Background: Acquisition of a healthcare associated infection ((HCAI) e.g. MRSA,Clostridiumdifficile) is one of the most frequent harmful events threatening patient safety globally, creating a major burden on individuals, their families, and the health services. In Ireland, a national median prevalence rate between 4.2-5.2% in long term and acute care facilities has been associated with additional bed days, increased costs andincreased mortality and morbidity.
In order to ensure patient treatment is evidence-based, safe, and of high quality, Ireland’s Ministerially appointed National Clinical Effectiveness Committee (NCEC) prioritised and quality assured two HCAI clinical guidelines that were then mandated by the Minister for Health for national implementation. However, guideline provision does not guarantee use in clinical practice and the uneven implementation of evidence-based guidelines is widely recognized as a continuing challenge to improving healthcare.
Aim: The aim of this research is to explore the implementation of NCEC HCAI National Clinical Guidelines in Irish healthcare organisations (hospitals, long stay care facilities and nursing homes). The secondary aim is to understand the complex organisational reality of using HCAI guidelines in clinical practice within six case study sites.
Methods: A mixed methods study with both qualitative and quantitative approaches will be conducted using ethnographic field work, non-participant observations, semi-structured interviews, documentary analysis, analysis of site specific HCAI prevalence data, and survey methods. This study has two arms:Arm I involves attaining a corporate perspective of the implementation of the guidelines (currently underway) whilst Arm II involves the attainment of perspectives of service users at the front-line of clinical practice in relation to the implementation of clinical guidelines. Arm II applies to the current HRB application.
Impact: It is anticipated that the results of this study will provide the evidence base for the planned update of the NCEC HCAI clinical guidelines.
