Researching effective approaches to cleaning in hospitals: Protocol of the REACH study, a multi-site stepped-wedge randomised trial

Journal article


Hall, Lisa, Farrington, Alison, Mitchell, Brett Gerard, Barnett, Adrian G., Halton, Kate, Allen, Michelle, Page, Katie, Gardner, Anne, Havers, Sally, Bailey, Emily, Dancer, Stephanie J., Riley, Thomas V., Gericke, Christian A., Paterson, David L. and Graves, Nicholas. (2016). Researching effective approaches to cleaning in hospitals: Protocol of the REACH study, a multi-site stepped-wedge randomised trial. Implementation Science. 11(1), pp. 1 - 10. https://doi.org/10.1186/s13012-016-0406-6
AuthorsHall, Lisa, Farrington, Alison, Mitchell, Brett Gerard, Barnett, Adrian G., Halton, Kate, Allen, Michelle, Page, Katie, Gardner, Anne, Havers, Sally, Bailey, Emily, Dancer, Stephanie J., Riley, Thomas V., Gericke, Christian A., Paterson, David L. and Graves, Nicholas
Abstract

Background: The Researching Effective Approaches to Cleaning in Hospitals ( REACH ) study will generate evidence about the effectiveness and cost-effectiveness of a novel cleaning initiative that aims to improve the environmental cleanliness of hospitals. The initiative is an environmental cleaning bundle, with five interdependent, evidence-based components ( training, technique, product, audit and communication ) implemented with environmental services staff to enhance hospital cleaning practices. Methods/design: The REACH study will use a stepped-wedge randomised controlled design to test the study intervention, an environmental cleaning bundle, in 11 Australian hospitals. All trial hospitals will receive the intervention and act as their own control, with analysis undertaken of the change within each hospital based on data collected in the control and intervention periods. Each site will be randomised to one of the 11 intervention timings with staggered commencement dates in 2016 and an intervention period between 20 and 50 weeks. All sites complete the trial at the same time in 2017. The inclusion criteria allow for a purposive sample of both public and private hospitals that have higher-risk patient populations for healthcare-associated infections ( HAIs ). The primary outcome ( objective one ) is the monthly number of Staphylococcus aureus bacteraemias ( SABs ), Clostridium difficile infections ( CDIs ) and vancomycin resistant enterococci ( VRE ) infections, per 10,000 bed days. Secondary outcomes for objective one include the thoroughness of hospital cleaning assessed using fluorescent marker technology, the bio-burden of frequent touch surfaces post cleaning and changes in staff knowledge and attitudes about environmental cleaning. A cost-effectiveness analysis will determine the second key outcome ( objective two ): the incremental cost-effectiveness ratio from implementation of the cleaning bundle. The study uses the integrated Promoting Action on Research Implementation in Health Services ( iPARIHS ) framework to support the tailored implementation of the environmental cleaning bundle in each hospital. Discussion: Evidence from the REACH trial will contribute to future policy and practice guidelines about hospital environmental cleaning. It will be used by healthcare leaders and clinicians to inform decision-making and implementation of best-practice infection prevention strategies to reduce HAIs in hospitals. Trial registration: Australia New Zealand Clinical Trial Registry ACTRN12615000325505

Keywordshospital cleaning; cleaning bundle; cost-effectiveness; healthcare-associated; infection; iPARIHS
Year2016
JournalImplementation Science
Journal citation11 (1), pp. 1 - 10
PublisherBiomed Central Ltd
ISSN1748-5908
Digital Object Identifier (DOI)https://doi.org/10.1186/s13012-016-0406-6
Scopus EID2-s2.0-84961990763
Open accessOpen access
Page range1 - 10
Research GroupSchool of Nursing, Midwifery and Paramedicine
Publisher's version
Additional information

