Improving uptake of new cleaning practices using implementation science

Michelle Allen 1,2, Kate Halton 1,2, Lisa Hall 1,2, Nicholas Graves 1,2,3

Queensland University Of Technology, Kelvin Grove, QLD, Australia

Centre for Research Excellence in Reducing Healthcare Associated Infections, Kelvin Grove, QLD, Australia

Australian Centre for Health Services Innovation, Kelvin Grove, QLD, Australia

 

Introduction
Translation of evidence into practice can be challenging. The PITCH study combined an environmental cleaning bundle with an implementation science framework called the Promoting Action on Research Implementation in Health Services (PARIHS) framework to maximize uptake of new practices. The PARIHS framework suggests that successful implementation is a product of the evidence and perceived value of the change, the local context and culture in which the change takes place, and the process by which the change is facilitated.

Methods
The bundle was implemented in a before and after study into a 400 bed metropolitan hospital for 6months. The PARIHS framework was used in a prospectively to assess the evidence and include local knowledge into the development of the bundle. Context mapping then assessed the hospital’s systems, culture, and barriers and enablers for environmental services staff. Information gained in these steps was synthesized to develop targeted training and project resources, and local implementation plan.

Results
Results demonstrated significant improvements to both the knowledge around cleaning practices and overall job satisfaction. Further, this led to significant improvements in cleaning performance, from 61% to 95% clean across the eight research wards. The PARIHS framework provided an easy to use, comprehensive process to support implementation of the bundle which led to strong practice change.

Conclusion
By combining infection prevention and implementation science, this evidence based environmental cleaning bundle improved patient care and will ultimately reduce the risk of HAIs.

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