Sustaining improvements in the management of infants with bronchiolitis – a PREDICT study
Co-ordinating PI
Emma Tavender/Sandy Middleton/Stuart Dalziel/ Ed Oakley
Study Co-ordinator
Emma Tavender/Tory Ramsden (PhD student)
Aim/s:
The aim of this study is to:
- determine if the use of targeted interventions from the PREDICT Bronchiolitis KT Study have been effective at sustaining improvements in evidence-based practices in Australasian paediatric acute care settings one and two years after completion of the trial at intervention group hospitals (n=13);
- determine if there are any improvements in control group hospitals (n=13);
- understand the factors which influenced the sustainability of improvements in intervention group hospitals and;
- explore factors which may have contributed to improvements at control group hospitals.
Study design:
A mixed-methods study design: retrospective medical record audit (approximately 150 infants per site for the years 2018 and 2019) and qualitative semi-structured individual or group interviews (3-5 individuals per site).
Primary outcomes:
- Outcomes: medical record audit:
The proportion of infants presenting with bronchiolitis to intervention and control group hospitals, who received care that adhered with five inappropriate therapies (chest X-ray, salbutamol, glucocorticoids, antibiotics, and adrenaline) one year (2018) and two years (2019) following delivery of an intervention designed to promote evidence-based practice adherence (composite of all five practices). - Outcomes: Qualitative interviews:
Factors that contributed to sustainability of improvements of evidence-based practice adherence at intervention group hospitals four years post-implementation; Factors that contributed to improvements/deterioration of evidence-based practice adherence at control group hospitals four years post-implementation; Fidelity and adaptation to the PREDICT Bronchiolitis KT Study implementation strategy at intervention and control group hospitals four years following intervention delivery (2018, 2019, 2020, 2021) (Control group hospitals received the intervention materials post trial completion).
Current status:
- 16 Australian and 6 New Zealand sites recruited. All sites have completed governance and commenced the study. Medical Record Audit data collection has been completed at all 21 sites. Qualitative interviews are now completed at all 12 Australian and New Zealand intervention hospitals.
- Conducting preliminary data analysis.
Publication:
Ramsden, V., Babl, F.E., Dalziel, S.R. et al. Sustainability of evidence-based practices in the management of infants with bronchiolitis in hospital settings – a PREDICT study protocol. BMC Health Serv Res 22, 1099 (2022). https://doi.org/10.1186/s12913-022-08450-z.