortality and costs, prevention guidelines and prevention focus almost exclusively on VAP. Scientific evidence about nvHAP prevention and its implementation is scarce. Therefore, we designed a mixed-methods hybrid type 2 effectiveness-implementation study to investigate both the effectiveness and implementation of a newly developed nvHAP prevention bundle. METHODS: This single-centre project at the 950-bed University Hospital Zurich (UHZ) will engage the wards of nine departments with substantial nvHAP rates. The nvHAP bundle consists of five primary prevention measures: 1) oral care, 2) prevention of dysphagia-related aspiration, 3) mobilization, 4) stopping unnecessary proton pump inhibitors, and, 5) respiratory therapy. Implementation includes the engagement of department-level implementation teams, who sustain the ‘core’ intervention components of education, training, and environmental restructuring and tailor the implementation strategy to local needs. Both effectiveness and implementation outcomes will be assessed using mixed-methods. As a primary outcome, nvHAP incidence rates will be analysed by Poisson regression models to compare incidence rates before, during, and after the implementation phases (on the hospital and department level). Additionally, the association between process indicators and nvHAP incidence rates will be analysed using longitudinal Poisson regression models. A longitudinal, qualitative study and formative evaluation based on interviews, focus groups, and observations identifies supporting or hindering factors for implementation success in participating departments dynamically over time. This accumulating implementation experience will be constantly fed back to the implementation teams and thus, represents an active implementation element. DISCUSSION: This comprehensive hybrid mixed-methods study is designed to both, measure the effectiveness of a new nvHAP prevention bundle and multifaceted implementation strategy, while also providing insights into how and why it worked or failed. The results of this study may contribute substantially to advancing knowledge and patient safety in the area of a rediscovered healthcare-associated infection - nvHAP. TRIAL REGISTRATION: ClinicalTrials.gov: NCT03361085. Registered December 2017.
has issue date	2020-08-17(xsd:dateTime)
bibo:doi	10.1186/s12879-020-05271-5
bibo:pmid	32807090
has license	cc-by
sha1sum (hex)	7dbc5f009715a3015291dc4ed874b2c2eb39dd8d
schema:url	https://doi.org/10.1186/s12879-020-05271-5
resource representing a document's title	Implementation and evaluation of a care bundle for prevention of non-ventilator-associated hospital-acquired pneumonia (nvHAP) – a mixed-methods study protocol for a hybrid type 2 effectiveness-implementation trial
has PubMed Central identifier	PMC7429945
has PubMed identifier	32807090
schema:publication	BMC Infect Dis
resource representing a document's body	covid:7dbc5f009715a3015291dc4ed874b2c2eb39dd8d#body_text
is schema:about of	named entity 'Therefore' named entity 'hospital-acquired pneumonia' named entity 'VENTILATOR' named entity 'TYPE 2' named entity 'HAP' named entity 'groups' named entity 'hybrid' named entity 'prevention' named entity 'hybrid' named entity 'ventilator-associated' named entity 'pneumonia' named entity 'HAP' named entity 'HAP' named entity 'VAP' named entity 'focus group' named entity 'Switzerland' named entity 'behaviour change' named entity 'HAP' named entity 'point prevalence' named entity 'pneumonia' named entity 'pneumonia' named entity 'pharmacological' named entity 'ECDC' named entity 'EMR' named entity 'VAP' named entity 'behaviour change' named entity 'GEE' named entity 'empathic' named entity 'HAI' named entity 'pneumonia' named entity 'University Hospital Zurich' named entity 'leading indicators' named entity 'breathing exercises' named entity 'ventilator-associated' named entity 'qualitative data' named entity 'incidence rate' named entity 'qualitative data' named entity 'fever' named entity 'implementation plans' named entity 'Action Plan' named entity 'infection prevention' named entity 'cardiac surgical' named entity 'incidence rate' named entity 'mortality rate' named entity 'pneumonia' named entity 'over-dispersion' named entity 'University Hospital Zurich' named entity 'non-documented' named entity 'medical specialties' named entity 'Kazaure' named entity 'orthopaedics' named entity 'Oral care' named entity 'pneumonia' named entity 'conceptual model' named entity 'HAI' named entity 'point prevalence' named entity 'pneumonia' named entity 'surgical specialties' named entity 'ECDC' named entity 'Action Plan' named entity 'VAP' named entity 'qualitative data' named entity 'incidence rate' named entity 'sample size' named entity '1, 2' named entity 'VAP' named entity 'action-plan' named entity 'Poisson regression' named entity 'pneumonia' named entity 'qualitative data' named entity 'pneumonia'

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