Implementation science in low-resource settings: using the interactive systems framework to improve hand hygiene in a tertiary hospital in Ghana.
Quality Issue: Low-resource clinical settings often face obstacles that challenge the implementation of recommended evidence-based practices (EBPs). Implementation science approaches are useful in identifying barriers and developing strategies to address them.Initial Assessment: Ridge Regional Hospi...
| Publicado en: | International Journal for Quality in Health Care Vol. 30; no. 9; pp. 724 - 731 |
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| Autores principales: | , , , , , , |
| Formato: | Journal Article |
| Publicado: |
Oxford University Press / USA
Nov2018
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=133953771&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 133953771 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 13534505 N5L jtl: International Journal for Quality in Health Care issn: 13534505 maglogo: N pubinfo: dt: Nov2018 vid: 30 iid: 9 pid: 622 pub: Oxford University Press / USA artinfo: ui: 133953771 133953771 NLM29788245 10.1093/intqhc/mzy111 NLM29788245 133953771 ppf: 724 ppct: 7 formats: tig: atl: Implementation science in low-resource settings: using the interactive systems framework to improve hand hygiene in a tertiary hospital in Ghana. aug: au: Kallam, Brianne Pettitt-Schieber, Christie Owen, Medge Asante, Rebecca Agyare Darko, Elizabeth Ramaswamy, Rohit Agyare Asante, Rebecca affil: Kybele, Inc., Lewisville, NC, USA sug: subj: Intensive Care Units, Neonatal Standards Handwashing Cross Infection Prevention and Control Ghana Guideline Adherence Hospitals, Special Health Personnel Psychosocial Factors Infant, Newborn Teaching Infection Control Methods Ferrans and Powers Quality of Life Index Scales Infant, Newborn: birth-1 month ab: Quality Issue: Low-resource clinical settings often face obstacles that challenge the implementation of recommended evidence-based practices (EBPs). Implementation science approaches are useful in identifying barriers and developing strategies to address them.Initial Assessment: Ridge Regional Hospital (RRH), a tertiary referral hospital in Accra, Ghana experienced a spike in rates of neonatal sepsis and launched a quality improvement (QI) initiative that identified poor adherence to hand hygiene in the neonatal intensive care unit as a potential source of infections.Choice Of Solution: A multi-modal change package of World Health Organization-recommended solutions was created to address this issue.Implementation: To ensure that the outputs of the QI effort were adopted within the organization, leaders at RRH and Kybele, Inc. used an implementation science framework called the 'Interactive Systems Framework for Dissemination and Implementation' (ISF) to create a package of locally acceptable implementation strategies. The ISF has never been used before to guide implementation in low-resource settings.Evaluation: Hand hygiene compliance rose from 67% to 92% overall, including a 36% increase during the night shifts-a group of healthcare workers with typically very low levels of compliance.Lessons Learned: The drastic improvement in adherence to hand hygiene suggests the potential value of the joint use of QI and implementation science to promote the creation and application of contextually appropriate EBPs in low-resource settings. Our results also suggest that using an implementation framework such as the ISF could rapidly increase the uptake of other evidence-based interventions in low-resource settings. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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