Researching effective approaches to cleaning in hospitals: Protocol of the REACH study, a multi-site stepped-wedge randomised trial

L. Hall, A. Farrington, B.G. Mitchell, A.G. Barnett, K. Halton, M. Allen, K. Page, A. Gardner, S. Havers, E. Bailey, S.J. Dancer, Thomas Riley, C.A. Gericke, D.L. Paterson, N. Graves

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    20 Citations (Scopus)

    Abstract

    © 2016 Hall et al. Background: The Researching Effective Approaches to Cleaning in Hospitals (REACH) study will generate evidence about the effectiveness and cost-effectiveness of a novel cleaning initiative that aims to improve the environmental cleanliness of hospitals. The initiative is an environmental cleaning bundle, with five interdependent, evidence-based components (training, technique, product, audit and communication) implemented with environmental services staff to enhance hospital cleaning practices. Methods/design: The REACH study will use a stepped-wedge randomised controlled design to test the study intervention, an environmental cleaning bundle, in 11 Australian hospitals. All trial hospitals will receive the intervention and act as their own control, with analysis undertaken of the change within each hospital based on data collected in the control and intervention periods. Each site will be randomised to one of the 11 intervention timings with staggered commencement dates in 2016 and an intervention period between 20 and 50 weeks. All sites complete the trial at the same time in 2017. The inclusion criteria allow for a purposive sample of both public and private hospitals that have higher-risk patient populations for healthcare-associated infections (HAIs). The primary outcome (objective one) is the monthly number of Staphylococcus aureus bacteraemias (SABs), Clostridium difficile infections (CDIs) and vancomycin resistant enterococci (VRE) infections, per 10,000 bed days. Secondary outcomes for objective one include the thoroughness of hospital cleaning assessed using fluorescent marker technology, the bio-burden of frequent touch surfaces post cleaning and changes in staff knowledge and attitudes about environmental cleaning. A cost-effectiveness analysis will determine the second key outcome (objective two): the incremental cost-effectiveness ratio from implementation of the cleaning bundle. The study uses the integrated Promoting Action on Research Implementation in Health Services (iPARIHS)
    Original languageEnglish
    Article number44
    Pages (from-to)1-10
    Number of pages10
    JournalImplementation Science
    Volume11
    DOIs
    Publication statusPublished - 24 Mar 2016

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    Hall, L., Farrington, A., Mitchell, B. G., Barnett, A. G., Halton, K., Allen, M., Page, K., Gardner, A., Havers, S., Bailey, E., Dancer, S. J., Riley, T., Gericke, C. A., Paterson, D. L., & Graves, N. (2016). Researching effective approaches to cleaning in hospitals: Protocol of the REACH study, a multi-site stepped-wedge randomised trial. Implementation Science, 11, 1-10. [44]. https://doi.org/10.1186/s13012-016-0406-6