Implementation evaluation of an evidence-based emergency nursing framework (HIRAID): study protocol for a step-wedge randomised control trial.

Curtis, K; Fry, M; Kourouche, S; Kennedy, B; Considine, J; Alkhouri, H; Lam, M; McPhail, SM; Aggar, C; Hughes, J; Murphy, M; Dinh, M; Shaban, R

Implementation evaluation of an evidence-based emergency nursing framework (HIRAID): study protocol for a step-wedge randomised control trial.

Curtis, K Fry, M

Kourouche, S Kennedy, B Considine, J Alkhouri, H Lam, M McPhail, SM Aggar, C Hughes, J Murphy, M Dinh, M Shaban, R

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Publisher:: BMJ PUBLISHING GROUP
Publication Type:: Journal Article
Citation:: BMJ Open, 2023, 13, (1), pp. e067022
Issue Date:: 2023-01-17

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Field	Value	Language
dc.contributor.author	Curtis, K
dc.contributor.author	Fry, M https://orcid.org/0000-0003-1265-7096
dc.contributor.author	Kourouche, S
dc.contributor.author	Kennedy, B
dc.contributor.author	Considine, J
dc.contributor.author	Alkhouri, H
dc.contributor.author	Lam, M
dc.contributor.author	McPhail, SM
dc.contributor.author	Aggar, C
dc.contributor.author	Hughes, J
dc.contributor.author	Murphy, M
dc.contributor.author	Dinh, M
dc.contributor.author	Shaban, R
dc.date.accessioned	2024-01-17T06:23:49Z
dc.date.available	2024-01-17T06:23:49Z
dc.date.issued	2023-01-17
dc.identifier.citation	BMJ Open, 2023, 13, (1), pp. e067022
dc.identifier.issn	2044-6055
dc.identifier.issn	2044-6055
dc.identifier.uri	http://hdl.handle.net/10453/174718
dc.description.abstract	INTRODUCTION: Poor patient assessment results in undetected clinical deterioration. Yet, there is no standardised assessment framework for >29 000 Australian emergency nurses. To reduce clinical variation and increase safety and quality of initial emergency nursing care, the evidence-based emergency nursing framework HIRAID (History, Identify Red flags, Assessment, Interventions, Diagnostics, communication and reassessment) was developed and piloted. This paper presents the rationale and protocol for a multicentre clinical trial of HIRAID. METHODS AND ANALYSIS: Using an effectiveness-implementation hybrid design, the study incorporates a stepped-wedge cluster randomised controlled trial of HIRAID at 31 emergency departments (EDs) in New South Wales, Victoria and Queensland. The primary outcomes are incidence of inpatient deterioration related to ED care, time to analgesia, patient satisfaction and medical satisfaction with nursing clinical handover (effectiveness). Strategies that optimise HIRAID uptake (implementation) and implementation fidelity will be determined to assess if HIRAID was implemented as intended at all sites. ETHICS AND DISSEMINATION: Ethics has been approved for NSW sites through Greater Western Human Research Ethics Committee (2020/ETH02164), and for Victoria and Queensland sites through Royal Brisbane & Woman's Hospital Human Research Ethics Committee (2021/QRBW/80026). The final phase of the study will integrate the findings in a toolkit for national rollout. A dissemination, communications (variety of platforms) and upscaling strategy will be designed and actioned with the organisations that influence state and national level health policy and emergency nurse education, including the Australian Commission for Quality and Safety in Health Care. Scaling up of findings could be achieved by embedding HIRAID into national transition to nursing programmes, 'business as usual' ED training schedules and university curricula. TRIAL REGISTRATION NUMBER: ACTRN12621001456842.
dc.format	Electronic
dc.language	eng
dc.publisher	BMJ PUBLISHING GROUP
dc.relation.ispartof	BMJ Open
dc.relation.isbasedon	10.1136/bmjopen-2022-067022
dc.rights	info:eu-repo/semantics/openAccess
dc.subject	1103 Clinical Sciences, 1117 Public Health and Health Services, 1199 Other Medical and Health Sciences
dc.subject.classification	32 Biomedical and clinical sciences
dc.subject.classification	42 Health sciences
dc.subject.classification	52 Psychology
dc.subject.mesh	Female
dc.subject.mesh	Humans
dc.subject.mesh	Australia
dc.subject.mesh	Emergency Nursing
dc.subject.mesh	New South Wales
dc.subject.mesh	Evidence-Based Nursing
dc.subject.mesh	Emergency Service, Hospital
dc.subject.mesh	Randomized Controlled Trials as Topic
dc.subject.mesh	Humans
dc.subject.mesh	Emergency Nursing
dc.subject.mesh	Emergency Service, Hospital
dc.subject.mesh	Australia
dc.subject.mesh	New South Wales
dc.subject.mesh	Female
dc.subject.mesh	Randomized Controlled Trials as Topic
dc.subject.mesh	Evidence-Based Nursing
dc.subject.mesh	Female
dc.subject.mesh	Humans
dc.subject.mesh	Australia
dc.subject.mesh	Emergency Nursing
dc.subject.mesh	New South Wales
dc.subject.mesh	Evidence-Based Nursing
dc.subject.mesh	Emergency Service, Hospital
dc.subject.mesh	Randomized Controlled Trials as Topic
dc.title	Implementation evaluation of an evidence-based emergency nursing framework (HIRAID): study protocol for a step-wedge randomised control trial.
dc.type	Journal Article
utslib.citation.volume	13
utslib.location.activity	England
utslib.for	1103 Clinical Sciences
utslib.for	1117 Public Health and Health Services
utslib.for	1199 Other Medical and Health Sciences
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Strength - CHSP - Health Services and Practice
utslib.copyright.status	open_access	*
dc.date.updated	2024-01-17T06:23:48Z
pubs.issue	1
pubs.publication-status	Published online
pubs.volume	13
utslib.citation.issue	1

Abstract:

INTRODUCTION: Poor patient assessment results in undetected clinical deterioration. Yet, there is no standardised assessment framework for >29 000 Australian emergency nurses. To reduce clinical variation and increase safety and quality of initial emergency nursing care, the evidence-based emergency nursing framework HIRAID (History, Identify Red flags, Assessment, Interventions, Diagnostics, communication and reassessment) was developed and piloted. This paper presents the rationale and protocol for a multicentre clinical trial of HIRAID. METHODS AND ANALYSIS: Using an effectiveness-implementation hybrid design, the study incorporates a stepped-wedge cluster randomised controlled trial of HIRAID at 31 emergency departments (EDs) in New South Wales, Victoria and Queensland. The primary outcomes are incidence of inpatient deterioration related to ED care, time to analgesia, patient satisfaction and medical satisfaction with nursing clinical handover (effectiveness). Strategies that optimise HIRAID uptake (implementation) and implementation fidelity will be determined to assess if HIRAID was implemented as intended at all sites. ETHICS AND DISSEMINATION: Ethics has been approved for NSW sites through Greater Western Human Research Ethics Committee (2020/ETH02164), and for Victoria and Queensland sites through Royal Brisbane & Woman's Hospital Human Research Ethics Committee (2021/QRBW/80026). The final phase of the study will integrate the findings in a toolkit for national rollout. A dissemination, communications (variety of platforms) and upscaling strategy will be designed and actioned with the organisations that influence state and national level health policy and emergency nurse education, including the Australian Commission for Quality and Safety in Health Care. Scaling up of findings could be achieved by embedding HIRAID into national transition to nursing programmes, 'business as usual' ED training schedules and university curricula. TRIAL REGISTRATION NUMBER: ACTRN12621001456842.

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http://hdl.handle.net/10453/174718