Nurse Promotion of IV to PO Antimicrobial Conversion (FERN-IPO)

Kelowna General Hospital

Status: Completed

Conditions: Behavior Change; Bacterial Infections

Treatments: Behavioral: Professional Behavior Change Intervention

Study type: Interventional

Funder types: Other

Identifiers

NCT03761043

IH1803202

Details and patient eligibility

About

This is a prospective, quasi-experimental, historically controlled study to evaluate if a behavioural change intervention informed by the COM-B model of behaviour change can improve nurses' self-perceived capability, opportunity, and motivation to engage in the assessment of patients who may be appropriate for IV to PO antimicrobial conversion. This study also seeks to determine if this translates into an increase in IV to PO antimicrobial conversion rates in the acute care setting.

Full description

Current antimicrobial stewardship guidelines recommend appropriate and timely IV to PO antimicrobial conversion in hospitalized patients. Published rates of IV to PO antimicrobial conversion are consistently below 50% in eligible inpatients. Studies have suggested that nurses may be well positioned to provide a positive influence on prescriber behavior related to antimicrobial IV to PO conversion, however, no published research has evaluated the impact of nurses on antimicrobial IV to PO conversion rates. Published research has described the barriers and enablers to nurse participation in promoting antimicrobial IV to PO conversion using the COM-B model of behaviour change. This quasi-experimental study will evaluate whether determinants of nurse behaviour and their actual behaviour can be changed to increase antimicrobial IV to PO conversion rates in hospitalized patients.

Enrollment: 853 patients

Sex: All

Ages: 19+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Nineteen years of age or older
• Employed as a RN or LPN at KGH in any capacity (full-time, part-time or casual employee)
• Practicing on a medicine/thoracic surgery ward (4A) or medicine/oncology/respiratory ward (4B)

Exclusion criteria

• RNs or LPNs on orientation shifts/training
• RNs or LPNs not engaged in patient care
• Student nurses/nurses in training

Trial design

Primary purpose: Health Services Research

Allocation: Non-Randomized

Interventional model: Crossover Assignment

Masking: None (Open label)

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853 participants in 2 patient groups

Pre-Intervention Arm

No Intervention group

Description:

The nurses will have not been exposed to the behavior change intervention.

Post-Intervention Arm

Experimental group

Description:

The nurses will have been exposed to the behavior change intervention.

Treatment:

Behavioral: Professional Behavior Change Intervention