Effect of a Standard vs Enhanced Implementation Strategy to Improve Antibiotic Prescribing in Nursing Homes
Author(s) -
James H. Ford,
Lillian Vranas,
DaRae Coughlin,
Kathi M. Selle,
Susan Nordman-Oliveira,
Brenda Ryther,
Tola Ewers,
Victoria L. Griffin,
Anna Eslinger,
Joe Boero,
Paula Hardgrove,
Christopher J. Crnich
Publication year - 2019
Publication title -
jama network open
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.278
H-Index - 39
ISSN - 2574-3805
DOI - 10.1001/jamanetworkopen.2019.9526
Subject(s) - psychological intervention , medicine , quality management , coaching , randomized controlled trial , nursing , cluster randomised controlled trial , operations management , management system , psychology , economics , psychotherapist
Key Points Question Does external facilitation improve adoption and effects of a complex antibiotic stewardship intervention in nursing homes? Findings This trial protocol describes a cluster-randomized hybrid type 2 effectiveness-implementation clinical trial of implementation of a multicomponent toolkit focused on improving the recognition and management of suspected urinary tract infection (UTI) in nursing homes. The trial seeks to evaluate whether delivery of external facilitation—coaching, collaborative learning, and peer comparison feedback—to implement this toolkit results in higher rates of toolkit adoption and reduced rates of urine testing and initiation of antibiotics for treatment of suspected UTI. Meaning If successful, external facilitation could become an effective approach for improving spread and adoption of antibiotic stewardship interventions, as well as other quality improvement initiatives, in the nursing home setting.
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