© 2016 Hall et al. Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

Place of publicationUnited Kingdom
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O'Connor, Lera, Gardner, Anne, Millar, Lynne and Bennett, Peter. (2009). Absolutely fabulous - but are we? Carers' perspectives on satisfaction with a palliative homecare service. Collegian. 16(4), pp. 201 - 209. https://doi.org/10.1016/j.colegn.2009.04.005
Implementing a journal club in a palliative care setting: A link in the chain of evidence-based practice
O'Connor, Lera, Bennett, Peter, Gardner, Anne, Hawkins, Mary and Wellman, David. (2009). Implementing a journal club in a palliative care setting: A link in the chain of evidence-based practice. Collegian. 16(3), pp. 147 - 152. https://doi.org/10.1016/j.colegn.2008.12.006
A literature review of central venous catheter dressings: Implications for haemodialysis in the tropics
McArdle, Joleen and Gardner, Anne. (2009). A literature review of central venous catheter dressings: Implications for haemodialysis in the tropics. Infection, Disease and Health. 14(4), pp. 139 - 146. https://doi.org/10.1071/HI09014
Excellence in regional stroke care: An evaluation of the implementation of a stroke care unit in regional Australia
McCann, Leanne, Groot, Patrick, Charnley, Chris and Gardner, Anne. (2009). Excellence in regional stroke care: An evaluation of the implementation of a stroke care unit in regional Australia. Australian Journal of Rural Health. 17(5), pp. 273 - 278. https://doi.org/10.1111/j.1440-1584.2009.01098.x
Writing ourselves into a web of obedience: A nursing policy analysis
Bail, Kasia, Cook, Robert, Gardner, Anne and Grealish, Laurie. (2009). Writing ourselves into a web of obedience: A nursing policy analysis. International Journal of Nursing Studies. 46(11), pp. 1457 - 1466. https://doi.org/10.1016/j.ijnurstu.2009.04.005
Potential scope and impact of a transboundary model of nurse practitioners in aged care
Bail, Kasia, Arbon, Paul, Eggert, Marlene, Gardner, Anne, Hogan, Sonia, Phillips, Christine, van Dieman, Nicole and Waddington, Gordon. (2009). Potential scope and impact of a transboundary model of nurse practitioners in aged care. Australian Journal of Primary Health. 15(3), pp. 232 - 237. https://doi.org/10.1071/PY09009
Patients' and nurses' perspectives on oxygen therapy: A qualitative study
Eastwood, Glenn, O'Connell, Beverley, Gardner, Anne and Considine, Julie. (2009). Patients' and nurses' perspectives on oxygen therapy: A qualitative study. Journal of Advanced Nursing. 65(3), pp. 634 - 641. https://doi.org/10.1111/j.1365-2648.2008.04933.x
Reporting a research project on the potential of aged care nurse practitioners in the Australian capital territory
Arbon, Paul, Bail, Kasia, Eggert, Marlene, Gardner, Anne, Hogan, Sonia, Phillips, Christine, van Dieman, Nicole and Waddington, Gordon. (2009). Reporting a research project on the potential of aged care nurse practitioners in the Australian capital territory. Journal of Clinical Nursing. 18(2), pp. 255 - 262. https://doi.org/10.1111/j.1365-2702.2008.02452.x
Selecting the right integration of research into practice strategy
Eastwood, Glenn, O'Connell, Beverley and Gardner, Anne. (2008). Selecting the right integration of research into practice strategy. Journal of Nursing Care Quality. 23(3), pp. 258 - 264. https://doi.org/10.1097/01.NCQ.0000324591.76590.e9
From competence to capability: A study of nurse practitioners in clinical practice
Gardner, Anne, Hase, Stewart, Gardner, Glenn, Dunn, Sandra and Carryer, Jenny. (2008). From competence to capability: A study of nurse practitioners in clinical practice. Journal of Clinical Nursing. 17(2), pp. 250 - 258. https://doi.org/10.1111/j.1365-2702.2006.01880.x
Evaluation of nasopharyngeal oxygen, nasal prongs and facemask oxygen therapy devices in adult patients: A randomised crossover trial
Eastwood, Glenn, O'Connell, Beverley, Gardner, Anne and Considine, Julie. (2008). Evaluation of nasopharyngeal oxygen, nasal prongs and facemask oxygen therapy devices in adult patients: A randomised crossover trial. Anaesthesia and Intensive Care. 36(5), pp. 691 - 694.
The core role of the nurse practitioner: practice, professionalism and clinical leadership
Carryer, Jenny, Gardner, Glenn, Dunn, Sandra and Gardner, Anne. (2007). The core role of the nurse practitioner: practice, professionalism and clinical leadership. Journal of Clinical Nursing. 16(10), pp. 1818 - 1825. https://doi.org/10.1111/j.1365-2702.2007.01823.x
Living with chronic illness
Gardner, Glenn and Gardner, Anne. (2007). Living with chronic illness. In In McAllister, Margaret (Ed.). Solution focused nursing : Rethinking practice pp. 143-153 Palgrave Macmillan.
Dealing with data: optimising data consistency to demonstrate the value of nurse practitioner service
