NCT03941509

Nurse-led Antimicrobial Stewardship Intervention to Increase Antibiotic Appropriateness in Residential Aged Care Facilities

Stepped-wedge Cluster Randomised Controlled Trial to Increase Antibiotic Appropriateness in Residential Aged Care Facilities: a Nurse-led Bundled Antimicrobial Stewardship Intervention.

• Status: Unknown
• Phase: N/A
• Study type: Interventional
• Enrollment: 700 (estimated)
• Sponsor: Bayside Health · Other Government
• Sex: All
• Age: —
• Healthy volunteers: Not accepted

Summary

The study will explore the impact of a nurse-led bundled antimicrobial stewardship intervention on the appropriateness of antimicrobial use in residential aged care facilities. The intervention will be assessed in a stepped-wedge cluster randomised controlled trial across 14 residential aged care facilities over an 18-month period.

Detailed description

The study will explore the impact of a nurse-led bundled antimicrobial stewardship intervention on the appropriateness of antimicrobial use in residential aged care facilities (RACFs). The antimicrobial stewardship intervention will include the following components: 1. Education * Focused on antimicrobial stewardship and appropriate antimicrobial use * Delivered face-to-face, via workbooks and fact sheets to aged care staff, general practitioners (GPs), pharmacists, and residents and families. Education will be delivered by the research coordinator. 2. Guidelines * Aged care-specific guidelines for the assessment and antimicrobial management of urinary tract infections, respiratory tract infections and skin and soft tissue infections. * Antimicrobial management recommendations including empirical oral therapy, doses and duration of therapy. 3. Communication * Documentation for the assessment and antimicrobial management of infections. * Nurse-led engagement with residents and families. * Newsletters and online updates to highlight evidence-based prescribing practice 4. Audit and feedback - Surveillance and feedback to prescribers on antimicrobial use and facility-level antimicrobial susceptibility data. The intervention bundle will first be implemented and tested for feasibility and acceptability over a 3-month period in two RACFs in Victoria, Australia. This tailored intervention will then be assessed in a stepped-wedge cluster randomised controlled trial across 12 RACFs over an 16-month period. A cluster of two facilities will each transition through three phases over the 16 month trial: * Control phase: baseline data collection. Usual care at each facility. * Transition phase: Delivery of education and integration of the intervention. No data collection. * Intervention phase: implementation of the intervention and outcome data collection. Ongoing education to new and existing staff will be provided as required. Following the 16-month trial, the refined intervention bundle will be implemented nationally across a network of RACFs.

Conditions

• Antimicrobial Stewardship
• Urinary Tract Infections
• Respiratory Tract Infections
• Skin and Soft Tissue Infections

Interventions

Type	Name	Description
BEHAVIORAL	Antimicrobial stewardship	Education, guidelines, communication tools and audit and feedback

Timeline

• Start date: 2021-01-01
• Primary completion: 2022-04-01
• Completion: 2022-06-01
• First posted: 2019-05-08
• Last updated: 2022-01-13

Locations

1 site across 1 country: Australia