Sustainability of evidence-based practices in the management of infants with bronchiolitis in hospital settings - a PREDICT study protocol
Journal article
Ramsden, Victoria, Babl, Franz E., Dalziel, Stuart R., Middleton, Sandra Jane, Oakley, Ed, Haskell, Libby, Lithgow, Anna, Orsini, Francesca, Schembri, Rachel, Wallace, Alexandra, Wilson, Catherine L., McInnes, Elizabeth Catherine, Wilson, Peter Henry and Tavender, Emma. (2022). Sustainability of evidence-based practices in the management of infants with bronchiolitis in hospital settings - a PREDICT study protocol. BMC Health Services Research. 22(1), pp. 1099-1109. https://doi.org/10.1186/s12913-022-08450-z
Authors | Ramsden, Victoria, Babl, Franz E., Dalziel, Stuart R., Middleton, Sandra Jane, Oakley, Ed, Haskell, Libby, Lithgow, Anna, Orsini, Francesca, Schembri, Rachel, Wallace, Alexandra, Wilson, Catherine L., McInnes, Elizabeth Catherine, Wilson, Peter Henry and Tavender, Emma |
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Abstract | Background: Understanding how and why de-implementation of low-value practices is sustained remains unclear. The Paediatric Research in Emergency Departments International CollaboraTive (PREDICT) Bronchiolitis Knowledge Translation (KT) Study was a cluster randomised controlled trial conducted in 26 Australian and New Zealand hospitals (May-November 2017). Results showed targeted, theory-informed interventions (clinical leads, stakeholder meetings, train-the-trainer workshop, targeted educational package, audit/feedback) were effective at reducing use of five low-value practices for bronchiolitis (salbutamol, glucocorticoids, antibiotics, adrenaline and chest x-ray) by 14.1% in acute care settings. The primary aim of this study is to determine the sustainability (continued receipt of benefits) of these outcomes at intervention hospitals two-years after the removal of study supports. Secondary aims are to determine sustainability at one-year after removal of study support at intervention hospitals; improvements one-and-two years at control hospitals; and explore factors that influence sustainability at intervention hospitals and contribute to improvements at control hospitals. Methods: A mixed-methods study design. The quantitative component is a retrospective medical record audit of bronchiolitis management within 24 hours of emergency department (ED) presentations at 26 Australian (n = 20) and New Zealand (n = 6) hospitals, which participated in the PREDICT Bronchiolitis KT Study. Data for a total of 1800 infants from intervention and control sites (up to 150 per site) will be collected to determine if improvements (i.e., no use of all five low-value practices) were sustained two- years (2019) post-trial (primary outcome; composite score); and a further 1800 infants from intervention and control sites will be collected to determine sustained improvements one- year (2018) post-trial (secondary outcome). An a priori definition of sustainability will be used. The qualitative component will consist of semi-structured interviews with three to five key emergency department and paediatric inpatient medical and nursing staff per site (total n = 78-130). Factors that may have contributed to sustaining outcomes and/or interventions will be explored and mapped to an established sustainability framework. Discussion: This study will improve our understanding of the sustainability of evidence-based bronchiolitis management in infants. Results will also advance implementation science research by informing future de-implementation strategies to reduce low-value practices and sustain practice change in paediatric acute care. Trial registration: Australian and New Zealand Clinical Trials Registry No: ACTRN12621001287820. |
Keywords | Sustainability; Sustainment; implementation science; evidence-based practice; Bronchiolitis; Acute care; Paediatric; Emergency medicine |
Year | 01 Jan 2022 |
Journal | BMC Health Services Research |
Journal citation | 22 (1), pp. 1099-1109 |
Publisher | NLM (Medline) |
ISSN | 1472-6963 |
Digital Object Identifier (DOI) | https://doi.org/10.1186/s12913-022-08450-z |
Web address (URL) | https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-022-08450-z |
Open access | Published as ‘gold’ (paid) open access |
Research or scholarly | Research |
Page range | 1099-1109 |
Publisher's version | License File Access Level Open |
Output status | Published |
Publication dates | |
Online | 29 Aug 2022 |
Publication process dates | |
Accepted | 12 Aug 2022 |
Deposited | 24 Feb 2025 |
Additional information | © The Author(s) 2022. |
This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. 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 in a credit line to the data. | |
Australian and New Zealand Clinical Trials Registry No: ACTRN12621001287820. | |
Place of publication | United Kingdom |
https://acuresearchbank.acu.edu.au/item/915v8/sustainability-of-evidence-based-practices-in-the-management-of-infants-with-bronchiolitis-in-hospital-settings-a-predict-study-protocol
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OA_Middleton_2022_Sustainability_of_evidence-based_practices_in.pdf | |
License: CC BY 4.0 | |
File access level: Open |
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