John McAteer1, Sheldon Stone2, Christopher Fuller3, Susan Michie4. 1. Scottish Collaboration for Public Health Research and Policy, Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK; Department of Psychology, University College London, London, UK. Electronic address: john.mcateer@ed.ac.uk. 2. Royal Free Campus, University College London Medical School, London, UK. 3. Centre for Infectious Disease Epidemiology, University College London, London, UK. 4. Department of Psychology, University College London, London, UK.
Abstract
BACKGROUND: The Feedback Intervention Trial was a national trial of an intervention to increase hand hygiene behavior in English and Welsh hospitals. It significantly improved behavior, the effect increasing with fidelity to intervention, but the intervention proved more difficult to implement than anticipated. This study aimed to identify the barriers to and facilitators of implementation as experienced by those who delivered the intervention. METHODS: Semistructured interviews were conducted with 17 intervention ward coordinators implementing the intervention. Interview questions were based on the Theoretical Domains Framework. Text relating to each domain was scored according to whether it indicated low or high likelihood of implementation, and thematic analysis conducted. RESULTS: The lowest scoring domains were "environmental context and resources," "beliefs about capabilities," "social influences," and "emotion." Lack of time and understaffing, perceived negativity from other staff members, and stress were identified as challenges to implementation. The highest scoring domains were "behavioral regulation," "motivation," "skills," "knowledge," and "professional role." Ward coordinators reported that they had the skills, understanding, and motivation to implement the intervention and spoke of consistency of tasks with existing roles. CONCLUSION: Implementation might be improved by giving designated time for intervention tasks and ensuring that the ward coordinator role is allocated to staff for whom tasks are commensurate with existing professional roles.
BACKGROUND: The Feedback Intervention Trial was a national trial of an intervention to increase hand hygiene behavior in English and Welsh hospitals. It significantly improved behavior, the effect increasing with fidelity to intervention, but the intervention proved more difficult to implement than anticipated. This study aimed to identify the barriers to and facilitators of implementation as experienced by those who delivered the intervention. METHODS: Semistructured interviews were conducted with 17 intervention ward coordinators implementing the intervention. Interview questions were based on the Theoretical Domains Framework. Text relating to each domain was scored according to whether it indicated low or high likelihood of implementation, and thematic analysis conducted. RESULTS: The lowest scoring domains were "environmental context and resources," "beliefs about capabilities," "social influences," and "emotion." Lack of time and understaffing, perceived negativity from other staff members, and stress were identified as challenges to implementation. The highest scoring domains were "behavioral regulation," "motivation," "skills," "knowledge," and "professional role." Ward coordinators reported that they had the skills, understanding, and motivation to implement the intervention and spoke of consistency of tasks with existing roles. CONCLUSION: Implementation might be improved by giving designated time for intervention tasks and ensuring that the ward coordinator role is allocated to staff for whom tasks are commensurate with existing professional roles.
Authors: Simon D French; Sally E Green; Jill J Francis; Rachelle Buchbinder; Denise A O'Connor; Jeremy M Grimshaw; Susan Michie Journal: BMJ Open Date: 2015-07-08 Impact factor: 2.692
Authors: Ted A Skolarus; Sarah T Hawley; Daniela A Wittmann; Jane Forman; Tabitha Metreger; Jordan B Sparks; Kevin Zhu; Megan E V Caram; Brent K Hollenbeck; Danil V Makarov; John T Leppert; Jeremy B Shelton; Vahakn Shahinian; Sriram Srinivasaraghavan; Anne E Sales Journal: Implement Sci Date: 2018-11-29 Impact factor: 7.327
Authors: Daniel J Livorsi; Cassie Cunningham Goedken; Michael Sauder; Mark W Vander Weg; Eli N Perencevich; Heather Schacht Reisinger Journal: JAMA Netw Open Date: 2018-10-05