Gardner, Anne, Millar, Lynne and Driscoll, Andrea. (2007). Dealing with data: optimising data consistency to demonstrate the value of nurse practitioner service. The Nurse Practitioner Series. 2(1), pp. 19 - 25.
Intravascular catheter bloodstream infections: An effective and sustained hospital-wide prevention program over 8 years
Collignon, Peter J., eimanis, Dianne E., Beckingham, Wendy D., Roberts, Jan L. and Gardner, Anne. (2007). Intravascular catheter bloodstream infections: An effective and sustained hospital-wide prevention program over 8 years. Medical Journal of Australia. 187(10), pp. 551 - 554.
The capability of nurse practitioners may be diminished by controlling protocols
Carryer, Jenny, Gardner, Glenn, Dunn, Sandra and Gardner, Anne. (2007). The capability of nurse practitioners may be diminished by controlling protocols. Australian Health Review. 31(1), pp. 108 - 115. https://doi.org/10.1071/AH070108
Clinical usefulness and feasibility of using Reality Orientation with patients who have dementia in acute care settings
O'Connell, Beverley, Gardner, Anne, Takase, Miyuki, Hawkins, Mary, Ostaszkiewicz, Joan, Ski, Chantal and Josipovic, Patricia. (2007). Clinical usefulness and feasibility of using Reality Orientation with patients who have dementia in acute care settings. International Journal of Nursing Practice. 13(3), pp. 182 - 192. https://doi.org/10.1111/j.1440-172X.2007.00624.x
Prevalence of genital human papillomavirus DNA in a sample of senior school-aged women in the Australian Capital Territory
O'Keefe, Elissa, Gardner, Anne, Currie, Marian, Garland, Suzanne, Tabrizi, Sepehr and Bowden, Francis. (2006). Prevalence of genital human papillomavirus DNA in a sample of senior school-aged women in the Australian Capital Territory. Sexual Health. 3(2), pp. 91 - 94. https://doi.org/10.1071/SH05047
Competency and capability: imperative for nurse practitioner education
Gardner, Glenn, Carryer, Jenny, Dunn, Sandra and Gardner, Anne. (2006). Competency and capability: imperative for nurse practitioner education. Australian Journal of Advanced Nursing. 24(1), pp. 8 - 14.
Using a monitored sip test to assess risk of aspiration in postoperative patients
Osborne, Sonya, Gardner, Glenn, Gardner, Anne, Franklin, Susan, Tuohy, Elizabeth and Fisher, Alex. (2006). Using a monitored sip test to assess risk of aspiration in postoperative patients. AORN Journal. 83(4), pp. 908 - 928. https://doi.org/10.1016/S0001-2092(06)60010-0
Sedation and analgesia management for mechanically ventilated adults: literature review, case study and recommendations for practice
Feeley, Kathy and Gardner, Anne. (2006). Sedation and analgesia management for mechanically ventilated adults: literature review, case study and recommendations for practice. Australian Critical Care. 19(2), pp. 73 - 77. https://doi.org/10.1016/S1036-7314(06)80012-3
How ophthalmic day surgery patients convalesce at home: an exploration of the salient issues
Ryan, Fiona, O'Connell, Beverley and Gardner, Anne. (2006). How ophthalmic day surgery patients convalesce at home: an exploration of the salient issues. Day Surgery Australia. 5(3), pp. 11 - 16.
Pressure injury: an exploration of the relationship between risk factors and interface pressure
Gardner, Anne, Dunk, Ann Marie, Eggert, Marlene, Gardner, Glenn and Wellman, David. (2006). Pressure injury: an exploration of the relationship between risk factors and interface pressure. Wound Practice & Research. 14(4), pp. 140 - 149.
Nurse Practitioner competency standards: Findings from collaborative Australian and New Zealand research
Gardner, Glenn, Carryer, Jenny, Gardner, Anne and Dunn, Sandra. (2006). Nurse Practitioner competency standards: Findings from collaborative Australian and New Zealand research. International Journal of Nursing Studies. 43(5), pp. 601 - 610. https://doi.org/10.1016/j.ijnurstu.2005.09.002
A trial of nurse practitioner scope of practice
Gardner, Anne and Gardner, Glenn. (2005). A trial of nurse practitioner scope of practice. Journal of Advanced Nursing. 49(2), pp. 135 - 145. https://doi.org/10.1111/j.1365-2648.2004.03273.x
Best practice in stabilisation of oral endotracheal tubes: a systematic review
Gardner, Anne, Hughes, Dot, Cook, Robert, Henson, Rachael, Osborne, Sonya and Gardner, Glenn. (2005). Best practice in stabilisation of oral endotracheal tubes: a systematic review. Australian Critical Care. 18(4), pp. 158 - 165. https://doi.org/10.1016/S1036-7314(05)80029-3
Parenting a preterm infant: Experiences in a regional neonatal health services programme
Rowe, Jennifer, Gardner, Glenn and Gardner, Anne. (2005). Parenting a preterm infant: Experiences in a regional neonatal health services programme. Neonatal, Paediatric and Child Health Nursing. 8(1), pp. 17 - 23.