Bronchiolitis Sustainability
Sustaining improvements in the management of infants with bronchiolitis – a PREDICT study
The PREDICT ‘Knowledge Translation in Australasian Paediatric Acute Care’ (PREDICT KT study) (HREC/16/RC), a multicentred, cluster, randomised control trial of infants with Bronchiolitis demonstrated that use of targeted, theory-informed interventions (clinical leads, stakeholder meeting, train-the-trainer workshop, targeted educational package, audit/feedback) significantly improved compliance with five key non-evidence-based practice recommendations for bronchiolitis (chest x-ray, salbutamol, glucocorticoids, antibiotics, and adrenaline) in acute care settings by 14.1% (adjusted risk difference, 95% CI, 6.5%-21.7%; P < .001).
The aim of this study is to assess sustainability of improvements in reducing inappropriate therapies in infants with Bronchiolitis, at the 26 sites which participated in the PREDICT KT Study, one (2018) and two year (2019) post implementation of intervention. A retrospective medical audit and qualitative semi-structured interviews will be conducted at each site over two years following initial implementation of the KT Study interventions. Our results will help determine the sustainability of this intervention over time, determine any improvements in control group hospitals, examine the learning and decay effects of the intervention, determine fidelity and adaptation of the intervention and explore factors which may have contributed to sustained improvements in either intervention or control group sites.
Study design
Mixed Methods – Quantitative Retrospective Medical Record Audit and Qualitative Semi-structured interviews.
A/Prof Emma Tavender
Professor Sandy Middleton
Timeframe
2022 – 2025
Funding
National Health and Medical Research Council Centre for Research Excellence Grant ID 1171228.
- Townsville Hospital, QLD (PI Julian Wong)
- The Prince Charles Hospital, QLD (PI Faye Jordan)
- Queensland Children’s Hospital, QLD (PI Natalie Philips)
- Women’s and Children’s Hospital, SA (PI Amit Kochar)
- Royal Darwin Hospital, NT (PI Kirsten Hrabar)
- The Children’s Hospital at Westmead, NSW (PI Shefali Jani)
- Ballarat Hospital, VIC (PI Bradley Dent)
- Cairns Hospital, QLD (PI Lambros Halkidis)
- Wollongong Hospital, NSW (PI Kate Curtis)
- Toowoomba Base Hospital, QLD (PI Alex King)
- Royal North Shore Hospital, NSW (PI Richard Lennon)
- Logan Hospital, QLD (PI Ben Lawton)
- The Northern Hospital, VIC (PI Mark Corden)
- Gold Coast University Hospital, QLD (PI Shane George)
- Sydney Children’s Hospital, NSW (PI Arjun Rao)
- Caboolture Hospital, QLD (PI Suzanne Kenny)
Sample
800 infants for 2018 and 1800 infants for 2019
Contact
Trial registration
ANZCTR (number: ACTRN12621001287820)
Publications to date
Ramsden V, Babl FE, Dalziel SR, Middleton S, Oakley E, Haskell L, Lithgow A, Orsini F, Schembri R, Wallace A, Wilson CL, McInnes E, Wilson PH, Tavender E. Sustainability of evidence-based practices in the management of infants with bronchiolitis in hospital settings – a PREDICT study protocol. BMC Health Serv Res. 2022 Aug 29;22(1):1099. doi: 10.1186/s12913-022-08450-z. PMID: 36038929; PMCID: PMC9423692. [Link]
Ramsden V, Middleton S, McInnes E, Babl FE, Tavender E. Review article: A primer for clinical researchers in the emergency department: Part XII. Sustainability of improvements in care: An introduction. Emerg Med Australas. 2022 Oct;34(5):670-674. doi: 10.1111/1742-6723.14052. Epub 2022 Aug 2. PMID: 35918063. [Link]