Effective communication network structures for hospital infection prevention

A study protocol

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Many hospitals are unable to successfully implement "evidence-based practices" at the unit level. For example, consistent implementation of the central line bundle (CLB), proven to prevent catheter-related bloodstream infections (CRBSIs) is often difficult. This problem has been broadly characterized as "change implementation failure" in health care organizations. Several studies have used retrospective designs to examine the problem; however, there are few prospective studies examining communication dynamics underlying successful implementation of change (eg, evidence-based practices). This prospective study will be set in 2 intensive care units at an academic medical center. At baseline, both units have low compliance with CLB and higher-than-expected CRBSIs. Periodic quality improvement (QI) interventions will be conducted over a 52-week period to promote implementation of CLB in both units. Simultaneously, the following parameters will be examined: (1) Structure and content of communication related to CLB in both units through "communication logs" completed weekly by nurses, physicians, and managers; and (2) outcomes, that is, CLB adherence in both units through weekly chart review. Catheter utilization and CRBSI (infection) rates will serve as additional unit-level outcome measures. The aim is 2-fold: (1) to examine associations between QI interventions and structure and content of communication at the unit level; and (2) to examine associations between structure and content of communication and outcomes at the unit level. The periodic QI interventions are expected to increase CLB adherence and reduce CRBSIs through their influence on structure and content of communication. The prospective design would help examine dynamics in unit-level communication structure and content related to CLB, as well as unit-level outcomes. The study has potential to make significant contributions to theory and practice, particularly if interventions are found to be effective in enabling successful practice change at the unit level. To this effect, the study has potential to provide insights into communication structure and content associated with collective learning and culture change at the unit level. Results and insights are expected to lay a foundation for generating context-sensitive "evidence-based management" strategies for successful practice change at the unit level. An ultimate expected deliverable is the development of an "action-learning framework" for successful implementation of evidence-based practices in health care organizations.

Original languageEnglish (US)
Pages (from-to)16-24
Number of pages9
JournalQuality management in health care
Volume22
Issue number1
DOIs
StatePublished - Jan 1 2013

Fingerprint

Cross Infection
Communication
Catheter-Related Infections
communication
Evidence-Based Practice
Quality Improvement
evidence
Learning
Prospective Studies
health care
Delivery of Health Care
learning
Intensive Care Units
nurse
Catheters
utilization
Nurses
physician
Outcome Assessment (Health Care)
manager

Keywords

  • Change implementation
  • Communication networks
  • Culture of safety
  • Evidence-based management
  • Evidence-based practices
  • infection prevention

ASJC Scopus subject areas

  • Leadership and Management
  • Health(social science)
  • Health Policy
  • Care Planning

Cite this

Effective communication network structures for hospital infection prevention : A study protocol. / Rangachari, Pavani.

In: Quality management in health care, Vol. 22, No. 1, 01.01.2013, p. 16-24.

Research output: Contribution to journalArticle

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