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

Nessun intervento: Pre-Intervention Arm

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

Sperimentale: Post-Intervention Arm

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

Comportamentale: Professional Behavior Change Intervention

IV to PO antimicrobial conversion guidelines for nurses, nurse in-services and internet education sessions, IV to PO antimicrobial conversion health record reminder, endorsement from antimicrobial stewardship program, prescribers, and nurse educators.

Altri nomi:

• Promemoria
• Printed educational materials
• Educational meetings
• Educational outreach visits
• Local opinion leaders

IV to PO antimicrobial conversion rate

Incidence of IV to PO antimicrobial conversion (defined as the initiation of a PO antimicrobial within 24 hours of discontinuation of an IV antimicrobial during a single treatment course in a specific patient) before and after behavior change intervention

Days of IV therapy prior to conversion to PO antimicrobial

For treatment courses that undergo IV to PO antimicrobial conversion, the days of IV antimicrobial therapy prior to PO conversion before and after intervention

Nurse perceptions of capability, opportunity and motivation to promote IV to PO antimicrobial conversion

Constructs are derived using the Theoretical Domains Framework and assess nurse perceived capability, motivation, and opportunity to promote IV to PO antimicrobial conversion using a 7-point Likert scale (1 - Strongly Disagree, 2 - Disagree, 3- Slightly Disagree, 4 - Neither Agree or Disagree, 5 - Slightly Agree, 6 - Agree, 7- Strongly Agree). The average Likert scale score for each of nine constructs (based on the Theoretical Domains Framework) will be calculated for the pre-intervention period and the post-intervention period. Change in the average Likert score for each construct (question) in the pre-intervention period versus the post-intervention period will be compared for each construct. A higher average Likert score on a construct in the post-intervention period compared to the pre-intervention period indicates improved perceptions about capability, opportunity, or motivation to promote IV to PO antimicrobial conversion.

Balancing measure - Failed IV to PO antimicrobial conversion

Incidence of failed IV to PO antimicrobial conversion (defined as the re-initiation of an IV antimicrobial within seven days following IV to PO conversion of an antimicrobial during a single treatment course for a specific patient) pre and post-intervention

Subgroup Analysis 1: Nursing Unit Conversion Comparison

Incidence of IV to PO antimicrobial conversion on nursing unit 1 (contains a clinical pharmacist) versus nursing unit 2 (does not contain a clinical pharmacist) pre and post-intervention

Subgroup Analysis 2: High Bioavailability Antimicrobial Conversion

Incidence of IV to PO antimicrobial conversion for highly bioavailable (F ≥ 80%) antimicrobials pre and post-intervention

Subgroup Analysis 2: Non-High Bioavailability Antimicrobial Conversion

Incidence of IV to PO antimicrobial conversion for non-highly bioavailable (F < 80%) antimicrobials pre and post-intervention