Implementation strategy fidelity evaluation for a multidisciplinary Chest Injury Protocol (ChIP)
Abstract Background Blunt chest wall injuries can lead to complications, especially without early intervention. A blunt Chest Injury Protocol (ChIP) was developed to help improve the consistency of evidence-based care following admission to the emergency department. Implementation strategy fidelity...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2021-08-01
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| Series: | Implementation Science Communications |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s43058-021-00189-8 |
| _version_ | 1819138195594412032 |
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| author | Sarah Kourouche Kate Curtis Belinda Munroe Michael Watts Sharyn Balzer Thomas Buckley |
| author_facet | Sarah Kourouche Kate Curtis Belinda Munroe Michael Watts Sharyn Balzer Thomas Buckley |
| author_sort | Sarah Kourouche |
| collection | DOAJ |
| description | Abstract Background Blunt chest wall injuries can lead to complications, especially without early intervention. A blunt Chest Injury Protocol (ChIP) was developed to help improve the consistency of evidence-based care following admission to the emergency department. Implementation strategy fidelity is the extent to which the strategies of implementation are delivered in line with the intended plan. The aim of this study was to assess fidelity to the strategies of the implementation plan developed for ChIP. Methods A retrospective evaluation of strategies used for implementation was performed, specifically the behaviour change techniques (BCTs). BCTs were used as part of an implementation plan derived based on the Behaviour Change Wheel from results from a staff survey at two hospitals. Levels of implementation or adaptation for BCTs were scored by implementers as follows: ‘Were the behaviour change interventions implemented?’ (0 = ‘not implemented’, 1 = partially implemented, and 2 = fully implemented); ‘Were adaptations made to the implementation plan?’, scored 1 (many changes from plan) to 4 (just as planned). Free text explanation to their responses was also collected with supporting evidence and documentation (such as emails, implementation checklists, audit reports, and incident reports). Results There was high overall fidelity of 97.6% for BCTs partially or fully implemented. More than three quarters (32/42, 76.2%) of the BCTs were fully implemented with an additional 9/42 (21.4%) partially implemented. BCTs that were not fully implemented were social support, feedback on behaviour, feedback on outcomes of behaviour, adding objects to the environment, and restructuring the environment. The modes of delivery with poorer implementation or increased adaptations were clinical champions and audit/feedback. Conclusions This study describes the evaluation of implementation strategy fidelity in the acute care context. The systematic use and application of the behaviour change wheel was used to develop an implementation plan and was associated with high implementation strategy fidelity. A fidelity checklist developed during the implementation process may help implementers assess fidelity. Trial registration Trial registered on ANZCTR. Registration number ACTRN12618001548224 , date approved 17/09/2018 |
| first_indexed | 2024-12-22T11:02:55Z |
| format | Article |
| id | doaj.art-520bef1c6b744da8953f0fab732582ed |
| institution | Directory Open Access Journal |
| issn | 2662-2211 |
| language | English |
| last_indexed | 2024-12-22T11:02:55Z |
| publishDate | 2021-08-01 |
| publisher | BMC |
| record_format | Article |
| series | Implementation Science Communications |
| spelling | doaj.art-520bef1c6b744da8953f0fab732582ed2022-12-21T18:28:25ZengBMCImplementation Science Communications2662-22112021-08-012111510.1186/s43058-021-00189-8Implementation strategy fidelity evaluation for a multidisciplinary Chest Injury Protocol (ChIP)Sarah Kourouche0Kate Curtis1Belinda Munroe2Michael Watts3Sharyn Balzer4Thomas Buckley5Faculty of Medicine and Health, Sydney Nursing School, The University of Sydney Susan Wakil School of Nursing and MidwiferyFaculty of Medicine and Health, Sydney Nursing School, The University of Sydney Susan Wakil School of Nursing and MidwiferyFaculty of Medicine and Health, Sydney Nursing School, The University of Sydney Susan Wakil School of Nursing and MidwiferyIntensive Care, Illawarra Shoalhaven Local Health District, Wollongong HospitalEmergency Services, Shoalhaven Memorial District HospitalFaculty of Medicine and Health, Sydney Nursing School, The University of Sydney Susan Wakil School of Nursing and MidwiferyAbstract Background Blunt chest wall injuries can lead to complications, especially without early intervention. A blunt Chest Injury Protocol (ChIP) was developed to help improve the consistency of evidence-based care following admission to the emergency department. Implementation strategy fidelity is the extent to which the strategies of implementation are delivered in line with the intended plan. The aim of this study was to assess fidelity to the strategies of the implementation plan developed for ChIP. Methods A retrospective evaluation of strategies used for implementation was performed, specifically the behaviour change techniques (BCTs). BCTs were used as part of an implementation plan derived based on the Behaviour Change Wheel from results from a staff survey at two hospitals. Levels of implementation or adaptation for BCTs were scored by implementers as follows: ‘Were the behaviour change interventions implemented?’ (0 = ‘not implemented’, 1 = partially implemented, and 2 = fully implemented); ‘Were adaptations made to the implementation plan?’, scored 1 (many changes from plan) to 4 (just as planned). Free text explanation to their responses was also collected with supporting evidence and documentation (such as emails, implementation checklists, audit reports, and incident reports). Results There was high overall fidelity of 97.6% for BCTs partially or fully implemented. More than three quarters (32/42, 76.2%) of the BCTs were fully implemented with an additional 9/42 (21.4%) partially implemented. BCTs that were not fully implemented were social support, feedback on behaviour, feedback on outcomes of behaviour, adding objects to the environment, and restructuring the environment. The modes of delivery with poorer implementation or increased adaptations were clinical champions and audit/feedback. Conclusions This study describes the evaluation of implementation strategy fidelity in the acute care context. The systematic use and application of the behaviour change wheel was used to develop an implementation plan and was associated with high implementation strategy fidelity. A fidelity checklist developed during the implementation process may help implementers assess fidelity. Trial registration Trial registered on ANZCTR. Registration number ACTRN12618001548224 , date approved 17/09/2018https://doi.org/10.1186/s43058-021-00189-8Implementation strategyIntervention fidelityProcess evaluationBehaviour changeEmergencynursing |
| spellingShingle | Sarah Kourouche Kate Curtis Belinda Munroe Michael Watts Sharyn Balzer Thomas Buckley Implementation strategy fidelity evaluation for a multidisciplinary Chest Injury Protocol (ChIP) Implementation Science Communications Implementation strategy Intervention fidelity Process evaluation Behaviour change Emergency nursing |
| title | Implementation strategy fidelity evaluation for a multidisciplinary Chest Injury Protocol (ChIP) |
| title_full | Implementation strategy fidelity evaluation for a multidisciplinary Chest Injury Protocol (ChIP) |
| title_fullStr | Implementation strategy fidelity evaluation for a multidisciplinary Chest Injury Protocol (ChIP) |
| title_full_unstemmed | Implementation strategy fidelity evaluation for a multidisciplinary Chest Injury Protocol (ChIP) |
| title_short | Implementation strategy fidelity evaluation for a multidisciplinary Chest Injury Protocol (ChIP) |
| title_sort | implementation strategy fidelity evaluation for a multidisciplinary chest injury protocol chip |
| topic | Implementation strategy Intervention fidelity Process evaluation Behaviour change Emergency nursing |
| url | https://doi.org/10.1186/s43058-021-00189-8 |
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